Fycompa (perampanel)
An approved treatment for Focal Epilepsy.
The same compound appears under different names depending on the context. Here is how to identify Perampanel wherever you encounter it, plus the key facts at a glance.
- Generic name
- Perampanel
- Brand name
- Fycompa
- Development code
- E2007
- Drug class
- AMPA receptor antagonist (antiseizure medication)
- Manufacturer
- Catalyst Pharmaceuticals
- How it's taken
- Taken by mouth once daily at bedtime, which helps limit daytime dizziness and drowsiness.
A once-daily seizure medication with a mechanism no other approved drug shares: it blocks the AMPA receptor, a key docking site for the brain's main excitatory chemical. That makes it a useful option when other drugs fail, though it carries a warning about serious mood and behavior effects.
Where Perampanel fits
A once-daily bedtime option for focal seizures, used alone or as an add-on, with a distinct AMPA mechanism, valuable when other drugs have not worked, but it carries a boxed warning for serious behavioral and psychiatric reactions, so it is dosed carefully and monitored.
How Perampanel works
Glutamate is the brain's main 'go' signal, and it delivers that signal by landing on receptors, including one called the AMPA receptor, on the receiving nerve cell. In a seizure, this excitatory signaling runs out of control. Perampanel sits on the AMPA receptor and dials down its response to glutamate, reducing the over-excitation that spreads a seizure.
No other approved seizure drug works primarily this way, which is why perampanel can help when sodium-channel and SV2A drugs have failed. The trade-off is that broadly reducing excitatory tone can affect mood and behavior in some people[2].
Mechanism: Selective non-competitive antagonist of the AMPA glutamate receptor, reducing excitatory signaling that drives seizures
Side effects and safety
Perampanel carries a boxed warning, the FDA's strongest, for serious psychiatric and behavioral reactions, including irritability, aggression, anger, anxiety, and, rarely, hostile or homicidal thoughts. These are more likely at higher doses or when the dose is raised quickly, and patients and families should watch for and report mood or behavior changes. Like other seizure medicines, perampanel can raise the risk of suicidal thoughts or actions, so new or worse depression or thoughts of self-harm should be reported right away. The label also warns about DRESS, a serious allergic reaction that can be life-threatening and can affect the skin, blood and organs such as the liver, and about more frequent seizures if it is stopped suddenly.
More routine side effects include dizziness, sleepiness, fatigue, unsteadiness, falls, and weight gain. Taking the dose at bedtime helps manage the dizziness and drowsiness[1].
This is not a complete list of side effects. Talk to your doctor or pharmacist about what to expect and when to seek medical attention.
Taking Perampanel
Taken by mouth once daily at bedtime, which helps limit daytime dizziness and drowsiness. The dose is increased slowly, usually no faster than every one to two weeks, because side effects are dose-related. Perampanel is a Schedule III controlled substance in the U.S.[1].
Availability and cost
Generic versions may be available at a lower cost. Ask your pharmacist.
Help paying for Fycompa
Pick your insurance to see which help fits. Drugmaker copay cards can't be used with Medicare, Medicaid or TRICARE; charity funds are the usual route there.
- Copay help
Eligible commercially insured patients may pay as little as $5; program pays up to $2,500 per year.
For: private insurance · source - Other support
Cash-paying patients may get up to $60 off per prescription, up to $720 per year.
For: no insurance · source - Free medicine program
Patient assistance for uninsured US residents who meet income criteria; financial documents required. Anyone with commercial or government coverage is not eligible.
For: no insurance · source
Good to know: US rights to FYCOMPA are now held by Catalyst Pharmaceuticals (not Eisai); program pages and forms are Catalyst's. Savings card excludes Medicare, Medicaid, Medigap, VA, DoD and TRICARE. PAP phone on the official enrollment form: 1-888-392-6674 (fax 1-844-633-8444). The form states enrollment valid through Dec 31, 2025, so the form may be out of date. Generic perampanel is available; these programs cover brand FYCOMPA.
- From a charity · The Assistance FundEpilepsy fundWaitlist
Pays for: Copays, coinsurance, deductibles and other health-related expenses.
The foundation says: “WAITLIST — Accepting Waitlist Patients. TAF is currently accepting requests to join the enrollment waitlist for this program. Waitlists a…”
Clinical trial results
The FDA approved perampanel in October 2012 as an add-on treatment for focal (partial-onset) seizures in patients 12 and older, based on placebo-controlled trials showing significant seizure reduction. It was later approved as monotherapy for focal seizures and as add-on therapy for primary generalized tonic-clonic seizures[1]. Today the label covers focal seizures in people 4 years and older, alone or as an add-on, and add-on treatment of primary generalized tonic-clonic seizures in people 12 and older.
