| Manufacturer || Eisai Ltd
| Disease || Epilepsy
| Indication || Partial-onset seizures
| Mode of Action || AMPA receptor antagonist
| Approval Status || EMA approved (EU); FDA approved (USA); PMDA approved (JAP); TGA approved (AUS); HSA approved (SGP)
| CAS Number || 380917-97-5
| HS Code || 30043900
| Strength || 6 mg, 2 mg, 4 mg, 8 mg, 10 mg, 12 mg
Who is perampanel for?
Fycompa (perampanel) is used to treat adults and children from 12 years of age with partial-onset seizures (epileptic fits) with or without secondary generalisation 
Complete information about Fycompa (perampanel) dosage and administration can be found here 
The standard dosage is:
- at the start of treatment 2 mg per day,
- if it is well tolerated it may be progressively increased by increments of 2 mg/day to a maximum dose of 12 mg per day .
Patients should be monitored for signs of suicidal ideation and behaviours and appropriate treatment should be considered 
.Consult your treating doctor for personalised dosing.
What is perampanel and how does it work?
Fycompa (perampanel) is an antiepileptic medicine used to treat adults and children from 12 years of age with partial-onset seizures (epileptic fits) with or without secondary generalisation 
Epilepsy is caused by excessive electrical activity in the brain. Although the precise mechanism by which Fycompa (perampanel) works is not fully understood, it is thought to block the action of the neurotransmitter glutamate. Neurotransmitters are naturally-occurring chemicals in the nervous system that allow nerve cells to communicate with each other. Glutamate is the main stimulatory neurotransmitter in nerve cells which can trigger and maintain seizures. Therefore by blocking glutamate’s actions, Fycompa (perampanel) is thought to stop epileptic seizures from occurring 
What is peramapanel's approval status?
Fycompa (perampanel) was approved by:
- FDA (USA) October 22, 2012 
- EMA (EU) on July 07, 2012 
- TGA (AUS) on May 23, 2014 
- PMDA (JAP) on March 28, 2016 
- HSA (Singapore) on September 2014 
for the treatment of partial-onset seizures in adults and children older than 12 years of age.
The approvals were based on several studies that have shown Fycompa (perampanel) to be more effective than placebo in reducing the frequency of epileptic seizures 
. In one study, the percentage of patients who experienced a decrease in seizure frequency of at least 50% was 37.6 % for patients taking 8 mg Fycompa (perampanel) and 36.1 % for patients taking 12 mg Fycompa (perampanel), compared with 26.4 % of patients taking placebo. In another study, 33.3 % and 33.9 % of patients taking 8 mg and 12 mg Fycompa (perampanel) respectively showed a decrease in seizure frequency of at least 50 %, compared with 14.7 % of patients taking placebo. A third study showed a significant decrease in seizure frequency only in patients taking 4 mg and 8 mg Fycompa but not in patients taking a dose of 2 mg 
For patients with primary generalised tonic-clonic seizures, a type of generalized seizure that affects the entire brain, Fycompa (perampanel) was also more effective than placebo: 58 % of the patients given Fycompa (perampanel) had at least a 50 % reduction in frequency of seizures, compared with 36 % of those given the dummy treatment. Supportive evidence from patients treated for up to 2 years suggested that the benefit was maintained with longer treatment and that some patients could benefit from doses up to 12 mg 
The most common side effects are dizziness and somnolence (sleepiness).
EMA. Human Medicines: Fycompa (perampanel), 7/08/2012 (last update: 29/09/2016), cited on 13/02/2017. http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/medicines/002434/human_med_001572.jsp&mid=WC0b01ac058001d124
Summary of Product Characteristics: Fycoma (perampanel), Eisai, FDA, Mar. 2016. https://www.fycompa.com/sites/all/themes/fycompa/pdf/fycompa_prescribing_information.pdf
Summary of Product Characteristics: Fycoma (perampanel), Eisai Europe Ltd., EMA, May 2017. http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/002434/WC500130815.pdf
Summary of Product Characteristics: Fycoma (perampanel), Eisai Australia Ltd., TGA, May 2016. https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2014-PI-02011-1&d=2017021316114622483
FDA News Release: FDA approves Fycompa to treat seizures, 22/10/2012. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm325038.htm
PMDA. New drugs approved in 2015. Page 3. http://ss.pmda.go.jp/en_all/muv_ajax.x?u=http%3A%2F%2Fwww.pmda.go.jp%2Ffiles%2F000213411.pdf%23page%3D3&p=3&t=&q=fycompa&s=jVxiwjtRQbu3kZsU-0z4UGnx5m56cjfp3NRnOl7tdNESUBPUMP1Od-2SPxc1wnSjSIZf5Fhtuhm6GjQD6_ueUu7EB0KxSmNdQtDnFkzwLHX40YxdzvH2McD0NVrhwbTQJRdEXn1vhw8rq6DG6ETGW-2jSn7ri1J4i_X3xtqfoeo.&lang=en
HSA. New drugs approvals: September 2014. http://www.hsa.gov.sg/content/hsa/en/Health_Products_Regulation/Western_Medicines/New_Drug_Approvals/2014/September.html