What it does
Perampanel is a medication used to help control seizures in people with epilepsy.
Commonly used for: seizures (epilepsy)
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Sourcing - Kenya onlyRegistration & product details
Source: Botswana Medicines Regulatory Authority · fetched 2026-04-15 20:42:22 · updated 2026-05-12 08:03:05
Drug Interactions
68Pharmacodynamic Warnings
Perampanel appears in TABLE 11: Drugs with CNS depressant effects
Severe (7)
Antiepileptics - decreases absorption
Iron chelators (dexrazoxane) might decrease the absorption of antiepileptics (fosphenytoin, phenytoin). Avoid.
Antiepileptics - decreases exposure
Lumacaftor is predicted to decrease the exposure to antiepileptics (carbamazepine, fosphenytoin, phenobarbital, phenytoin, primidone). Avoid.
Antiepileptics - decreases concentration
St John’s wort is predicted to decrease the concentration of antiepileptics (fosphenytoin, phenobarbital, phenytoin, primidone). Avoid.
Antiepileptics - increases risk of overheating and dehydration
Hydroxyzine potentially increases the risk of overheating and dehydration when given with antiepileptics (zonisamide). Avoid in children.
Antiepileptics - increases risk of overheating and dehydration
Haloperidol potentially increases the risk of overheating and dehydration when given with antiepileptics (zonisamide). Avoid in children.
Antiepileptics - decreases absorption
Dexrazoxane might decrease the absorption of antiepileptics (fosphenytoin, phenytoin). Avoid.
Antiepileptics - increases risk of overheating and dehydration
Oxybutynin potentially increases the risk of overheating and dehydration when given with antiepileptics (zonisamide). Avoid in children.
Moderate (28)
Antiepileptics - increases concentration
Intravenous chloramphenicol increases the concentration of antiepileptics (fosphenytoin, phenytoin) and antiepileptics (fosphenytoin, phenytoin) affect the concentration of intravenous chloramphenicol
Antiepileptics - decreases concentration
Diazoxide decreases the concentration of antiepileptics (fosphenytoin, phenytoin) and antiepileptics (fosphenytoin, phenytoin) are predicted to decrease the effects of diazoxide. Monitor concentration
Antiepileptics - increases concentration
Disulfiramincreasestheconcentrationofantiepileptics (fosphenytoin,phenytoin).Monitorconcentrationandadjust dose.rStudy →AlsoseeTABLE12p.1520
Antiepileptics - increases concentration
Fluorouracilincreasestheconcentrationofantiepileptics (fosphenytoin,phenytoin).Monitorconcentrationandadjust dose.rAnecdotal 1xidneppA|snoitcaretnI A1 https://www.facebook.c (Books-Courses-Medic
Antiepileptics - decreases concentration
Folates are predicted to decrease the concentration of antiepileptics (fosphenytoin, phenobarbital, phenytoin, primidone). Monitor concentration and adjust dose.
Unknown (33)
Antiepileptics - increases risk of overheating and dehydration
Acetazolamide potentially increases the risk of overheating and dehydration when given with antiepileptics (zonisamide). Avoid in children.
Antiepileptics - increases risk of visual disturbances
Alcohol potentially increases the risk of visual disturbances when given with antiepileptics (retigabine).
Antiepileptics - decreases exposure
Enzalutamide is predicted to slightly decrease the exposure to antiepileptics (brivaracetam).
Antiepileptics - decreases exposure
Apalutamidepotentiallydecreasestheexposureto antiepileptics(valproate).nTheoretical
Antiepileptics - increases concentration
Capecitabine increases the concentration of antiepileptics (fosphenytoin, phenytoin).
Data from BNF 85 (British National Formulary). This is not a substitute for professional medical advice. Matched via: class
About this medicine
Perampanel is a medication used to help control seizures in people with epilepsy.
What it treats
- seizures (epilepsy)
How it works
Perampanel helps to prevent seizures by reducing abnormal electrical activity in the brain.
Who it's for
It is for individuals diagnosed with epilepsy who experience seizures.
Drug class
Antiepileptics
Cautions
- • Be careful if you are taking other medications that can cause drowsiness or affect the brain.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
Clinical monograph: Perampanel
BNF-referencedPerampanel is an antiepileptic medication primarily used as an adjunctive treatment for focal seizures, with or without secondary generalization, and for primary generalized tonic-clonic seizures in adults and children. It acts by inhibiting neuronal excitation in the central nervous system, contributing to its anticonvulsant effects. The medication is taken orally and is known for its non-competitive antagonism of the AMPA receptor, which plays a critical role in excitatory neurotransmission.
Indications
- Adjunctive treatment of focal seizures with or without secondary generalised seizures
- Adjunctive treatment of primary generalised tonic-clonic seizures
Dosage
Children: Child 12–17 years: Initially 2 mg once daily, dose to be taken before bedtime, increased if tolerated in steps of 2 mg at intervals of at least every 2 weeks, adjusted according to response; maintenance 4–8 mg once daily; maximum 12 mg per day.
Adults: Initially 2 mg once daily, dose to be taken before bedtime, increased if tolerated in steps of 2 mg at intervals of at least every 2 weeks, adjusted according to response; maintenance 4–8 mg once daily; maximum 12 mg per day.
Mechanism of action
Perampanel decreases neuronal excitation through non-competitive inhibition of the AMPA receptor, which is implicated in the pathophysiology of seizure disorders.
Pharmacodynamics
Perampanel's pharmacodynamics involve the inhibition of excitatory neurotransmission in the central nervous system, which leads to a decrease in psychomotor performance and seizure activity. The full extent of its action on neuronal circuits remains to be fully elucidated.
Pharmacokinetics
Perampanel is well absorbed after oral administration, with peak plasma concentrations typically reached within 0.5 to 1.5 hours. It is extensively metabolized in the liver, primarily by CYP3A4. The elimination half-life is approximately 105 hours, allowing for once-daily dosing. The drug's clearance can be affected by concomitant use of other medications that induce or inhibit CYP3A4.
Contra-indications
- Hypersensitivity to perampanel or any of its components
- Severe hepatic impairment
Adverse effects
- Dizziness
- Somnolence
- Fatigue
- Irritability
- Nausea
- Vomiting
- Weight gain
- Skin reactions (e.g. rash)
- Neutropenia
- Psychiatric disorders (e.g. aggression, hostility, anxiety)
Interactions
- Mitotane - Moderate (decreases exposure)
- St. John's Wort - Moderate (decreases exposure)
- Rifampicin - Moderate (decreases exposure)
Precautions
- Monitor for signs of psychiatric disorders
- Use caution in patients with a history of substance use disorder
- Monitor plasma sodium concentration in patients at risk of hyponatraemia
- Consider HLA-B*1502 testing in certain Asian populations
Pregnancy
Clinical response should be monitored during pregnancy, and plasma concentration of the active metabolite should be considered for monitoring.
Breast-feeding
Amount probably too small to be harmful, but manufacturer advises to avoid.
Storage
Store at room temperature, away from moisture and heat.
Formulations
- Tablets: 2 mg, 4 mg, 6 mg, 8 mg
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Molecular reference: Perampanel
PubChem CID 9924495Molecular formula: C23H15N3O
Mechanism of action
The exact mechanism of action of perampanel in seizures is not yet determined, but it is known that perampanel decreases neuronal excitation by non-competitive ihibition of the AMPA receptor.
Pharmacodynamics
Perampanel is involved in inhibiting neuronal excitation in the central nervous system leading to such effects as decreased pyschomotor performance.
Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.
This drug in other countries
The same active ingredient registered across other registries we cover - including different brands.