Peranel 4 Tablet
Perampanel
4mg
Square Pharmaceuticals Ltd.
| Pack size | 20’s Pack |
|---|---|
| Unite Price | 25.00 BDT |
Indications
Peranel 4 Tablet is used for:
Perampanel an anti-epileptic drug is indicated for:
Treatment of partial-onset seizures with or without secondarily generalized seizures in patients with epilepsy from 4 years of age and older.
Adjunctive therapy in the treatment of primary generalized tonic-clonic seizures in patients with epilepsy from12 years of age and older.
Adult Dose
Adult
Oral
Partial-onset seizures
Initially 2 mg daily at bedtime.
May be increased by increments of 2 mg (either wkly or every 2 wk) to a maintenance dose of 4-8 mg daily, w/ 1 wk interval between dose increases.
Max dose: 12 mg daily.
Primary generalised tonic-clonic seizures
Initially 2 mg daily at bedtime.
May be increased by increments of 2 mg (either wkly or every 2 wk) to a maintenance dose of 8 mg daily, w/ 1 wk interval between dose increases.
Then, may be further increased up to 12 mg daily.
Hepatic impairment
Mild-to-moderate: 2 mg PO daily at bedtime. initially; increase by 2 mg/day increments no more frequently than q2weeks to target dose
Mild (maximum dose): Not to exceed 6 mg/day
Moderate (maximum dose): Not to exceed 4 mg/day
Severe: Not recommended
Child Dose
Partial Onset Seizures
Indicated as monotherapy or adjunctive therapy for partial-onset seizures with or without secondarily generalized seizures in patients with epilepsy
<4 years: Safety and efficacy not established
>4 years
Initial
In absence of enzyme-inducing AEDs: 2 mg daily at bedtime; increase by 2 mg/day increments in at least weekly intervals to 4-8 mg daily at bedtime based on clinical response and tolerability
Maintenance
Dosage range: 8-12 mg/day
Response may occur with 4mg/day; 12 mg/day resulted in greater seizure rate reductions and greater substantial increase in side effects
Tonic Clonic Seizures
Indicated as adjunctive therapy of primary generalized tonic-clonic seizures in patients with epilepsy
<12 years: Safety and efficacy not established
Renal Dose
Renal impairment
Moderate: May be used with close monitoring and slower titration
Severe or hemodialysis: Not recommended
Administration
May be taken with or without food.
Contra Indications
Hypersensitivity.
Precautions
Serious psychiatric and behavioral reactions (eg, hostility, aggression) may emerge and appear to be dose related
Antiepileptic drugs increase risk of suicidal thoughts or behavior; monitor for emergence or worsening of depression, suicidal thoughts or behavior, and unusual mood/behavior changes
Dizziness, vertigo, and gait disturbances reported; monitor
Somnolence and fatigue reported; caution patients against engaging in hazardous activities that require mental alertness
Increased risk of falls
Pregnancy-Lactation
Pregnancy
There are no adequate data on the developmental risk associated with use in pregnant women; in animal studies, perampanel induced developmental toxicity in pregnant rat and rabbit at clinically relevant doses
Contraception
Advise women who are using a levonorgestrel-containing contraceptive to use an additional non-hormonal form (eg, condoms) of contraception while in therapy and for a month after discontinuation
Lactation
Perampanel and/or its metabolites are present in rat milk, and are detected at concentrations higher than that in maternal plasma
The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for therapy and any potential adverse effects on the breastfed child from therapy or from the underlying maternal condition
Interactions
Decreased levonorgestrel exposure. May decrease efficacy of progestative containing OCs. Increased clearance w/ CYP450 3A enzyme inducers eg, carbamazepine, phenytoin, oxcarbazepine. Reduced levels w/ carbamazepine. Decreased clearance of oxcarbazepine. Decreased AUC of midazolam. Decreased conc w/ strong CYP450 inducers eg, rifampicin & hypericum; felbamate. Increased AUC & prolonged t½ w/ ketoconazole. Additive or supra-additive effects of alcohol on tasks involving alertness & vigilance.
Side Effects
Side effects of Perampanel :
>10%
Dizziness (16-43%)
Somnolence (9-18%)
Headache (11-13%)
Fatigue (8-12%)
Irritability (4-12%)
1-10%
Falls (2-10%)
Nausea (6-8%)
Ataxia (1-8%)
Vertigo (3-5%)
Balance disorder (3-5%)
Back pain (2-5%)
Weight gain (4%)
Vomiting (2-4%)
Anxiety (3-4%)
Blurred vision (1-4%)
Dysarthria (1-4%)
Cough (1-4%)
Hypoaesthesia (3%)
Constipation (2-3%)
Arthralgia (2-3%)
Extremity pain (2-3%)
Aggression (1-3%)
Anger (1-3%)
Myalgia (1-3%)
Diplopia (1-3%)
Injuries due to falls (1-3%)
Hypersomnia (1-3%)
Hyponatremia (2%)
Contusions (2%)
Oropharyngeal pain (2%)
Asthenia (1-2%)
Confusional state (1-2%)
Euphoric mood (1-2%)
Altered mood (1-2%)
Abnormal coordination (1-2%)
Musculoskeletal pain (1-2%)
Peripheral edema (1-2%)
Memory impairment (1-2%)
Paraesthesia (1-2%)
Mode of Action
Noncompetitive antagonist of alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) glutamate receptor on post-synaptic neurons; glutamate is a primary excitatory neurotransmitter in the CNS and is implicated in various neurological disorders caused by neuronal over excitation.
Note
Peranel 4 4mg Tablet generic name is Perampanel. Peranel 4 4mg Tablet is manufactured by Square Pharmaceuticals Ltd.Peranel 4 is availble in all over Bangladesh.
Mes BD drug index information on Peranel 4 Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.