Short answer: Brivaracetam (Briviact) is a prescription antiseizure medicine for partial-onset seizures in people 1 month and older. It is a Schedule V controlled substance. A close relative of levetiracetam (Keppra), it can cause sleepiness and mood changes such as irritability.
Key takeaways
- What it is: Brivaracetam is an antiseizure medicine (sv2a ligand) and a Schedule V controlled substance in the US.
- Main uses: Partial-onset seizures.
- Timing: effects start in peak levels in about 1 hour and last twice-daily dosing.
- Most dangerous mix: Rifampin, which can cause lower brivaracetam levels.
- Naloxone: it does not reverse this drug, but give it whenever opioids could be involved.
- Dependence risk: Low.
- Legal route: only with a prescription from a DEA-registered clinician, filled by a licensed pharmacy.
What is brivaracetam?
Brivaracetam treats partial-onset seizures, alone or with other medicines. It binds the same target as levetiracetam but more strongly, and enters the brain quickly.
Some people who had behavioral side effects on levetiracetam tolerate brivaracetam better, though it can cause similar effects.
Quick facts
| Fact | Brivaracetam |
|---|---|
| Generic name | Brivaracetam |
| Brand names | Briviact |
| Drug class | Antiseizure medicine; synaptic vesicle protein 2A (SV2A) ligand |
| US legal status | Schedule V, prescription only |
| Approved uses | Partial-onset seizures, age 1 month and older |
| Forms | Tablets, oral solution, injection |
| Half-life | About 9 hours |
How long does brivaracetam last?
- Starts working: Peak levels in about 1 hour
- Effects last: Twice-daily dosing
- Half-life: About 9 hours
Timing varies with the dose, the form, how it is taken, liver and kidney function, age, and other drugs taken at the same time.
What are the biggest risks of brivaracetam?
Common side effects include sleepiness, dizziness, tiredness, and nausea.
Psychiatric effects: irritability, anxiety, aggression, and, rarely, psychosis.
Mood: like all antiseizure medicines, it carries a warning about a small increase in suicidal thoughts and behavior. Report new or worsening depression, anxiety, or agitation.
What should you never mix with brivaracetam?
| Combined with | What happens | Label guidance |
|---|---|---|
| Rifampin | Lower brivaracetam levels | Increase dose |
| Carbamazepine | Higher carbamazepine-epoxide levels | Monitor |
| Levetiracetam | No added benefit | Not usually combined |
| Alcohol and sedatives | More drowsiness | Use caution |
Check any combination with the DoseUses combination checker or ask a pharmacist.
What are the signs of a brivaracetam overdose, and what should you do?
Limited data. Overdose is expected to cause drowsiness, dizziness, and unsteadiness.
If someone may have overdosed
- Call 911 if the person is unresponsive, hard to wake, or breathing slowly.
- For advice when the person is awake and stable, call Poison Help at 1-800-222-1222 (US, free, 24 hours).
- If opioids could be involved, including pills not from a pharmacy, give naloxone if you have it. Naloxone does not reverse brivaracetam, but it will not harm the person.
- Stay with the person and place them on their side if they are drowsy or vomiting.
What happens if you stop brivaracetam suddenly?
Brivaracetam has low misuse potential, which is why it is in Schedule V. The main danger of stopping suddenly is not withdrawal but a rise in seizures.
- DaysSeizure riskSeizures can return or become more frequent, including prolonged seizures.
- TaperGradual reductionThe label advises tapering over at least a week or longer.
- OngoingReassessChanges in seizure medicines should be planned with a neurologist.
See the withdrawal timelines and the full brivaracetam withdrawal guide.
Is brivaracetam legal?
In the United States, brivaracetam is a Schedule V controlled substance. The only legal way to get it is with a prescription from a clinician registered with the Drug Enforcement Administration (DEA), filled by a licensed pharmacy. Depending on state law, that can be a physician, nurse practitioner, or physician assistant.
- Refills: Schedule V prescriptions can be refilled as the prescriber authorizes, subject to state law.
- Telehealth: federal flexibilities let DEA-registered clinicians prescribe Schedule II to V medicines after a telemedicine visit, without a prior in-person exam, through December 31, 2026. A permanent DEA rule was under final review in late 2026. State rules can be stricter.
- Monitoring: prescribers and pharmacists in most states check a prescription drug monitoring program, a database of controlled-substance prescriptions, before prescribing or dispensing.
Outside the United States
| Country | Status |
|---|---|
| United Kingdom | Prescription-only medicine; not controlled |
| European Union | Prescription only |
| International | Not under UN control |
Frequently asked questions about brivaracetam
Is brivaracetam the same as Keppra?
No, but it is closely related to levetiracetam (Keppra) and acts on the same target.
Why is Briviact a controlled substance?
Studies found a small potential for euphoria at high doses, so it is in Schedule V.
Can brivaracetam cause anger or mood changes?
Yes, irritability and aggression are possible; report them to the prescriber.
How fast does brivaracetam work?
It reaches the brain quickly, within minutes when given intravenously.
Can you stop Briviact suddenly?
No. It should be tapered to avoid seizures.
Sources
- Briviact (brivaracetam) prescription information, DailyMed, US National Library of Medicine.
- Controlled Substance Schedules, DEA Diversion Control Division.
- Prescribing controlled substances via telehealth, US Department of Health and Human Services.
- BeSafeRx: Your Source for Online Pharmacy Information, US Food and Drug Administration.
- Safe Pharmacy, National Association of Boards of Pharmacy.
- One Pill Can Kill, US Drug Enforcement Administration.
- International drug control conventions, United Nations Office on Drugs and Crime.
This guide summarizes the sourced DoseUses Brivaracetam profile, written from FDA labels, DEA rules, and federal health agencies. It is educational and is not medical advice. Last updated October 5, 2026.
