Parenteral Manual

Brivaracetam

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Alternate Name(s): 
Brivlera
Classification: 
Anticonvulsant
Original Date: 
November 2020
Indications: 
  • Treatment of partial onset seizures
Reconstitution and Stability: 
  • Supplied as 10 mg/mL single use colourless, clear glass vials. Use immediately after opening and discard unused portion
  • Store vial at room temperature (15 - 30 degrees C)
  • May dilute to 0.1 - 1.5 mg/mL
  • Diluted solution is stable for 4 hours at room temperature and may be stored in polyvinyl chloride (PVC) or polyolefin bags

 

Compatibility: 

Solutions Compatible: 0.9% NaCl, D5W, Lactated Ringer's

 

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct

YES  

Over 2 - 10 minutes. Undiluted or diluted

Usual dilution: 0.1 - 1.5 mg/mL
IV Intermittent Infusion

YES.

Over 10 - 15 min. Undiluted or diluted

Usual dilution: 0.1 - 1.5 mg/mL

  
IV Continuous Infusion NO

 

Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric:

Adolescents > 16 years:

  • Initial: 50 mg twice daily; range 25 - 100 mg twice daily based on individual patient response and tolerability; max daily dose: 200 mg/day

Adult:

  • See adolescent dosing

Dosing in renal/hepatic impairment:

  • Use is not recommended in end stage renal disease
  • Dose should be reduced in patients with mild to severe hepatic impairment - refer to available references or clinical pharmacist for dose adjustment
Potential hazards of parenteral administration: 
  • CNS: euphoria, infusion site pain, intoxicated feeling, sedation, dizziness, drowsiness, psychiatric disturbance, fatigue, hypersomnia, lethargy, malaise, abnormal gait, ataxia, equilibrium disturbance, vertigo
  • GI: dysgeusia
  • Hematologic: decreased WBC
Notes: 
  • Use injection when oral route is temporarily not feasible; clinical study experience with brivaracetam injection is limited to 4 consecutive days of treatment
  • IV:PO conversion is 1:1
  • Do not abruptly discontinue therapy. Withdraw gradually to reduce potential for increased seizure frequency
  • Monitor: CBC with differential, liver and renal function, and symptoms of depression and suicidality (baseline and as clinically indicated) 

 

References: 
  • Pediatric and Neonatal Lexi-Drugs (Brivaracetam)
  • Brivlera Product Monograph (UCB Canada Inc.)

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