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levetiracetam

Pronunciation

Generic Name: levetiracetam (LEE ve tye RA se tam)
Brand Name: Keppra, Keppra XR, Spritam, Roweepra

What is levetiracetam?

Levetiracetam is an anti-epileptic drug, also called an anticonvulsant.

Levetiracetam is used to treat partial onset seizures in adults and children who are at least 4 years old.

Levetiracetam is also used to treat tonic-clonic seizures in adults and children who are at least 6 years old, and myoclonic seizures in adults and children who are at least 12 years old.

Levetiracetam may also be used for purposes not listed in this medication guide.

What is the most important information I should know about levetiracetam?

Some people have thoughts about suicide when first taking this medicine. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

What should I discuss with my healthcare provider before taking levetiracetam?

You should not use levetiracetam if you are allergic to it.

To make sure levetiracetam is safe for you, tell your doctor if you have:

  • kidney disease (or if you are on dialysis);

  • depression or other mood problems;

  • a history of mental illness or psychosis; or

  • a history of suicidal thoughts or actions.

You may have thoughts about suicide while taking this medicine. Tell your doctor if you have symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Do not start or stop taking levetiracetam during pregnancy without your doctor's advice. Having a seizure during pregnancy could harm both mother and baby. Tell your doctor right away if you become pregnant while taking levetiracetam for seizures.

Seizure control is very important during pregnancy. The benefit of preventing seizures may outweigh any risks posed by taking levetiracetam. There may be other seizure medications that can be more safely used during pregnancy. Follow your doctor's instructions about taking this medicine while you are pregnant.

Levetiracetam can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using levetiracetam.

Do not give this medicine to a child without the advice of a doctor. Your child's dose needs are based on age and weight. The child should remain under the care of a doctor while using levetiracetam.

How should I take levetiracetam?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Levetiracetam is usually taken once every 12 to 24 hours. Take the medicine at the same time each day. You may take levetiracetam with or without food.

If a child is using this medicine, tell your doctor if the child has any changes in weight. Levetiracetam doses are based on weight in children, and any changes may affect your child's dose.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

To take the Spritam dissolvable tablet:

  • Keep the tablet in its blister pack until you are ready to take it. Open the package and peel back the foil. Do not push a tablet through the foil or you may damage the tablet.

  • Use dry hands to remove the tablet and place it on your tongue. Then take a sip of liquid and hold it in your mouth.

  • Do not swallow the tablet whole. Allow it to dissolve in your mouth with the sip of liquid.

  • Swallow only after the tablet has completely dissolved, which should take less than 30 seconds.

Use levetiracetam regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Do not stop using levetiracetam suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor's instructions about tapering your dose.

Seizures are often treated with a combination of drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice.

Wear a medical alert tag or carry an ID card stating that you take levetiracetam. Any medical care provider who treats you should know that you take seizure medication.

While using levetiracetam, your kidney function may need to be tested often.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include extreme drowsiness, agitation, aggression, shallow breathing, weakness, or fainting.

What should I avoid while taking levetiracetam?

Avoid drinking alcohol. It can increase some of the side effects of levetiracetam and may also increase the risk of seizures.

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Levetiracetam side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, panic attacks, trouble sleeping, or if you feel agitated, hostile, irritable, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • unusual changes in mood or behavior (unusual risk-taking behavior, being irritable or talkative);

  • confusion, hallucinations, loss of balance or coordination;

  • extreme drowsiness, feeling very weak or tired;

  • bruising, severe tingling, numbness, pain, muscle weakness;

  • problems with walking or movement;

  • the first sign of any skin rash, no matter how mild;

  • severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling; or

  • signs of infection--fever, swollen gums, painful mouth sores, pain when swallowing, skin sores, cold or flu symptoms, cough, trouble breathing.

Common side effects may include:

  • dizziness, drowsiness;

  • feeling tired;

  • weakness;

  • feeling aggressive or irritable;

  • loss of appetite;

  • stuffy nose; or

  • infection.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Levetiracetam dosing information

Usual Adult Dose for Epilepsy:

PARTIAL ONSET SEIZURES:
-IV: 1000 mg daily given as 500 mg 2 times a day: increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. There is no evidence that doses greater than 3000 mg/day confer additional benefit.
-ORAL IMMEDIATE-RELEASE: 1000 mg daily given as 500 mg 2 times a day; increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. There is no evidence that doses greater than 3000 mg/day confer additional benefit.
-ORAL EXTENDED-RELEASE: 1000 mg once a day; increase in increments of 1000 mg every 2 weeks to the maximum daily dose of 3000 mg

MYOCLONIC SEIZURES IN PATIENTS WITH JUVENILE MYOCLONIC EPILEPSY:
-IV: 1000 mg daily given as 500 mg 2 times a day; increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been studied.
-ORAL IMMEDIATE-RELEASE: 1000 mg/day, given as twice daily dosing (500 mg 2 times a day); increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg/day. The effectiveness of doses lower than 3000 mg/day has not been studied.

PRIMARY GENERALIZED TONIC-CLONIC SEIZURES:
IV: 1000 mg daily given as 500 mg 2 times a day; increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been studied.
-ORAL IMMEDIATE-RELEASE: 1000 mg/day, given as twice daily dosing (500 mg 2 times a day); increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been studied.

Uses:
-Adjunct therapy in the treatment of partial onset seizures in patients with epilepsy
-Adjunctive therapy in the treatment of juvenile myoclonic epilepsy
-Adjunctive therapy in the treatment of primary generalized tonic-clonic seizures in patients with idiopathic generalized epilepsy

Usual Adult Dose for Seizures:

PARTIAL ONSET SEIZURES:
-IV: 1000 mg daily given as 500 mg 2 times a day: increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. There is no evidence that doses greater than 3000 mg/day confer additional benefit.
-ORAL IMMEDIATE-RELEASE: 1000 mg daily given as 500 mg 2 times a day; increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. There is no evidence that doses greater than 3000 mg/day confer additional benefit.
-ORAL EXTENDED-RELEASE: 1000 mg once a day; increase in increments of 1000 mg every 2 weeks to the maximum daily dose of 3000 mg

MYOCLONIC SEIZURES IN PATIENTS WITH JUVENILE MYOCLONIC EPILEPSY:
-IV: 1000 mg daily given as 500 mg 2 times a day; increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been studied.
-ORAL IMMEDIATE-RELEASE: 1000 mg/day, given as twice daily dosing (500 mg 2 times a day); increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg/day. The effectiveness of doses lower than 3000 mg/day has not been studied.

PRIMARY GENERALIZED TONIC-CLONIC SEIZURES:
IV: 1000 mg daily given as 500 mg 2 times a day; increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been studied.
-ORAL IMMEDIATE-RELEASE: 1000 mg/day, given as twice daily dosing (500 mg 2 times a day); increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been studied.

Uses:
-Adjunct therapy in the treatment of partial onset seizures in patients with epilepsy
-Adjunctive therapy in the treatment of juvenile myoclonic epilepsy
-Adjunctive therapy in the treatment of primary generalized tonic-clonic seizures in patients with idiopathic generalized epilepsy

Usual Pediatric Dose for Epilepsy:

