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Fycompa
perampanel
Black Box Warnings .
Severe Psychiatric and Behavioral Rxns
serious or life-threatening rxns, incl. aggression, hostility, irritability, anger, homicidal ideation and threats reported; seen in pts w/ and w/o psychiatric hx, prior aggressive behavior, or concomitant meds assoc. w/ hostility and aggression; closely monitor pts during titration and at higher doses; advise pts and caregivers to promptly report any changes in mood, behavior, or personality; decr. dose if sx occur or immediately D/C tx if severe or worsening sx occur
Adult Dosing .
Dosage forms: TAB: 2 mg, 4 mg, 6 mg, 8 mg, 10 mg, 12 mg; SUSP: 0.5 mg per mL
partial seizures
- [monotherapy]
- Dose: 8-12 mg PO qhs; Start: 2 mg PO qhs, then incr. by 2 mg/day no more frequently than qwk; Max: 12 mg/day; Info: in elderly pts, incr. dose no more frequently than q2wk; taper dose gradually to D/C
- [enzyme-inducing AED adjunct]
- Dose: 8-12 mg PO qhs; Start: 4 mg PO qhs, then incr. by 2 mg/day no more frequently than qwk; Max: 12 mg/day; Info: in elderly pts, incr. dose no more frequently than q2wk; enzyme-inducing AEDs incl. carbamazepine, phenytoin, phenobarbital, primidone; taper dose gradually to D/C
- [non-inducing AED adjunct]
- Dose: 8-12 mg PO qhs; Start: 2 mg PO qhs, then incr. by 2 mg/day no more frequently than qwk; Max: 12 mg/day; Info: in elderly pts, incr. dose no more frequently than q2wk; taper dose gradually to D/C
seizures, primary generalized tonic clonic
- [enzyme-inducing AED adjunct]
- Dose: 8-12 mg PO qhs; Start: 4 mg PO qhs, then incr. by 2 mg/day no more frequently than qwk; Max: 12 mg/day; Info: in elderly pts, incr. dose no more frequently than q2wk; enzyme-inducing AEDs incl. carbamazepine, phenytoin, phenobarbital, primidone; taper dose gradually to D/C
- [non-inducing AED adjunct]
- Dose: 8-12 mg PO qhs; Start: 2 mg PO qhs, then incr. by 2 mg/day no more frequently than qwk; Max: 12 mg/day; Info: in elderly pts, incr. dose no more frequently than q2wk; taper dose gradually to D/C
renal dosing
- [see below]
- moderate impairment: caution advised, consider titrating slowly; severe impairment: avoid use
- HD/PD: not defined
hepatic dosing
- [see below]
- Child-Pugh Class A: start 2 mg qhs, then incr. by 2 mg/day no more frequently than q2wk, max 6 mg/day; Child-Pugh Class B: start 2 mg qhs, then incr. by 2 mg/day no more frequently than q2wk, max 4 mg/day; Child-Pugh Class C: avoid use
Peds Dosing .
- Dosage forms: TAB: 2 mg, 4 mg, 6 mg, 8 mg, 10 mg, 12 mg; SUSP: 0.5 mg per mL
partial seizures
- [monotherapy, 4 yo and older]
- Dose: 8-12 mg PO qhs; Start: 2 mg PO qhs, then incr. by 2 mg/day no more frequently than qwk; Max: 12 mg/day; Info: taper dose gradually to D/C
- [enzyme-inducing AED adjunct, 4 yo and older]
- Dose: 8-12 mg PO qhs; Start: 4 mg PO qhs, then incr. by 2 mg/day no more frequently than qwk; Max: 12 mg/day; Info: enzyme-inducing AEDs incl. carbamazepine, phenytoin, phenobarbital, primidone; taper dose gradually to D/C
- [non-inducing AED adjunct, 4 yo and older]
- Dose: 8-12 mg PO qhs; Start: 2 mg PO qhs, then incr. by 2 mg/day no more frequently than qwk; Max: 12 mg/day; Info: taper dose gradually to D/C
seizures, primary generalized tonic clonic
- [enzyme-inducing AED adjunct, 12 yo and older]
- Dose: 8-12 mg PO qhs; Start: 4 mg PO qhs, then incr. by 2 mg/day no more frequently than qwk; Max: 12 mg/day; Info: enzyme-inducing AEDs incl. carbamazepine, phenytoin, phenobarbital, primidone; taper dose gradually to D/C
- [non-inducing AED adjunct, 12 yo and older]
- Dose: 8-12 mg PO qhs; Start: 2 mg PO qhs, then incr. by 2 mg/day no more frequently than qwk; Max: 12 mg/day; Info: taper dose gradually to D/C
renal dosing
- [see below]
- moderate impairment: caution advised, consider titrating slowly; severe impairment: avoid use
- HD/PD: not defined
hepatic dosing
- [see below]
- Child-Pugh Class A: start 2 mg qhs, then incr. by 2 mg/day no more frequently than q2wk, max 6 mg/day; Child-Pugh Class B: start 2 mg qhs, then incr. by 2 mg/day no more frequently than q2wk, max 4 mg/day; Child-Pugh Class C: avoid use