Pregnancy & Fertility
Pregnancy
There are limited amounts of data (less than 300 pregnancy outcomes) from the use of perampanel in pregnant women. Studies in animals did not indicate any teratogenic effects in rats or rabbits, but embryotoxicity was observed in rats at maternally toxic doses. Perampanel is not recommended during pregnancy.
Fertility
In the fertility study in rats, prolonged and irregular oestrous cycles were observed at high-dose (30 mg/kg) in females; however, these changes did not affect the fertility and early embryonic development. There were no effects on male fertility. The effect of perampanel on human fertility has not been established.
Women of childbearing potential and contraception in males and females
Perampanel is not recommended in women of childbearing potential not using contraception unless clearly necessary. Perampanel may decrease the effectiveness of progestative‑containing hormonal contraceptives. An additional non‑hormonal form of contraception is, therefore recommended.
Lactation
Studies in lactating rats have shown excretion of perampanel and/or its metabolites in milk (for details see 5.3). It is not known whether perampanel is excreted in human milk. A risk to the newborns/infants cannot be excluded. A decision must be made whether to discontinue breast-feeding or to discontinue/abstain from perampanel therapy taking into account the benefit of breast-feeding for the child and the benefit of therapy for the woman.