Development history
Perampanel was discovered and developed by the Japanese company Eisai and launched as Fycompa in 2012, notable as the first-in-class selective AMPA receptor antagonist for epilepsy. Generic versions have since become available. Its unique mechanism keeps it in use for treatment-resistant seizures despite the behavioral cautions[2].
Explore Focal Epilepsy trials
Other Focal Epilepsy treatments
Common questions about Perampanel
▸What is Perampanel (Fycompa)?
A once-daily seizure medication with a mechanism no other approved drug shares: it blocks the AMPA receptor, a key docking site for the brain's main excitatory chemical. That makes it a useful option when other drugs fail, though it carries a warning about serious mood and behavior effects.
▸How does Perampanel work?
Glutamate is the brain's main 'go' signal, and it delivers that signal by landing on receptors, including one called the AMPA receptor, on the receiving nerve cell. In a seizure, this excitatory signaling runs out of control. Perampanel sits on the AMPA receptor and dials down its response to glutamate, reducing the over-excitation that spreads a seizure.
No other approved seizure drug works primarily this way, which is why perampanel can help when sodium-channel and SV2A drugs have failed. The trade-off is that broadly reducing excitatory tone can affect mood and behavior in some people[2].
▸What are the side effects of Perampanel?
Perampanel carries a boxed warning, the FDA's strongest, for serious psychiatric and behavioral reactions, including irritability, aggression, anger, anxiety, and, rarely, hostile or homicidal thoughts. These are more likely at higher doses or when the dose is raised quickly, and patients and families should watch for and report mood or behavior changes. Like other seizure medicines, perampanel can raise the risk of suicidal thoughts or actions, so new or worse depression or thoughts of self-harm should be reported right away. The label also warns about DRESS, a serious allergic reaction that can be life-threatening and can affect the skin, blood and organs such as the liver, and about more frequent seizures if it is stopped suddenly.
More routine side effects include dizziness, sleepiness, fatigue, unsteadiness, falls, and weight gain. Taking the dose at bedtime helps manage the dizziness and drowsiness[1].
▸How is Perampanel taken?
Taken by mouth once daily at bedtime, which helps limit daytime dizziness and drowsiness. The dose is increased slowly, usually no faster than every one to two weeks, because side effects are dose-related. Perampanel is a Schedule III controlled substance in the U.S.[1].
▸Is Perampanel FDA approved?
Yes, Perampanel (Fycompa) is FDA approved (2012) for the treatment of Focal Epilepsy.
▸What is perampanel (Fycompa) used for?
The FDA approved perampanel (Fycompa) in October 2012 as an add-on treatment for focal (partial-onset) seizures in patients 12 and older, based on placebo-controlled trials showing significant seizure reduction. Today the label covers focal seizures in people 4 years and older, alone or as an add-on, and add-on treatment of primary generalized tonic-clonic seizures in people 12 and older. Its unique mechanism keeps perampanel in use for treatment-resistant seizures, and generic versions are available. [1][2]
▸How does perampanel work?
Perampanel sits on the AMPA receptor, a key docking site for glutamate, the brain's main excitatory chemical, and dials down its response so the over-excitation that spreads a seizure is reduced. No other approved seizure drug works primarily this way, which is why perampanel can help when sodium-channel and SV2A drugs have failed. The trade-off is that broadly reducing excitatory tone can affect mood and behavior in some people. [2]
▸What are the side effects of perampanel?
Perampanel carries a boxed warning, the FDA's strongest, for serious psychiatric and behavioral reactions, including irritability, aggression, anger, anxiety and, rarely, hostile or homicidal thoughts; these are more likely at higher doses or when the dose is raised quickly. Like other seizure medicines, it can raise the risk of suicidal thoughts or actions, and the label also warns about DRESS, a serious allergic reaction, and about more frequent seizures if it is stopped suddenly. More routine side effects include dizziness, sleepiness, fatigue, unsteadiness, falls and weight gain, and taking the dose at bedtime helps manage the dizziness and drowsiness. [1]
▸How is perampanel taken?
Perampanel is taken by mouth once daily at bedtime, which helps limit daytime dizziness and drowsiness. The dose is increased slowly, usually no faster than every 1 to 2 weeks, because its side effects are dose-related. Perampanel is a Schedule III controlled substance in the U.S. [1]
Sources and references
Every factual claim on this page is drawn from the public sources listed below. Click any reference to open the original document.
- Eisai Inc.. Eisai Announces FDA Approval of FYCOMPA (perampanel) for the Adjunctive Treatment of Partial-Onset Seizures. https://media-us.eisai.com/2012-10-22-Eisai-Announces-FDA-Approval-of-FYCOMPA-perampanel-for-the-Adjunctive-Treatment-of-Partial-Onset-Seizures-in-Patients-with-Epilepsy-Age-12-and-Older
- PMC. Perampanel (Fycompa): A Review of Clinical Efficacy and Safety in Epilepsy. https://pmc.ncbi.nlm.nih.gov/articles/PMC5083075/