[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Antiseizure medicines](https://durgical.com/en/pharmacology/classes/antiseizure-medicines/) › Brivaracetam

# Brivaracetam

## Antiseizure medicines?

Antiseizure medicines

A newer relative of levetiracetam that binds the synaptic vesicle protein SV2A more strongly. It treats focal seizures.

Updated Nov 1, 2026

## Quick facts

**Group**
[Antiseizure medicines](https://durgical.com/en/pharmacology/classes/antiseizure-medicines/)

**Target**
Synaptic vesicle glycoprotein 2A (SV2A)

**Used for**
Partial-onset

**Key effects**
Drowsiness · Extreme tiredness · Nausea

**Monitor**
Seizure diary · Mood · Liver disease

**ATC**
N03AX23

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

◆**Synaptic vesicle glycoprotein 2A (SV2A)**Brivaracetam

ⓘ The figure shows brivaracetam bound to human SV2A, a membrane protein of synaptic vesicles.

**Target in 3D:** Synaptic vesicle glycoprotein 2A (SV2A). PDB structure 8YF1 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/8YF1) · Drag to rotate · pinch to zoom

Brivaracetam is an analogue of levetiracetam and a high-affinity, selective ligand of SV2A, a protein of the synaptic vesicles that take part in neurotransmitter release. Binding SV2A is thought to modify vesicle function and reduce excessive release during a seizure. It also has some inhibitory effect on neuronal voltage-gated sodium channels.

- Brivaracetam binds SV2A with high affinity
- Synaptic vesicle release is modulated
- Excessive neuronal firing is damped
- Fewer focal seizures

## Indications

- Partial-onset (focal) seizures [Epilepsy and seizures →](https://durgical.com/en/conditions/epilepsy-and-seizures/)

## Adverse effects

### Common

- Drowsiness, sedation and dizziness
- Extreme tiredness
- Nausea, vomiting and constipation
- Blurred vision and poor balance

### Serious (rare, important)

- Hypersensitivity: swelling of the face or throat, difficulty breathing
- Rash, blistering or peeling skin, mouth sores
- Psychiatric symptoms: hallucinations, delusions, irritability, aggression
- Suicidal thoughts or behaviour

## Contraindications

- Allergy to brivaracetam or any component of the product

## Key interactions

**Alcohol**
Brivaracetam makes the effects of alcohol worse

**Other sedatives**
More drowsiness and poorer coordination

## What is monitored

- Seizure diary
- Mood, behaviour and suicidal thoughts
- Liver disease (the dose may need adjusting)

## Administration and safety

- Tablets swallowed whole with liquid; not split, chewed or crushed
- The liquid is measured with the device supplied, not a kitchen spoon
- It can be habit-forming: it is used only as prescribed
- It is tapered rather than stopped suddenly

## Pregnancy and breastfeeding

Its safety in pregnancy is not well established; pregnancy is discussed with the treating team, who weighs the risk of uncontrolled seizures.

## Nursing care

- Ask about depression, past substance use and liver disease before starting
- Assess drowsiness and fall risk
- Teach the family to report mood or behaviour changes
- Check the skin and mouth for rash or sores

## Pharmacokinetics

**Absorption**
Rapidly absorbed by mouth; also available as a liquid and an injection

**Half-life**
Short; usually given twice a day

## Memory aid

«BRIVaracetam = BRIEF name, STRONGER grip»: the same SV2A target as levetiracetam, held more tightly.

## Test yourself

Think of the answer, then tap the question to see it.

## What is the molecular target of brivaracetam?

The synaptic vesicle glycoprotein SV2A.

## Which older antiseizure medicine is brivaracetam an analogue of?

Levetiracetam.

## Which kind of seizures is brivaracetam approved for?

Partial-onset (focal) seizures.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/brivaracetam/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 3

- [Levetiracetam](https://durgical.com/en/pharmacology/levetiracetam/)
- [Lacosamide](https://durgical.com/en/pharmacology/lacosamide/)
- [Lamotrigine](https://durgical.com/en/pharmacology/lamotrigine/)

## Related conditions 1

- [Epilepsy and seizures](https://durgical.com/en/conditions/epilepsy-and-seizures/)

[← Back to the class: Antiseizure medicines](https://durgical.com/en/pharmacology/classes/antiseizure-medicines/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Brivaracetam: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a616027.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=N03AX23) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); [RCSB PDB - 8YF1: Cryo-EM structure of human SV2A in complex with Brivaracetam](https://www.rcsb.org/structure/8YF1) (RCSB Protein Data Bank, 2026).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/pharmacology/brivaracetam/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/brivaracetam/