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Hair loss is not established as a common side effect of brivaracetam (Briviact) in the U.S. prescribing information. The FDA has reviewed one report of complete hair loss after treatment began, but the patient also took lamotrigine and had low iron. That single, confounded report cannot show that brivaracetam caused the hair loss or how often it might happen.
What the evidence says about brivaracetam and hair loss
The U.S. BRIVIACT prescribing information identifies somnolence or sedation, dizziness, fatigue, and nausea or vomiting as the most common adverse reactions in adults. Hair loss is not identified among those common reactions in the label. This does not prove that hair loss can never occur, but the available information does not establish it as a common effect.
There is no incidence figure for hair loss attributable to brivaracetam in the reviewed sources. A single postmarketing report cannot be used to calculate a rate.
What the FDA report describes
The FDA’s Brivact Safety Review describes a 16-year-old male with epilepsy who was taking oral brivaracetam 100 mg twice daily and lamotrigine. About two months after brivaracetam was started, alopecia totalis—loss of all scalp and body hair—was reported.
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The report also notes low serum iron and low iron saturation. Iron was supplemented, brivaracetam was continued, and the hair loss had not resolved when described in the review. FDA reviewers noted the timing of the report but also that lamotrigine is itself labeled for alopecia. Because this was one report with other possible explanations, it cannot establish that brivaracetam caused the hair loss.
Hair loss is different from a serious skin reaction
Brivaracetam product information also addresses serious skin reactions, which should not be confused with ordinary hair shedding. The European Medicines Agency’s Briviact product information lists Stevens-Johnson syndrome under skin and subcutaneous tissue disorders at a frequency of “not known.” That warning concerns a serious skin condition; it is not evidence that routine hair loss is a brivaracetam effect.
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What to do if you notice hair loss
- Contact the clinician who prescribes brivaracetam. Explain when the shedding began and whether it has changed, and review other medicines and possible health-related causes.
- Do not stop or change your dose on your own. The brivaracetam tablets prescribing information states: “Brivaracetam should be gradually withdrawn.” Abruptly stopping an antiseizure medicine can increase seizure frequency or lead to status epilepticus.
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