perampanel
Brand names: Fycompa
Perampanel is a medicine used to treat seizures. It works by reducing the activity of certain chemicals in the brain that can cause seizures.
Drug Pricing (NADAC)
Brand Price
$4.47/unit
Generic Available
Yes (4 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Perampanel is used to treat partial-onset seizures in people with epilepsy who are 4 years and older.
Common side effects
Dizziness, Sleepiness, Tiredness
Key warnings
Perampanel can cause serious mental and behavior changes, including aggression, hostility, irritability, anger, and thoughts of harming yourself or others.
How It Works
Perampanel blocks a specific receptor in the brain called the AMPA glutamate receptor. By blocking this receptor, perampanel reduces the excessive brain activity that leads to seizures. This helps to control seizures.
How to Take It
Take perampanel tablets once a day at bedtime. The starting dose is usually 2 mg. Your doctor may increase the dose by 2 mg each week, depending on how well the medicine works and how you feel. The usual maintenance dose for partial-onset seizures is 8 mg to 12 mg daily. For primary generalized tonic-clonic seizures, the usual maintenance dose is 8 mg daily.
Pregnancy & Breastfeeding
Perampanel may harm an unborn baby. If you are pregnant or plan to become pregnant, talk to your doctor about the risks and benefits of taking perampanel. It is not known if perampanel passes into breast milk. Talk to your doctor before breastfeeding.
Missed Dose
If you miss a dose of perampanel, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take your next dose at the regular time.
Storage
Store perampanel tablets at room temperature, between 68°F and 77°F.
Side Effects (from patient reports)
Based on 5,522 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 7,188 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2012–2025.
Total Reports
7,188
Death-Related Reports
453
Hospitalization Reports
2,745
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | SEIZURE | 1,098 |
| 2 | DRUG INEFFECTIVE | 1,044 |
| 3 | OFF LABEL USE | 728 |
| 4 | SOMNOLENCE | 491 |
| 5 | AGGRESSION | 485 |
| 6 | DIZZINESS | 384 |
| 7 | EPILEPSY | 332 |
| 8 | STATUS EPILEPTICUS | 324 |
| 9 | DRUG INTERACTION | 323 |
| 10 | MULTIPLE-DRUG RESISTANCE | 313 |
| 11 | FATIGUE | 292 |
| 12 | IRRITABILITY | 239 |
| 13 | CONDITION AGGRAVATED | 226 |
| 14 | FALL | 220 |
| 15 | PRODUCT USE IN UNAPPROVED INDICATION | 217 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Perampanel can cause serious mental and behavior changes, including aggression, hostility, irritability, anger, and thoughts of harming yourself or others. Tell your doctor right away if you have any of these changes. Your doctor may need to lower your dose or stop the medicine. Watch for these changes especially when starting perampanel or when your dose is increased.
Known Drug Interactions
7 DRUG INTERACTIONS Contraceptives: 12 mg once daily may decrease the effectiveness of hormonal contraceptives containing levonorgestrel ( 7.1 ) Moderate and Strong CYP3A4 Inducers (including carbamazepine, oxcarbazepine, and phenytoin): increase clearance of perampanel and decrease perampanel plasma concentrations. 7.2 Moderate and Strong CYP3A4 Inducers The concomitant use of known moderate and strong CYP3A4 inducers including carbamazepine, phenytoin, or oxcarbazepine with perampanel decreased the plasma levels of perampanel by approximately 50% to 67% [see Clinical Pharmacology (12.3) ] .
Mechanism: Carbamazepine speeds up how fast your body gets rid of perampanel, which significantly lowers the amount of medicine in your system.
What to do: Your doctor may need to increase your dose of perampanel to make sure it still works to prevent seizures.
7 DRUG INTERACTIONS Contraceptives: 12 mg once daily may decrease the effectiveness of hormonal contraceptives containing levonorgestrel ( 7.1 ) Moderate and Strong CYP3A4 Inducers (including carbamazepine, oxcarbazepine, and phenytoin): increase clearance of perampanel and decrease perampanel plasma concentrations. 7.2 Moderate and Strong CYP3A4 Inducers The concomitant use of known moderate and strong CYP3A4 inducers including carbamazepine, phenytoin, or oxcarbazepine with perampanel decreased the plasma levels of perampanel by approximately 50% to 67% [see Clinical Pharmacology (12.3) ] .