PARTIAL ONSET SEIZURES:
-IV:
1 month to less than 6 months: 7 mg/kg 2 times a day; increase by 7 mg/kg 2 times a day every 2 weeks to maximum dose of 21 mg/kg 2 times a day
6 months to less than 4 years: 10 mg/kg 2 times a day; increase by 10 mg/kg 2 times a day every 2 weeks to maximum dose of 25 mg/kg 2 times a day
4 years to less than 16 years: 10 mg/kg 2 times a day; increase by 10 mg/kg 2 times a day every 2 weeks to maximum dose of 30 mg/kg 2 times a day
16 years and older: Refer to adult dosing
-ORAL IMMEDIATE-RELEASE:
4 to less than 16 years old: 10 mg/kg/dose orally 2 times a day; increase every 2 weeks by 10 mg/kg/dose to the maximum dose of 30 mg/kg 2 times a day (60 mg/kg/daily). The daily dose of 60 mg/kg may be reduced in patients who cannot tolerate this dose. Patients with body weight 20 kg or less should be dosed with the oral solution. Patients with body weight above 20 kg can be dosed with either tablets or oral solution.
-FILM COATED TABLETS:
1 MONTH TO LESS THAN 6 MONTHS: 7 mg/kg 2 times a day; increase by 7 mg/kg 2 times a day every 2 weeks to recommended dose of 21 mg/kg 2 times a day
6 MONTHS TO LESS THAN 4 YEARS: 10 mg/kg 2 times a day; increase by 10 mg/kg 2 times a day every 2 weeks to recommended dose of 25 mg/kg 2 times a day
4 YEARS TO LESS THAN 16 YEARS: 10 mg/kg 2 times a day; increase by 10 mg/kg 2 times a day every 2 weeks to recommended dose of 30 mg/kg 2 times a day
PEDIATRIC PATIENTS WEIGHING 20 TO 40 KG: Initiate treatment with a daily dose of 500 mg given as twice daily dosing (250 mg 2 times a day). Increase the daily dose every 2 weeks by increments of 500 mg to a maximum recommended daily dose of 1500 mg (750 mg 2 timed a day).
PEDIATRIC PATIENTS WEIGHING MORE THAN 40 KG: Initiate treatment with a daily dose of 1000 mg/day given as twice daily dosing (500 mg 2 times a day). Increase the daily dose every 2 weeks by increments of 1000 mg/day to a maximum recommended daily dose of 3000 mg (1500 mg 2 times a day).

-MYOCLONIC SEIZURES IN PEDIATRIC PATIENTS 12 YEARS AND OLDER: See Adult Dosing

PRIMARY GENERALIZED TONIC-CLONIC SEIZURES:
-IV:
6 years to less than 16 years: 10 mg/kg 2 times a day, increase in increments of 10 mg/kg 2 times a day every 2 weeks to recommended dose of 30 mg/kg 2 times a day. The effectiveness of doses lower than 60 mg/kg/day has not been adequately studied.
16 years and older: See Adult Dosing
-ORAL IMMEDIATE-RELEASE:
6 YEARS TO LESS THAN 16 YEARS: 10 mg/kg 2 times a day, increase in increments of 10 mg/kg 2 times a day every 2 weeks to recommended dose of 30 mg/kg 2 times a day. The effectiveness of doses lower than 60 mg/kg/day has not been adequately studied. Patients with body weight 20 kg or less should be dosed with oral solution. Patients with body weight above 20 kg can be dosed with either tablets or oral solution.
16 YEARS AND OLDER: See Adult Dosing

Comments:
-Only whole tablets should be given.
-The oral solution should be used in pediatric patients with body weight of 20 kg or less.
-For pediatric patients, use weight-based dosing for the oral solution with a calibrated measuring device (not a household teaspoon or tablespoon)

Uses:
-Monotherapy in the treatment of partial onset seizures with or without secondary generalization in patients 16 years and older with newly diagnosed epilepsy
-Adjunctive therapy in the treatment of partial onset seizures with or without secondary generalization in patients with epilepsy
-Adjunctive therapy in the treatment of myoclonic seizures in patients with juvenile myoclonic epilepsy
-Adjunctive therapy in the treatment of primary generalized tonic-clonic seizures with idiopathic generalized epilepsy

Usual Pediatric Dose for Seizures:

