Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: levetiracetam
BRAND NAME: Keppra, Keppra XR
DRUG CLASS AND MECHANISM: Levetiracetam is an antiseizure
(antiepileptic) drug. Its mechanism of action is unknown, but it inhibits the
spread of seizure activity in the brain. In studies, addition of levetiracetam
to other antiseizure drugs reduced the frequency of
seizures more than placebo.
The FDA approved levetiracetam in November 1999.
GENERIC AVAILABLE: Yes
PRESCRIPTION: Yes
PREPARATIONS: Tablets
(immediate release): 250, 500, 750 and 1000 mg. Tablets
(extended release): 500 and 750 mg. Oral solution: 100 mg/ml. Injection solution: 100 mg/ml.
STORAGE: Levetiracetam should be stored at 25 C (77 F). Brief storage at
15-30 C (59-86 F) is acceptable.
PRESCRIBED FOR: Levetiracetam is used in combination with other
antiseizure medications to treat myoclonic, partial onset, or tonic clonic
seizures in children and adults.
DOSING: The recommended daily dose of levetiracetam in adults is 3000
mg. Therapy is initiated with 1000 mg daily (500 mg twice daily) and increased
by 1000 mg/day every two weeks up to the maximum recommended dose of 3000
mg/day. Immediate release tablets, oral solution, and intravenous solutions are
administered twice daily, and extended release tablets are administered once
daily. The recommended daily dose for children is 60 mg/kg (30 mg/kg twice
daily). Therapy is initiated with 20 mg/kg (10 mg/kg twice daily) and increased
by 20 mg/kg every two weeks until the recommended daily dose of 60 mg/kg is
reached.
DRUG INTERACTIONS: Probenecid
(Benemid) reduces the elimination of levetiracetam
by the kidneys, potentially doubling the concentration of levetiracetam in the
body. This could lead to side effects from probenecid.
PREGNANCY: Levetiracetam has not been adequately studied in pregnant
women. Levetiracetam is used during
pregnancy only if the benefit justifies the
potential risk to the fetus.
NURSING MOTHERS: Levetiracetam is excreted in breast milk. To avoid
potential serious side effects in infants who are
breastfeeding mothers should
consider not breast-feeding while taking levetiracetam.
SIDE EFFECTS: Common side effects associated with levetiracetam
include headache, sleepiness, weakness, dizziness, and infection. Difficulty
walking or moving, hostility, irritability, mood swings, anxiety,
hallucinations, and delusions also have been associated with
levetiracetam. A small number of patients may experience a decrease in red or
white blood cell counts. Like other antiseizure medications, levetiracetam
should not be discontinued suddenly because of the risk of increased seizure
activity.
Antiepileptic medications have been associated
with increased risk of suicidal thinking and behavior. Anyone
considering the use of antiepileptic drugs must balance this risk of suicide with the clinical need. Patients who are
started on therapy should be closely observed for clinical worsening, suicidal
thoughts, or unusual changes in behavior.
Last Editorial Review: 12/10/2008
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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