Mechanism: Oxcarbazepine makes your body break down perampanel much faster than normal. This causes the amount of perampanel in your blood to drop, which may make it less effective.
What to do: Your doctor may need to increase your dose of perampanel to ensure it still works correctly.
7 DRUG INTERACTIONS Contraceptives: 12 mg once daily may decrease the effectiveness of hormonal contraceptives containing levonorgestrel ( 7.1 ) Moderate and Strong CYP3A4 Inducers (including carbamazepine, oxcarbazepine, and phenytoin): increase clearance of perampanel and decrease perampanel plasma concentrations. 7.2 Moderate and Strong CYP3A4 Inducers The concomitant use of known moderate and strong CYP3A4 inducers including carbamazepine, phenytoin, or oxcarbazepine with perampanel decreased the plasma levels of perampanel by approximately 50% to 67% [see Clinical Pharmacology (12.3) ] .
Mechanism: Phenytoin speeds up the process of clearing perampanel from your system. This can lower the level of perampanel in your body by more than half.
What to do: Your healthcare provider might need to adjust your perampanel dosage while you are taking phenytoin.
7 DRUG INTERACTIONS Contraceptives: 12 mg once daily may decrease the effectiveness of hormonal contraceptives containing levonorgestrel ( 7.1 ) Moderate and Strong CYP3A4 Inducers (including carbamazepine, oxcarbazepine, and phenytoin): increase clearance of perampanel and decrease perampanel plasma concentrations. Dose adjustment of perampanel tablets may be necessary ( 2.3 , 7.2 ) 7.1 Contraceptives With concomitant use, perampanel at a dose of 12 mg per day reduced levonorgestrel exposure by approximately 40% [see Clinical Pharmacology (12.3) ] . Use of perampanel with contraceptives co...
Mechanism: Taking a high dose of perampanel can lower the amount of birth control medicine in your blood. This makes the birth control less likely to work to prevent pregnancy.
What to do: You should use an additional or different method of birth control while taking this medication.
Common Questions
Can I drink alcohol while taking perampanel?
Will perampanel interact with my birth control?
Can I drive while taking perampanel?
What should I do if I have thoughts of harming myself?
How often will I see the doctor while taking perampanel?
What if I have liver problems?
What if I have kidney problems?
What if I am elderly?
Are there any other medicines that interact with perampanel?
What do the different colored tablets mean?
What are the common side effects of perampanel?
Does perampanel interact with other medications?
What drug class is perampanel?
Is perampanel safe during pregnancy?
Related Medications in Anticonvulsant (AMPA Antagonist)
Other drugs grouped near perampanel — same-class peers and common alternatives.
brivaracetam
Briviact
Brivaracetam is a medicine used to treat partial-onset seizures.
Compare with perampanel →
cannabidiol
Epidiolex
Epidiolex is a medicine that contains cannabidiol.
Compare with perampanel →
carbamazepine
Tegretol
Carbamazepine is a medicine used to control seizures and treat nerve pain.
Compare with perampanel →
cenobamate
Xcopri
Xcopri is a medicine used to treat partial-onset seizures in adults.
Compare with perampanel →
clobazam
Onfi, Sympazan
Clobazam oral suspension is a medicine used with other medicines to treat seizures caused by Lennox-Gastaut syndrome.
Compare with perampanel →
Medication Guides
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What the FDA Data Shows for perampanel
The FDA label for perampanel (sold under brand names such as Fycompa) classifies it as a prescription-only medication in the Anticonvulsant (AMPA Antagonist) class. Perampanel is used to treat partial-onset seizures in people with epilepsy who are 4 years and older. Official labeling lists 14 commonly reported side effects, including Dizziness, Sleepiness, Tiredness.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 5,522 voluntary reports. The database also lists 4 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated minor severity. NADAC pricing from CMS.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: December 19, 2025
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages