Lindsay Cook, PharmD is a board-certified consultant pharmacist.

Warning: Fycompa (perampanel) has caused severe psychiatric and behavioral responses, such as aggression, hostility, irritability, anger, and homicidal ideation and threats. A caregiver or family member should monitor your behaviors for any abnormal mood, behavior, or personality changes. If these adverse effects become severe, immediately contact a healthcare provider.

Fycompa (perampanel) is a prescription anti-seizure medication used to prevent several types of seizures that can occur due to epilepsy.

This medication is a non-competitive AMPA glutamate receptor antagonist that inhibits the action of the glutamate receptor in the brain. Glutamate is an excitatory neurotransmitter, and inhibiting its receptor may prevent overactivity of specific brain areas, such as the brain activity involved in epilepsy.

Perampanel is listed as a Schedule III controlled substance due to its potential to lead to moderate or low physical or high psychological dependence. Controlled substances are more strictly regulated than other noncontrolled substances in how they are used, handled, stored, and distributed.

Fycompa is available as a tablet and in an oral suspension formulation.

Brand Name(s): Fycompa

Controlled Substance: Schedule III

Dosage Form(s): Tablet, solution

Fycompa is used for preventing focal and generalized seizures. Its approval for different seizure types has specifications with respect to age and use with other anti-epilepsy medications.

The Food and Drug Administration (FDA) approved Fycompa for:

You should take Fycompa as prescribed, usually every day at bedtime.

Store this medication in its original container and out of the reach of children or pets:

Healthcare providers may prescribe perampanel for off-label uses, meaning for conditions not specifically indicated by the FDA.

This medication has been examined for potential off-label use for:

On average, Fycompa begins to work around 24 hours (with a range of eight to 48 hours) after you start taking it.

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Fycompa can cause side effects, including potentially harmful reactions.

The most common side effects of Fycompa include:

Talk to your healthcare provider if you experience side effects. You may benefit from treatment for side effects that are bothering you.

Less often, Fycompa can cause serious side effects that can be dangerous or life-threatening. Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include the following:

Fycompa is a controlled substance, meaning it has the potential for physical and psychological dependence. It may cause dependence and withdrawal symptoms, such as:

Additionally, abruptly stopping treatment with Fycompa can cause an increase in seizure frequency.

You may need emergency treatment for the above-listed side effects. Your healthcare provider may stop this medication if you experience severe side effects and start you on another anti-epilepsy medication.

The effects of this medication should wear off within a week after you stop taking it. However, severe injuries or physical harm that occurred as a side effect can lead to long-term problems (such as organ failure) even after discontinuing the medication.

Fycompa may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Your dosage of Fycompa may vary based on factors such as clinical response, tolerability, health conditions, and whether you are taking other medications. In addition, the following circumstances can influence dosage and administration:

If you miss a dose, take it as soon as you remember. However, if it is close enough to your next dose, skip the missed dose and resume your regular dosing schedule. Contact your healthcare provider if you miss multiple doses.

Harmful effects from taking too much Fycompa can be prolonged while the medication is metabolized (processed and eliminated) from your body.

Effects of an overdose can include:

Treatment of an overdose includes careful observation of vital signs and heart function. Treatment can include management of symptoms, airway management to improve breathing, and oxygen supplementation as necessary.

If you think you or someone else may have overdosed on Fycompa, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Fycompa, call 911 immediately.

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Also tell your doctor if you or your child have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. If you, your child, or your caregiver notice any of these side effects, tell your doctor right away.

This medicine may cause some people to become dizzy, drowsy, clumsy, faint, unsteady, or less alert than they are normally. It may also cause trouble with controlling body movements, which may lead to falls, fractures, or other injuries. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

Check with your doctor right away if you have a fever, chills, cough, sore throat, swollen, painful, or tender lymph glands in the neck, armpit, or groin, or yellow skin or eyes while using this medicine. These could be symptoms of a serious condition, called drug reaction with eosinophilia and systemic symptoms (DRESS).

This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

Do not stop taking this medicine without checking first with your doctor. Stopping the medicine suddenly may cause your seizures to return or to occur more often. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely.

Birth control pills containing levonorgestrel may not work as well while you are using this medicine. Use another form of birth control together with your pills during treatment and for at least 1 month after the last dose to avoid getting pregnant. Talk to your doctor if you have questions.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines, medicines for hay fever, allergies or colds, sedatives, tranquilizers, or sleeping medicines, prescription pain medicines or narcotics, and other medicines for seizures. Check with your doctor before taking any of these medicines together with perampanel.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

Fycompa has no contraindications or specific scenarios in which this medication would be harmful. However, it is not recommended to use Fycompa if you have severe liver disease. Additionally, you may need to stop using this medication if it causes severe side effects, especially abnormal behavior or mood changes that may be dangerous.

Using Fycompa with alcohol or any medications that cause drowsiness can make you very sleepy or can lead to confusion or loss of consciousness.

Additionally, Fycompa can interact with:

This is not a complete list of all drug interactions that may occur with Fycompa. Share your medical history and use of prescription and over-the-counter (OTC) medications, vitamins, and herbal supplements with a healthcare provider or pharmacist. They can help you avoid important drug or supplement interactions.

Fycompa is one of many anti-epilepsy medications. Its mechanism of action is unique. 

Commonly used anticonvulsants (i.e., anti-seizure medications) that have different mechanisms include:

Fycompa is prescribed for use in preventing two types of seizures: Partial-onset seizures and primary generalized tonic-clonic seizures.

Fycompa inhibits glutamate, an excitatory neurotransmitter, by blocking glutamate receptors in the brain. This helps reduce and prevent seizure activity.

This medication can reduce the action of contraceptives containing levonorgestrel. Additionally, taking Fycompa with alcohol or other sedating substances can cause severe fatigue or loss of consciousness. Medications classified as strong or moderate CYP3A4 inducers can decrease your Fycompa level.

This medication can cause varying degrees of dizziness, balance problems, fatigue, nausea, vomiting, anxiety, and headaches. It also poses a risk of suicidal thoughts or actions or a severe hypersensitivity reaction.

You should not suddenly stop taking Fycompa. If you need to stop this medication, you should follow the instructions provided to you by your healthcare provider. Abruptly stopping can induce a seizure.

The following steps can help you stay healthy while taking Fycompa:

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

Food and Drug Administration. Fycompa label.

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Newey CR, Mullaguri N, Hantus S, Punia V, George P. Super-refractory status epilepticus treated with high dose perampanel: case series and review of the literature. Case Rep Crit Care. 2019:3218231. doi:10.1155/2019/3218231

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By Heidi Moawad, MD Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.  

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