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Perampanel, marketed as Fycompa, is associated with several important safety considerations and warnings that should be reviewed carefully. If you or those around you observe any changes in your behavior or mood, seek medical advice promptly.

• Mental and Mood Changes: Perampanel can potentially exacerbate or induce mood and mental disorders. Symptoms may include aggression, irritability, anxiety, paranoia, hallucinations, delusions, and thoughts of harming others. These changes are particularly concerning when starting the medication or altering the dosage. Be vigilant for these symptoms even after discontinuation of the drug. Alcohol consumption can heighten these effects and should be avoided.

• Suicidal Thoughts and Behavior: There is an increased risk of suicidal thoughts or actions when using this medication, which can manifest within a week of starting treatment. If you or someone you know experiences worsening depression or unusual behavioral changes such as anxiety, panic attacks, or restlessness, seek immediate medical attention. The risk is heightened if taking other anti-seizure drugs.

• Cognitive and Motor Impairment: Perampanel may cause significant dizziness, sleepiness, and concentration difficulties, raising the risk of falls. These effects may be amplified when combined with other sedative medications like benzodiazepines or muscle relaxants, or with alcohol, particularly in individuals over 65. Ensure you understand how the drug affects you before engaging in activities that require mental alertness.

• Severe Allergic and Skin Reactions: Life-threatening allergic reactions, such as facial swelling or anaphylaxis, and severe skin reactions like DRESS, are possible. Discontinue use and seek emergency medical care if you experience facial swelling, difficulty breathing, or significant skin changes (e.g., rash, blisters).

• Seizure Risk and Withdrawal: Abrupt cessation of perampanel can lead to increased seizure activity and withdrawal symptoms such as anxiety and insomnia. It is crucial to consult your healthcare provider before changing your dose to ensure a gradual reduction.

Please consult your healthcare provider for further guidance and to address any concerns related to the use of perampanel.

When taking this medication, you might encounter some common side effects, which are generally mild. These include dizziness, sleepiness, headaches, irritability, tiredness, nausea or vomiting, and difficulty with movement or coordination. If these symptoms persist or worsen, it is advisable to consult your healthcare provider for guidance.

Other side effects that some individuals may experience include muscle, joint, or back pain, constipation, weight gain, upper respiratory tract infections, numbness, slurred speech, vision changes, difficulty walking, a spinning sensation, and anxiety. These effects can vary in intensity, so it is important to monitor them and seek medical advice if necessary.

There are also serious side effects associated with this medication, although they are rare. Immediate medical attention is crucial if you experience suicidal thoughts or behavior, or a serious allergic reaction characterized by fever, swollen lymph nodes, rash, itching/swelling (particularly of the face, tongue, or throat), severe dizziness, or trouble breathing. These reactions are significant and should be addressed promptly to ensure your safety.

Perampanel, sold under the brand name Fycompa, can interact with a variety of medications and supplements. It's important to inform your doctor and pharmacist about all medications and supplements you are currently taking, including prescription, over-the-counter, vitamins, and herbal products.

One medication that may interact with perampanel is orlistat. Additionally, drugs such as rifamycins (like rifabutin) and St. John's wort can influence how perampanel is processed in your body, potentially affecting its effectiveness.

Perampanel may also reduce the effectiveness of birth control methods containing levonorgestrel, which could lead to an unintended pregnancy. It is advisable to discuss using reliable non-hormonal backup contraception, such as condoms or a diaphragm with spermicide, with your doctor while taking perampanel and for one month after stopping it. Notify your doctor if you experience unusual spotting or breakthrough bleeding, as these could indicate reduced birth control efficacy.

Furthermore, combining perampanel with substances that cause drowsiness, such as alcohol, marijuana, antihistamines (like cetirizine and diphenhydramine), sleep or anxiety medications (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (like codeine), may enhance these effects. Always check your medication labels for ingredients that may cause drowsiness and consult your pharmacist on safe usage.

In some cases, your doctor might prescribe perampanel together with other medications that typically are not recommended, such as alprazolam, clarithromycin, orphine, among others. If so, they may adjust the dosage or frequency to minimize risks. Always follow your healthcare provider's guidance when managing medication interactions.