Perampanel
(Date: September 2023. Version: 1.0)
This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.
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.
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.
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.
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.
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 allows women with a current or previous pregnancy to create a digitally secure ‘my bumps record’. You will be asked to enter information about your health, whether or not you take any medicines, and your pregnancy outcome. 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 www.medicinesinpregnancy.org/Login to register.
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General information
Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks. They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.
Medicines use in pregnancy
Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby. There are, however, some medicines that can harm a baby’s normal development. How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.
If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.
When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.
Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.
www.medicinesinpregnancy.org