Perampanel 4mg
Perampanel is a highly selective, noncompetitive AMPA type glutamate receptor antagonist. Perampanel was approved as adjunct therapy for focal-onset seizure in adults. It is highly protein bound (~ 95%); after oral administration it is almost completely absorbed and is converted via hepatic metabolism by CYP3A4 to an inactive metabolite, then excreted renally. Perampanel carries an FDA “black box warning” for adverse events including serious psychiatric, behavioral, mood, or personality changes, which may be life threatening. Additional adverse effects include dizziness, somnolence, headache, and ataxia. While perampanel has several attractive characteristics—a relatively novel mechanism of action and once-daily dosing—perampanel is considered a third-line therapy for epilepsy in the elderly at this time, given the risk of falls (Trinka et al., 2016), limited clinical experience, and lack of generic formulations.
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