Perampanel

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Date: September 2023, Version 1.0

Quick read

Perampanel is occasionally used in pregnancy if it is the most suitable treatment for epilepsy.

What is perampanel? 

Perampanel (Fycompa®) is used in combination with other medicines to treat some forms of epilepsy.

Benefits

What are the benefits of using perampanel in pregnancy?

Use of parampanel can ensure that epilepsy is well-controlled during pregnancy. Uncontrolled seizures can be dangerous to the woman and her unborn baby. 

Risks

What are the risks of using perampanel in pregnancy?

There is very little information about perampanel use in pregnancy. While the current information does not indicate it harms a developing baby, more women taking parampanel need to be studied to confirm this. 

Perampanel used around the time of delivery can affect the baby after birth. The baby may be ‘jittery’, have feeding problems, and initially need some help with breathing. These problems usually settle within the first few days. 

Pregnant women who take parampanel should contact their neurologist or epilepsy specialist nurse as soon as possible. They will review whether parampanel is still needed and ensure that the dose is correct. Pregnant women should not stop taking parampanel or change the dose without speaking to a healthcare professional.

All pregnant women in the UK who take an antiseizure medicine (including parampanel) are advised to take high dose (5mg per day) folic acid.

Alternatives

Are there any alternatives to using perampanel in pregnancy?

Possibly - some women can be switched to an alternative anti-seizure medicine. Women who are planning a pregnancy or become pregnant whilst using perampanel should be reviewed by a neurologist or an epilepsy specialist nurse. Perampanel should be continued until the review appointment unless a healthcare professional has advised otherwise.

No treatment

What if I prefer not to take perampanel during pregnancy?

To keep both the woman and her baby safe, it is important that the correct antiseizure medication is continued during pregnancy. Some women may be advised that they can use alternative antiseizure medicines during pregnancy, but for others, parampanel may be the best choice to control their epilepsy.

Will I or my baby need extra monitoring?

As part of routine antenatal care in the UK, women are invited for a very detailed scan at around 20 weeks of pregnancy to check the baby’s development. Further scans to check for birth defects are not usually required following use of perampanel in pregnancy. 

Women with epilepsy are likely to be offered closer monitoring during pregnancy to ensure that their epilepsy is stable and that the medicines they are using are at the correct doses.

Are there any risks to my baby if the father has used perampanel? 

There is no evidence that perampanel use by the father can harm the baby through effects on the sperm.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.

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