PARTIAL ONSET SEIZURES:
-IV:
1 month to less than 6 months: 7 mg/kg 2 times a day; increase by 7 mg/kg 2 times a day every 2 weeks to maximum dose of 21 mg/kg 2 times a day
6 months to less than 4 years: 10 mg/kg 2 times a day; increase by 10 mg/kg 2 times a day every 2 weeks to maximum dose of 25 mg/kg 2 times a day
4 years to less than 16 years: 10 mg/kg 2 times a day; increase by 10 mg/kg 2 times a day every 2 weeks to maximum dose of 30 mg/kg 2 times a day
16 years and older: Refer to adult dosing
-ORAL IMMEDIATE-RELEASE:
4 to less than 16 years old: 10 mg/kg/dose orally 2 times a day; increase every 2 weeks by 10 mg/kg/dose to the maximum dose of 30 mg/kg 2 times a day (60 mg/kg/daily). The daily dose of 60 mg/kg may be reduced in patients who cannot tolerate this dose. Patients with body weight 20 kg or less should be dosed with the oral solution. Patients with body weight above 20 kg can be dosed with either tablets or oral solution.
-FILM COATED TABLETS:
1 MONTH TO LESS THAN 6 MONTHS: 7 mg/kg 2 times a day; increase by 7 mg/kg 2 times a day every 2 weeks to recommended dose of 21 mg/kg 2 times a day
6 MONTHS TO LESS THAN 4 YEARS: 10 mg/kg 2 times a day; increase by 10 mg/kg 2 times a day every 2 weeks to recommended dose of 25 mg/kg 2 times a day
4 YEARS TO LESS THAN 16 YEARS: 10 mg/kg 2 times a day; increase by 10 mg/kg 2 times a day every 2 weeks to recommended dose of 30 mg/kg 2 times a day
PEDIATRIC PATIENTS WEIGHING 20 TO 40 KG: Initiate treatment with a daily dose of 500 mg given as twice daily dosing (250 mg 2 times a day). Increase the daily dose every 2 weeks by increments of 500 mg to a maximum recommended daily dose of 1500 mg (750 mg 2 timed a day).
PEDIATRIC PATIENTS WEIGHING MORE THAN 40 KG: Initiate treatment with a daily dose of 1000 mg/day given as twice daily dosing (500 mg 2 times a day). Increase the daily dose every 2 weeks by increments of 1000 mg/day to a maximum recommended daily dose of 3000 mg (1500 mg 2 times a day).

-MYOCLONIC SEIZURES IN PEDIATRIC PATIENTS 12 YEARS AND OLDER: See Adult Dosing

PRIMARY GENERALIZED TONIC-CLONIC SEIZURES:
-IV:
6 years to less than 16 years: 10 mg/kg 2 times a day, increase in increments of 10 mg/kg 2 times a day every 2 weeks to recommended dose of 30 mg/kg 2 times a day. The effectiveness of doses lower than 60 mg/kg/day has not been adequately studied.
16 years and older: See Adult Dosing
-ORAL IMMEDIATE-RELEASE:
6 YEARS TO LESS THAN 16 YEARS: 10 mg/kg 2 times a day, increase in increments of 10 mg/kg 2 times a day every 2 weeks to recommended dose of 30 mg/kg 2 times a day. The effectiveness of doses lower than 60 mg/kg/day has not been adequately studied. Patients with body weight 20 kg or less should be dosed with oral solution. Patients with body weight above 20 kg can be dosed with either tablets or oral solution.
16 YEARS AND OLDER: See Adult Dosing

Comments:
-Only whole tablets should be given.
-The oral solution should be used in pediatric patients with body weight of 20 kg or less.
-For pediatric patients, use weight-based dosing for the oral solution with a calibrated measuring device (not a household teaspoon or tablespoon)

Uses:
-Monotherapy in the treatment of partial onset seizures with or without secondary generalization in patients 16 years and older with newly diagnosed epilepsy
-Adjunctive therapy in the treatment of partial onset seizures with or without secondary generalization in patients with epilepsy
-Adjunctive therapy in the treatment of myoclonic seizures in patients with juvenile myoclonic epilepsy
-Adjunctive therapy in the treatment of primary generalized tonic-clonic seizures with idiopathic generalized epilepsy

What other drugs will affect levetiracetam?

Other drugs may interact with levetiracetam, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about levetiracetam.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 8.02. Revision Date: 2016-03-10, 12:48:00 PM.

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