Last update Feb. 5, 2022

Perampanel

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

Glutamate AMPA receptor antagonist. Indicated in the concomitant treatment of certain types of epilepsy. Single-dose oral administration, nightly

It is excreted in human milk in a small amount, but it could be clinically significant, with a relative dose (RD) that can reach 10%.(Landmark 2021)

The plasma levels of the infants whose mothers took it were between one-sixth and one-half of the maternal levels. (Landmark 2021)

Expert authors consider the use of this medication safe during breastfeeding (LactMed, Cabo 2019), following the sedation/irritability, weight gain and neurological development of the baby

Alternatives

  • Carbamazepine (Safe product and/or breastfeeding is the best option.)
  • Gabapentin (Safe product and/or breastfeeding is the best option.)
  • Lamotrigine (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Valproate, Valproic Acid (Safe product and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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Other names

Perampanel in other languages or writings:

Group

Perampanel belongs to this group or family:

Tradenames

Main tradenames from several countries containing Perampanel in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 349 daltons
Protein Binding 95 %
Tmax 0.5 - 2.5 hours
T½ 105 (25 +Carbamaz) hours
M/P ratio 0.10 - 0.17 -
Theoretical Dose 0.008 - 0.016 mg/Kg/d
Relative Dose 6 - 12 %

References

  1. LactMed. Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/ 2006 - Consulted on April 16, 2024 Full text (link to original source)
  2. Landmark CJ, Rektorli L, Burns ML, Revdal E, Johannessen SI, Brodtkorb E. Pharmacokinetic data on brivaracetam, lacosamide and perampanel during pregnancy and lactation. Epileptic Disord. 2021 Apr 1;23(2):426-431. Abstract
  3. Eisai Limited. Perampanel (Fycompa). Drug Summary. 2020 Full text (in our servers)
  4. Cabo-Lopez I, Canneti B, Puy-Nunez A. Epilepsia y lactancia materna: del mito a la realidad. [Epilepsy and breastfeeding: from myth to reality]. Rev Neurol. 2019 Jul 16;69(2):68-76. Abstract
  5. EMA. Perampanel (Fycompa). Ficha técnica. 2017 Full text (in our servers)

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