Perampanel is an anticonvulsant that is used to treat partial onset seizures that may or may not develop into general seizures in people with epilepsy who are at least 4 years old.

Perampanel is also used to treat tonic-clonic seizures in people with epilepsy who are at least 12 years old.

Perampanel may also be used for purposes not listed in this medication guide.

Some people taking perampanel have had serious psychotic effects, especially when starting this medicine or changing doses. Stay alert to changes in your mood or symptoms.

Call your doctor right away if you have any changes in mood or behavior changes, personality changes, thoughts about suicide, or thoughts about hurting others. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Perampanel comes as a tablet and as an suspension (liquid) to take by mouth. It is usually taken once a day at bedtime. Take perampanel at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take perampanel exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Shake the suspension well before each use to mix the medication evenly.

Always use the oral (by mouth) dosing syringe that comes with perampanel suspension to prepare and measure your dose. Do not use a household spoon to measure your dose.

Your doctor will probably start you on a low dose of perampanel and gradually increase your dose, not more than once every week.

Perampanel may be habit forming. Do not take a larger dose, take it more often, or take it for a longer period of time than prescribed by your doctor.

Perampanel may help control your condition but does not cure it. Do not stop taking perampanel without talking to your doctor. If you suddenly stop taking perampanel, your seizures may become worse. Your doctor will probably decrease your dose gradually.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Perampanel is usually taken at bedtime. Follow your doctor's dosing instructions very carefully.

Perampanel may be habit-forming. Misuse can cause addiction, overdose, or death. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law.

Shake the oral suspension (liquid) before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

Do not stop using perampanel suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor's instructions about tapering your dose.

Store at room temperature away from moisture and heat. Do not freeze.

Throw away any leftover liquid medicine 90 days after you first opened the bottle.

Keep track of your medicine. You should be aware if anyone is using it improperly or without a prescription.

You should not use perampanel if you are allergic to it.

Tell your doctor if you have ever had:

• depression, a mood disorder, or other mental health problems;

• thoughts of hurting yourself or others;

• liver or kidney disease;

• drug addiction; or

• if you drink alcohol.

Some people taking perampanel have had serious psychotic effects such as anger, aggression, feeling hostile or irritable, and thoughts about hurting others. These effects may be more likely to occur when you first start taking perampanel, or whenever your dose is changed. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Do not start or stop taking seizure medication during pregnancy without your doctor's advice. Having a seizure during pregnancy could harm both mother and baby. Tell your doctor right away if you become pregnant.

Perampanel can make some birth control pills less effective. Ask your doctor about using a non-hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of perampanel on the baby.

It may not be safe to breastfeed while using perampanel. Ask your doctor about any risk.

Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.

Call your doctor for instructions if you miss your perampanel dose for more than one day.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Do not freeze the suspension. Discard any unused suspension 90 days after first opening the bottle.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

Unless your doctor tells you otherwise, continue your normal diet.

Avoid driving or hazardous activity until you know how perampanel will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Drinking alcohol with this medicine can cause side effects.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, fear, panic attacks, trouble sleeping, or if you feel irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself or someone else.

Perampanel may cause serious side effects. Call your doctor at once if you have:

• severe dizziness, spinning sensation, feeling like you might pass out;

• trouble walking, loss of balance or coordination;

• feeling very weak or tired;

• an accidental fall; or

• memory problems, confusion, hallucinations.

Accidental falls may occur more often in elderly patients who take perampanel. Use caution to avoid falling or accidental injury while taking perampanel.

Common side effects of perampanel may include:

• headache, dizziness, drowsiness;

• feeling anxious, tired, or irritable;

• nausea, vomiting, stomach pain;

• bruising;

• weight gain; or

• loss of coordination.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Using perampanel with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Tell your doctor about all your other medicines, especially:

• birth control pills;

• rifampin;

• St. John's wort;

• other seizure medicine--carbamazepine, oxcarbazepine, phenytoin.

This list is not complete. Other drugs may affect perampanel, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Keep all appointments with your doctor.

Do not let anyone else take your medication. Perampanel is a controlled substance. Prescriptions may be refilled only a limited number of times; ask your pharmacist if you have any questions.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.