Levetiracetam

Levetiracetam is a prescription medication used to treat certain seizures in children and adults with epilepsy. Levetiracetam belongs to a group of drugs called anticonvulsants, which may work by decreasing abnormal excitement in the brain.

Levetiracetam comes in tablet, extended-release tablet, and liquid forms. It is usually taken once or twice a day, with or without food, depending on which form you are taking. The extended-release tablets are usually taken once a day. Swallow levetiracetam tablets whole

Levetiracetam is also available in injectable form to be given directly into a vein (IV) by a healthcare professional.

Common side effects of levetiracetam include drowsiness, weakness, and dizziness. Do not drive or operate heavy machinery until you know how levetiracetam affects you.

Levetiracetam is a prescription medicine taken by mouth that is used with other medicines to treat:

• partial onset seizures
• myoclonic seizures in people with juvenile myoclonic epilepsy
• primary generalized tonic-clonic seizures with certain types of generalized epilepsy

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Levetiracetam may be found in some form under the following brand names:

• Elepsia XR

• Keppra

• Spritam

The most common side effects seen in people who take levetiracetam include:

• sleepiness
• weakness
• dizziness
• infection

The most common side effects seen in children who take levetiracetam include, in addition to those listed above:

• accidental injury
• irritability
• hostility

These side effects can happen at any time but happen more often within the first 4 weeks of treatment except for infection.

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

No levetiracetam drug interactions have been identified. However, you should tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Not all drug interactions are known or reported and new drug interactions are continually being reported.

Like other antiepileptic drugs, levetiracetam may cause suicidal thoughts or actions in a very small number of people, about 1 in 500 people taking it.

Call your doctor right away if you have any of these symptoms, especially if they are new, worse, or worry you:

• thoughts about suicide or dying
• attempts to commit suicide
• new or worse depression
• new or worse anxiety
• feeling agitated or restless
• panic attacks
• trouble sleeping (insomnia)
• new or worse irritability
• acting aggressive, being angry, or violent
• acting on dangerous impulses
• an extreme increase in activity and talking (mania)
• other unusual changes in behavior or mood

How can I watch for early symptoms of suicidal thoughts and actions?

• Pay attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings.
• Keep all follow-up visits with your healthcare provider as scheduled.
• Call your doctor between visits as needed, especially if you are worried about symptoms.

Do not stop levetiracetam without first talking to your doctor.

• Stopping levetiracetam suddenly can cause serious problems. Stopping a seizure medicine suddenly can cause seizures that will not stop (status epilepticus).
• Suicidal thoughts or actions can be caused by things other than medicines. If you have suicidal thoughts or actions, your healthcare provider may check for other causes.

Call your healthcare provider right away if you have any of these symptoms:

• mood and behavior changes such as aggression, agitation, anger, anxiety, apathy, mood swings, depression, hostility, and irritability. A few people may get psychotic symptoms such as hallucinations (seeing or hearing things that are really not there), delusions (false or strange thoughts or beliefs) and unusual behavior.
• extreme sleepiness, tiredness, and weakness
• problems with muscle coordination (problems walking and moving)
• a skin rash. Serious skin rashes can happen after you start taking levetiracetam. There is no way to tell if a mild rash will become a serious reaction.

Levetiracetam may make you drowsy or dizzy. Do not drive a car or operate machinery until you know how levetiracetam will affect you.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of levetiracetam there are no specific foods that you must exclude from your diet when receiving levetiracetam.

Before taking levetiracetam, tell your doctor about all of your medical conditions, including if you:

• have or have had depression, mood problems or suicidal thoughts or behavior
• have kidney problems
• are pregnant or planning to become pregnant. It is not known if levetiracetam will harm your unborn baby. 
• are breastfeeding. Levetiracetam can pass into your milk and may harm your baby. 

Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. Do not start a new medicine without first talking with your doctor.

Know the medicines you take. Keep a list of them to show your doctor and pharmacist each time you get a new medicine.

Tell your doctor if you are pregnant or planning to become pregnant. 

It is not known if levetiracetam will harm your unborn baby. You and your doctor will have to decide if you should take levetiracetam while you are pregnant. If you become pregnant while taking levetiracetam, talk to your doctor about registering with the North American Antiepileptic Drug Pregnancy Registry. You can enroll in this registry by calling 1-888-233-2334. You can also enroll in the UCB AED Pregnancy Registry by calling 1-888-537-7734. The purpose of these registries is to collect information about the safety of levetiracetam and other antiepileptic medicine during pregnancy.

Tell your doctor if you are breastfeeding or planning to breastfeed. Levetiracetam can pass into your milk and may harm your baby. You and your healthcare provider should discuss whether you should take levetiracetam or breast-feed; you should not do both.

Take levetiracetam exactly as prescribed.

• Your doctor will tell you how much levetiracetam to take and when to take it.
• Levetiracetam tablets and solution is usually taken twice a day.
• Levetiracetam extended release tablets are taken once a day.
• Take levetiracetam at the same times each day.
• Your doctor may change your dose. Do not change your dose without talking to your doctor.
• Take levetiracetam with or without food.
• Ask your doctor for levetiracetam oral solution if you cannot swallow tablets.
• If your doctor has prescribed levetiracetam oral solution, be sure to ask your pharmacist for a medicine dropper or medicine cup to help you measure the correct amount of levetiracetam oral solution. Do not use a household teaspoon. Ask your pharmacist for instructions on how to use the measuring device the right way.
• Levetiracetam is also available in injectable form to be given directly into a vein (IV) by a healthcare professional.
• If you miss a dose of levetiracetam, take it as soon as you remember. If it is almost time for your next dose, just skip the missed dose. Take the next dose at your regular time. Do not take two doses at the same time.

Take levetiracetam exactly as prescribed by your doctor. Follow the directions on your prescription label carefully. Your doctor will determine the best dose for you.

The injectable form of levetiracetam is for adult use only.

Levetiracetam regular release tablets and solution

The recommended dose range of levetiracetam for the treatment of partial onset seizures in adults is 1000 to 3000 mg, equally divided into 2 doses per day.

The recommended dose range of levetiracetam for the treatment of partial onset seizures ages 1 month to less than 6 months old is 4 mg/kg in two divided doses (7 mg/kg twice daily) to 42 mg/kg (21 mg/kg twice daily).

The recommended dose range of levetiracetam for the treatment of partial onset seizures ages 6 months to less than 4 years old is 20 mg/kg in two divided doses (10 mg/kg twice daily) to 50 mg/kg (25 mg/kg twice daily).

The recommended dose range of levetiracetam for the treatment of partial onset seizures ages 4 years old to less than 16 years old is 20 mg/kg in two divided doses (10 mg/kg twice daily) to 60 mg/kg (30 mg/kg twice daily).

The levetiracetam tablet dose range for partial onset seizures in children weighing 20 to 40 kg is 500 mg given as twice daily dosing (250 mg twice daily) to 1500 mg (750 mg twice daily).

For levetiracetam tablet dosing for partial onset seizures in children weighing more than 40 kg, treatment should be started with 1000 mg/day given as twice daily dosing (500 mg twice daily) to 3000 mg (1500 mg twice daily).

The recommended dose range of levetiracetam for the treatment of myoclonic seizures in those with juvenile myoclonic epilepsy in adults (ages 12 years old and older) is 1000 to 3000 mg, equally divided into 2 doses per day.

The recommended dose range of levetiracetam for the treatment of primary generalized tonic-clonic seizures in adults (ages 16 years old and older) is 1000 to 3000 mg, equally divided into 2 doses per day.

The recommended dose range of levetiracetam for the treatment of primary generalized tonic-clonic seizures in children ages 6 to less than 16 years old is 20 mg/kg in two divided doses (10 mg/kg twice daily) to 60 mg/kg (30 mg/kg twice daily).

Levetiracetam extended release tablets

The recommended starting dose of levetiracetam extended release tablets, for the treatment of partial onset seizures in patients ≥ 12 years of age with epilepsy, is 1000 mg once daily. The dosage may be adjusted in increments of 1000 mg every 2 weeks, to a maximum recommended dose of 3000 mg once daily.

Dose changes may be made depending on degree of kidney dysfunction.

If you take too much levetiracetam (more than the prescribed amount), call your local Poison Control Center or seek emergency medical attention right away.

• Store levetiracetam at room temperature, 59°F to 86°F (15°C to 30°C) away from heat and light.
• Keep levetiracetam and all medicines out of the reach of children.