Products
Perampanel is commercially available in the form of film-coated tablets (Fycompa). It has been approved in many countries since late 2012. In 2020, an oral suspension was also registered.
Structure and properties
Perampanel (C23H15N3O, Mr = 349.4 g/mol) is a pyridine derivative. It exists in the drug as a white to yellowish powder that is practically insoluble in water.
Effects
Perampanel (ATC N03AX22) is antiepileptic and reduces seizure frequency. It is a selective and noncompetitive antagonist of the ionotropic AMPA glutamate receptor on postsynaptic neurons. The effects are due to antagonism of the excitatory neurotransmitter glutamate at the receptor. Glutamate is thought to play a central role in the development of epilepsy.
Indications
As adjunctive therapy of focal seizures with or without secondary generalization in epilepsy.
Dosage
According to the SmPC. The drug is taken as a single dose before bedtime and independently of meals.
Contraindications
- Hypersensitivity
For complete precautions, see the drug label.
Interactions
Perampanel is metabolized by CYP3A and corresponding drug-drug interactions are possible. Other interactions have been described with progestogen-containing contraceptives, some antiepileptic drugs, and alcohol.
Adverse effects
The most common potential adverse effects include dizziness and somnolence. Perampanel may cause neuropsychiatric disorders such as aggression, anger, anxiety, and confusion.
