Levetiracetam: 6 things you should know
Medically reviewed by C. Fookes, BPharm Last updated on Dec 5, 2018.
1. How it works
- Levetiracetam is an anticonvulsant that may be used for the treatment of certain types of epilepsy.
- Experts aren't sure exactly how levetiracetam works but suggest it dampens down excessive nerve firing and reduces seizure propagation, possibly through an impact on pathways involving calcium, glycine, and GABA.
- Levetiracetam belongs to the class of medicines known as anticonvulsants.
- Used in combination with other anticonvulsants for the treatment of partial onset, myoclonic, or generalized tonic-clonic seizures. May also be used for some other seizure types.
- Levetiracetam is approved to treat adults and children aged at least one month with partial onset seizures. However, the Spritam brand should not be used in children younger than four years or who weigh less than 44 pounds (20kg).
- Levetiracetam is approved to treat adults and children at least six with tonic-clonic seizures and myoclonic seizures in adults and children aged at least 12 years.
- Does not require monitoring of blood concentrations.
- Available as oral tablets (both immediate-release and extended-release), oral solution and in an injectable form.
- Usually taken once or twice daily.
- Generic levetiracetam is available.
If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:
- Drowsiness which may affect your ability to drive or operate machinery. Avoid alcohol.
- Aggression, nasal congestion, headache, decreased appetite, infection, dizziness, pain, sore throat, depression, nervousness, and fatigue are reasonably common side effects. Hematologic abnormalities, co-ordination difficulties and serious dermatological reactions (for example, Stevens-Johnson syndrome [SJS] and toxic epidermal necrolysis [TEN]) have also been reported.
- Young children are more likely than adults to experience behavioral abnormalities (eg, overactivity or agitation) or psychotic symptoms as well as other side effects such as a decreased appetite, increased blood pressure, or nasal congestion while taking levetiracetam.
- As with other antiepileptics, levetiracetam may increase the risk of suicidal thoughts or behavior; monitor for worsening depression or mood changes. Levetiracetam may also cause behavioral problems such as aggression, anxiety, irritability, and nervousness; talk to your doctor if you experience any changes in your mood.
- Dosage may need reducing in people with kidney disease.
- May not be suitable for everybody including those with kidney disease, with a history of mental health problems, and taking certain medications (such as propoxyphene, buprenorphine, sedating antihistamines). Generally, less likely than some other anticonvulsants to interact with other medications.
- In children aged 1 month to 4 years, levetiracetam has been associated with an increase in blood pressure.
- Alcohol may worsen the side effects of levetiracetam such as drowsiness and dizziness.
Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.
- Oral tablets and solution may be given with or without food.
- Take exactly as directed. Do not increase or decrease the dose without your doctor's advice.
- If you are taking levetiracetam solution, use the dosing syringe provided or a properly calibrated liquid measure (these can be bought from a drug-store). Do not use a kitchen teaspoon.
- Extended-release tablets should be swallowed whole. Do not crush, chew or break.
- Dissolvable tablets should be removed from their foil packet with dry hands and then placed on the tongue. The tablet should be left to dissolve without swallowing with a sip of liquid (should take about 30 seconds).
- Discontinue slowly to minimize the potential for rebound seizures, unless a rapid withdrawal is justified.
- Talk to your doctor if you feel like your mood has changed for the worse or you have any thoughts about suicide or self-harm. Levetiracetam may also cause aggression, anxiety, depression, and irritability.
- Levetiracetam may cause drowsiness and affect your ability to drive or operate machinery. Avoid alcohol.
- Talk to your doctor immediately if you develop a rash while taking levetiracetam.
6. Response and Effectiveness
- Levetiracetam is rapidly and almost completely absorbed after oral administration. It reduces seizure frequency by about half in 20% to 40% of all people who take it.
- The dosage for levetiracetam tablets and injection is the same.
Levetiracetam [Package Insert]. Revised 12/2017. Zydus Pharmaceuticals (USA) Inc. https://www.drugs.com/pro/keppra-injection.html
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use levetiracetam only for the indication prescribed.
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