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Precautions and Warnings With Perampanel

Even though perampanel can be an effective anti-seizure medication, it may increase the risk for suicidal thoughts or other potentially serious complications. This medicine may not be safe for people who have problems with their liver or kidneys, or for those who have certain other medical conditions. Precautions and warnings with perampanel also apply to people who have certain allergies or who are taking certain medications.


What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking perampanel (Fycompa™) if you have:
  • Liver disease, such as hepatitis, cirrhosis, or liver failure
  • Kidney disease, such as kidney failure (renal failure)
  • Thoughts of suicide or of harming yourself
  • Depression, bipolar disorder, or any other mental health condition or mood problem
  • A history of aggressive or hostile behavior
  • Ever abused or been addicted to alcohol, prescription drugs, or street drugs
  • Any allergies, including to foods, dyes, or preservatives.
In addition, let your healthcare provider know if you:
  • Drink alcohol
  • Are pregnant or thinking of becoming pregnant
  • Are breastfeeding.
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Perampanel Precautions and Warnings

Some warnings and precautions to be aware of prior to taking this medication include the following:
  • Perampanel has been reported to cause aggressive and hostile behavior, changes in mood, and other unusual mental health problems. These effects appear to be more likely at higher doses and within the first six weeks of treatment, but can occur at any time and at any dosage.

    You and your family should carefully monitor your mood and behavior during treatment and for at least one month after you take your last dose. Let your healthcare provider know immediately if you experience any unusual changes in your thoughts, mood, or behaviors, such as:
    • Aggressive or hostile thoughts or behaviors
    • Irritability
    • Anger
    • Anxiety
    • Very high or very low moods
    • Thoughts about harming yourself or others
    • Attempts at harming yourself or others
    • Feeling disoriented or confused
    • Thinking others are out to get you or feeling distrustful
    • Believing things that are not real.
  • Drinking alcohol during perampanel treatment can increase your risk for developing mood changes and hostile behavior. It can also add to the drowsiness you may feel from the drug, which would impair your thinking, judgment, and motor skills. Do not drink alcohol during treatment.
  • All anti-seizure medicines (anti-epileptic medicines), including perampanel, may increase the risk for suicidal thoughts and behavior, regardless of the reason they are being used. Let your healthcare provider know right away if you experience any unusual changes in your mood or behavior, new or worsening depression, or have thoughts of suicide or harming yourself while taking this medicine (see Seizure Medications and Suicide).
  • Do not stop taking this medication suddenly, as doing so could increase your risk for seizures. If you will no longer be taking perampanel, your healthcare provider will determine whether it is best for you to stop it slowly or all at once, based on your individual needs.
  • This medication can cause significant drowsiness and dizziness. It can also affect your balance and coordination, which could impair your ability to walk normally and cause you to fall down. These problems are more likely to occur when your dose is being increased. Older individuals appear to have a higher risk for these side effects. You should not engage in any activities that require mental alertness, such as driving or operating heavy machinery, until you know how this medication affects you.
  • Perampanel can make you more likely to fall down, especially if you are an older individual. These falls can lead to serious problems, such as head injuries and bone fractures. Let your healthcare provider know if you feel particularly unsteady or have a fall during treatment.
  • Perampanel is a pregnancy Category C medication, which means it may not be safe for use during pregnancy (see Fycompa and Pregnancy).
  • It is unknown whether this medication passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Fycompa and Breastfeeding).
Know the Signs - Concussion Safety

Perampanel Medication Information

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