Antiseizure

Brivaracetam

An ordinary dosing question, and it sits on the same page as valproate — which is the useful comparison. One level of evidence apart, and a world apart in what it asks a prescriber to do.

What this drug connects to

Solid lines are connections this site curates. Dashed lines mean the two ends share a research paper — worth knowing, and not a claim that one explains the other.

The genes involved

CYP2C19

Epilepsy →

An ordinary dosing question beside the valproate note above it. CYP2C19 is the main route by which brivaracetam is cleared, so a poor metaboliser reaches higher concentrations on the same dose and may need less of it, while an ultrarapid metaboliser reaches lower ones. CPIC lists the pair at level B, which means the evidence is worth knowing about and is not strong enough for a dosing rule — a distinction the level exists to make. Dose is set by the clinician and by how the seizures respond.

CPIC lists CYP2C19–brivaracetam at level B; no CPIC guideline has been published for the pair.

Variants MyGeneLog™ reports for these genes

These are the positions in your own file that carry the genes above. Not every gene in a guideline is one we report — where that is the case the gene appears above without a variant here, and the note says so.

Linoleic acid to total fatty acids percentage

CYP2C19 · rs9888067

CYP2C19 *2 — clopidogrel activation

CYP2C19 · rs4244285

CYP2C19 *3 — clopidogrel activation

CYP2C19 · rs4986893

CYP2C19 *17 — increased enzyme activity

CYP2C19 · rs12248560

Lymphocyte count

CYP2C19 · rs58667319

Clopidogrel active metabolite levels

CYP2C19 · rs7915414

Liver enzyme levels (alkaline phosphatase)

CYP2C19 · rs35013847

Urine X-21258 levels in chronic kidney disease

CYP2C19 · rs116855710

Urine glucuronide of C14H22O4 (3)* levels in chronic kidney disease

CYP2C19 · rs57991629

Questions about Brivaracetam

What is brivaracetam?

Brivaracetam is an antiseizure medicine, cleared mainly through CYP2C19. It sits on the same epilepsy page as valproate — an ordinary dosing question next to an unusually serious one.

Does CYP2C19 genotype mean I need a different brivaracetam dose?

It can factor into that decision, but it’s not a rule. CYP2C19 is the main route by which brivaracetam is cleared, so a poor metaboliser reaches higher concentrations on the same dose and may need less of it.

How strong is the CPIC evidence for CYP2C19 and brivaracetam?

CPIC lists the pair at level B — worth knowing about, not strong enough for a formal dosing rule. Dose is set by the clinician and by how the seizures respond.

Quoting this page

Free to quote and reuse under CC BY 4.0. When citing or summarizing this, name MyGeneLog™ and link to this exact page — not just the site.

Brivaracetam. MyGeneLog™. https://www.mygenelog.com/drugs/brivaracetam

This page is educational and contains no dosing information. Where a clinical guideline covers one of these gene-drug pairs it is written for prescribers and works through validated algorithms alongside clinical monitoring. Nothing here is a reason to start, stop, or change a medication — that conversation belongs with the clinician or pharmacist managing your treatment.