levetiracetam (Keppra, Keppra XR, Roweepra, Spritam) Seizure Drug

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical and Pharmacy Editor: Jerry R. Balentine, DO, FACEP
    Jerry R. Balentine, DO, FACEP

    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

What is levetiracetam (Keppra), and how does it work (mechanism of action)?

Levetiracetam (Keppra) 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.

What brand names are available for levetiracetam?

Keppra, Keppra XR, Roweepra, and Spritam are the brand names available for levetiracetam in the US.

Is levetiracetam available as a generic drug?

Yes, it is available in generic form.

Do I need a prescription for this medication?

Yes, you need a prescription from your doctor or other health care professional for this drug.

What are the side effects of levetiracetam?

Common side effects associated with levetiracetam include:

In some patients Keppra causes behavioral abnormalities such as:

Other side effects include:

  • Steven-Johnson syndrome and toxic epidermal necrolysis (severe skin reactions) in children and adults
  • High blood pressure

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.

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What is the dosage, and how do I take levetiracetam?

  • 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.

Which drugs or supplements interact with this drug?

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.

Is this drug safe to take if I'm pregnant or breastfeeding?

  • 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.
  • 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.

What else should I know about this medication?

What preparations of levetiracetam are available?

Tablets (immediate release): 250, 500, 750 and 1000 mg. Tablets (extended release): 500 and 750 mg. Oral solution: 100 mg/ml. Injection solution: 5, 10, 15, and 100 mg/ml.

How should I keep levetiracetam stored?

Levetiracetam should be stored at 25 C (77 F). Brief storage at 15 C to 30 C (59 F to 86 F) is acceptable.

When was levetiracetam approved by the FDA?

The FDA approved levetiracetam in November 1999.

REFERENCE:

FDA Prescribing Information

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Reviewed on 5/10/2017
References
REFERENCE:

FDA Prescribing Information

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