Fycompa

• Fycompa is used to help prevent partial seizures, with or without secondary generalisation and primary generalised tonic clonic seizures. This medicine is used as an add-on therapy for adults and adolescents aged 12 years and over who are already taking other antiepileptic medicines.

How does Fycompa work?

• Fycompa tablets contain the active ingredient perampanel, which is a medicine that is used to treat epilepsy. It works by stabilising electrical activity in the brain.
• The brain and nerves are made up of many nerve cells that communicate with each other through electrical signals. These signals must be carefully regulated for the brain and nerves to function properly. When abnormally rapid and repetitive electrical signals build up and spread through the brain, the brain becomes over-stimulated and normal function is disturbed. This can result in seizures or fits.
• Perampanel prevents epileptic fits by preventing the excessive electrical activity in the brain. It is not fully understood how perampanel works, but it is thought to block the action of glutamate, which is a neurotransmitter found in nerve cells. Neurotransmitters are chemicals that are stored in nerve cells and are involved in transmitting messages between the nerve cells.
• Glutamate is a neurotransmitter that acts as a natural 'nerve-exciting' agent. It is released when electrical signals build up in nerve cells and subsequently excites more nerve cells. It is thought to play a key role in causing epileptic seizures.
• Perampanel decreases the ability of glutamate to excite the nerve cells. It does this by blocking glutamate receptors on the nerve cells in the brain. This is thought to help stabilise the electrical activity in the brain and prevent epileptic fits.

How do I take Fycompa?

• The dose of this medicine that is prescribed depends on the individual and how well your seizures are controlled. Your dose will be increased gradually to begin with. Follow the instructions given by your doctor. These will also be printed on the dispensing label that your pharmacist has put on the medicine. It may take a few weeks to find the right dose for you.
• Fycompa tablets are taken once daily at bedtime. The tablets should be swallowed whole with a drink of water. Do not chew, break or crush the tablets.
• Fycompa tablets can be taken with or without food.
• If you forget to take a dose don't worry, just take your next dose as usual the following evening. Don't take a double dose to make up for a missed dose.
• If you forget to take more than seven doses in a row you should get advice from your doctor or pharmacist straight away, as you may need to re-start your treatment with a lower dose.
• It is important to take your medication regularly, as directed by your doctor, because missing doses can trigger seizures in some people. If you have trouble remembering to take your medicine you should ask your pharmacist for advice. You may find a pill reminder box helpful.
• You should not suddenly stop taking this medicine without consulting your doctor, as this may result in your seizures returning or getting worse. If it is decided that you should stop taking this medicine, the dose should usually be reduced gradually. Follow the instructions given by your doctor.

Fycompa should be used with caution by

• People over 65 years of age.
• People with mild to moderately decreased liver function.
• People with a history of drug, medication or alcohol abuse.

Fycompa should not be used by

• People with severely decreased liver function.
• People with moderate to severely decreased kidney function.
• This medicine is not recommended for children under 12 years of age because its safety and effectiveness have not been studied in this age group.
• Fycompa tablets contain lactose and should not be taken by people with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption.
• This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• It is very important for women with epilepsy to talk to the doctor responsible for their epilepsy treatment about getting pregnant and planning a family. Antiepileptic medicines are associated with an increased risk of developmental disorders and malformations in the baby. However, stopping antiepileptic treatment during pregnancy runs the risk of the mother having seizures, which can harm both the mother and the developing baby. This risk may be higher than that from continuing the medication. It is important that all the risks and benefits of treatment are weighed up. Seek medical advice from your doctor.
• The manufacturer of this medicine states that there is only limited information regarding its use in pregnant women and for this reason it is not recommended for use during pregnancy. They recommend that women who could get pregnant should use an effective method of contraception to prevent pregnancy while taking this medicine. Perampanel may make some hormonal contraceptives less effective (see end of factsheet) so it is important to get advice from your doctor regarding contraceptives that are suitable for you.
• It is not known if this medicine passes into breast milk. The manufacturer recommends that it should be avoided by women who are breastfeeding, unless the benefits of the medicine outweigh any risks to the nursing infant. Mothers who need treatment with this medicine should discuss the risks and benefits of breastfeeding compared to bottle-feeding with their doctor.

Possible side effects of Fycompa

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

Very common 

• Sleepiness.
• Dizziness.

Common 

• Anxiety.
• Irritability.
• Aggression and anger (see warning section above).
• Confusion.
• Shaky movements and unsteady walk (ataxia).
• Problems with balance.
• Abnormal gait.
• Increased risk of falls (especially in elderly people).
• Increased or decreased appetite.
• Speech problems.
• Double or blurred vision.
• Sensation of spinning (vertigo).
• Feeling sick.
• Back pain.
• Weight gain.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

If you think you have experienced a side effect from a medicine or vaccine you should check the patient information leaflet. This lists the known side effects and what to do if you get them. You can also get advice from your doctor, nurse or pharmacist. If they think it's necessary they'll report it for you.

How can Fycompa affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.

The following medicines may increase the breakdown of perampanel in the body. As this could decrease the level of perampanel in your blood and may make it less effective, your doctor may need to increase your dose of perampanel if you are prescribed any of these:

• carbamazepine
• felbamate
• oxcarbazepine
• phenytoin
• rifampicin
• topiramate.

High doses of this medicine can make hormonal contraceptives such as the pill less effective at preventing pregnancy, because it speeds up the breakdown of progesterone medicines such as levonorgestrel or desogestrol. For this reason, it is recommended that if you are taking a hormonal contraceptive such as the pill and your daily dose of Fycompa is 12mg, you should also use an extra form of contraception, such as condoms, to prevent pregnancy. Ask your doctor or pharmacist for further advice.

It is recommended that people who are taking any antiepileptic medicines should avoid taking the herbal remedy St John's wort (Hypericum perforatum). This is because St John's wort may affect the level of antiepileptic medicines in the blood and could increase the risk of seizures.

If you feel sleepy or dizzy, this effect is likely to be increased if you take it in combination with other medicines that can cause drowsiness or with alcohol.

References:

https://www.fycompa.com/about-fycompa/side-effects

http://www.netdoctor.co.uk/medicines/brain-and-nervous-system/a8855/fycompa-perampanel/

https://www.rxlist.com/fycompa-side-effects-drug-center.htm

https://www.webmd.com/drugs/2/drug-165545/fycompa-oral/details

https://www.drugs.com/fycompa.html