What Is Briviact?

Briviact (Brivaracetam) is an antiepileptic drug manufactured by UCB, Inc. It is FDA-approved as adjunctive therapy for partial-onset (focal) seizures in patients 1 month of age and older, and as monotherapy for partial-onset seizures in patients 16 years and older.

Briviact belongs to the racetam family of medications and is chemically related to Levetiracetam (Keppra), but it binds to its target with approximately 20 times greater affinity. Many patients are switched to Briviact from Levetiracetam when they experience behavioral side effects like irritability or mood changes.

How does Briviact work?

Briviact works by selectively binding to synaptic vesicle protein 2A (SV2A) in the brain. SV2A plays a key role in regulating the release of neurotransmitters at synapses. By binding to SV2A with high affinity, Brivaracetam modulates neurotransmitter release and reduces the abnormal electrical activity (neuronal hyperexcitability) that causes seizures.

Compared to Levetiracetam, Briviact has approximately 20 times greater affinity for SV2A, which may contribute to its efficacy and its generally more favorable side-effect profile regarding behavioral symptoms.

What doses are available for Briviact?

• Tablets: 10 mg, 25 mg, 50 mg, 75 mg, 100 mg
• Oral solution: 10 mg/mL (300 mL bottle)
• Injection: 50 mg/5 mL single-dose vial (for IV use when oral administration is temporarily not feasible)

The typical adult dose ranges from 50 mg to 200 mg per day, divided into two doses taken twice daily.

How hard is it to find Briviact in stock?

Briviact (Brivaracetam) scores a 55 out of 100 on our findability scale, meaning it can be intermittently difficult to locate in stock. While there is no active FDA shortage, Briviact is a specialty antiepileptic that many chain pharmacies do not routinely stock. Patients often need to call multiple pharmacies or work with their neurologist's office to find it. Generic Brivaracetam has been FDA-approved but is not yet widely available at all pharmacies, which adds to the challenge.

If you're struggling to find Briviact, Medfinder can help you locate pharmacies that have it in stock near you — no more endless phone calls.

Who Can Prescribe Briviact?

Briviact is most commonly prescribed by:

• Neurologists — the primary prescribers for epilepsy management
• Epileptologists — neurologists who specialize specifically in epilepsy
• Pediatric neurologists — for children with partial-onset seizures
• Primary care physicians — may continue established Briviact prescriptions originally started by a specialist

Because Briviact is a Schedule V controlled substance, any licensed prescriber with DEA authorization can write a prescription, though initial prescriptions typically originate from a neurology specialist.

Is Briviact a controlled substance?

Yes, Briviact is classified as a Schedule V (CV) controlled substance by the DEA. Schedule V is the lowest level of controlled substance classification, indicating a low potential for abuse relative to Schedule IV drugs. Despite this classification, prescriptions for Briviact may still require additional steps at some pharmacies, and refill regulations may apply depending on your state.

Common Side Effects of Briviact

The most frequently reported side effects of Briviact include:

• Somnolence (drowsiness) and sedation — the most common side effect, especially when starting treatment
• Dizziness
• Fatigue
• Nausea and vomiting
• Balance and coordination problems

Serious but less common side effects include suicidal thoughts or behavior (a risk shared by all antiepileptic drugs), psychiatric symptoms such as irritability, anxiety, aggression, or depression, and hypersensitivity reactions. Contact your doctor immediately if you experience mood changes, allergic reactions, or worsening symptoms.

Alternative Medications to Briviact

If you are unable to find or afford Briviact, several alternative antiepileptic drugs may be options to discuss with your neurologist:

• Levetiracetam (Keppra) — A closely related racetam derivative that also targets SV2A. Widely available as a generic at much lower cost ($15–$50/month). Often tried before Briviact due to insurance step therapy requirements.
• Lacosamide (Vimpat) — Works by enhancing slow inactivation of sodium channels. Used as adjunctive or monotherapy for partial-onset seizures. Also a Schedule V controlled substance.
• Perampanel (Fycompa) — An AMPA receptor antagonist approved for partial-onset and primary generalized tonic-clonic seizures. Schedule III controlled substance.
• Cenobamate (Xcopri) — A newer AED that modulates sodium channels and GABA-A receptors. Approved for partial-onset seizures in adults. Schedule V.

Important: Never switch or stop epilepsy medications without guidance from your prescriber. Abrupt changes can trigger breakthrough seizures.

Drug Interactions with Briviact

Briviact can interact with several medications. Tell your doctor about all medications you take, especially:

• Rifampin — Can significantly decrease Briviact levels in your blood. Your doctor may need to double the Briviact dose.
• Carbamazepine — Briviact can increase levels of carbamazepine's active metabolite (carbamazepine epoxide), potentially increasing side effects.
• Phenytoin — Briviact may raise phenytoin levels, requiring monitoring and possible dose adjustment.
• CNS depressants (alcohol, benzodiazepines, opioids) — Increased risk of sedation and drowsiness when combined with Briviact.
• Selinexor — Increased risk of neurological toxicities; this combination should be avoided.

Briviact can be taken with or without food and has no significant food interactions, but alcohol should be avoided.

Final Thoughts on Briviact

Briviact is an effective antiepileptic medication that fills an important role for patients with partial-onset seizures, particularly those who experienced behavioral side effects on Levetiracetam. While it scores a 55 on our findability scale due to limited pharmacy stocking and still-emerging generic availability, it is not currently in shortage.

The biggest challenge for most patients is the high cash price ($1,450–$1,550/month for brand-name). However, UCB's savings card can reduce costs to as little as $10/month for commercially insured patients, and their patient assistance program offers the medication at no cost to qualifying uninsured patients.

If you're having trouble finding Briviact at your local pharmacy, try Medfinder to search for pharmacies that have it in stock near you.