Fycompa
Drug - Fycompa™ (perampanel) [Eisai Inc]
August 2017
Therapeutic area - Antiepileptic
Approval criteria
- Patient is 12 years of age or older AND
- Patient has a diagnosis of partial-onset seizures OR
- Patient has a diagnosis of generalized tonic-clonic seizures AND
- Patient has tried and failed THREE or more anti-epileptic drugs which include: gabapentin, lamotrigine, levetiracetam, ethosuximide, oxcarbazepine, topiramate or carbamazepine OR
- Prescriber is a neurologist and patient has tried and failed at least TWO anti-epileptic drugs which include: gabapentin, lamotrigine, levetiracetam, ethosuximide, oxcarbazepine, topiramate or carbamazepine
Quantity limits
- Tablets (all strengths): 34 tablets per 34 days (all strengths)
- Oral suspension (0.5 mg/mL): 840 mL per 34 days
Background information
FYCOMPA (perampanel) is indicated for the treatment of partial-onset seizures with or without secondarily generalized seizures in patients with epilepsy 12 years of age and older or adjunctive therapy for the treatment of primary generalized tonic-clonic seizures in patients with epilepsy aged 12 years and older. Patients taking FYCOMPA should be monitored for changes in mood, behavior or personality that are atypical for the patient.
Questions?
MHCP Provider Call Center 651-431-2700 or 800-366-5411
