BMA Concise Guide to Medicine & Drugs

Levetiracetam

Brand name Keppra

Used in the following combined preparations None

QUICK REFERENCE

Drug group Anticonvulsant drug

Overdose danger rating Medium

Dependence rating Low

Prescription needed Yes

Available as generic Yes

GENERAL INFORMATION

Levetiracetam is given for the treatment of some forms of epilepsy as it reduces the likelihood of seizures caused by abnormal nerve signals in the brain. It may be used alone or in combination with other anti-epileptic drugs. Levetiracetam is chemically different from other anti-epileptic drugs, and the precise way in which it works is not fully understood.

Compared to other anti-epileptic drugs, levetiracetam usually produces relatively few adverse effects, most commonly headache, dizziness, drowsiness, and gastrointestinal disturbances such as nausea, vomiting, and indigestion. In addition, it does not interact with other anti-epileptic drugs, which is a significant advantage and has led to it becoming increasingly commonly prescribed. As with all anti-epileptic drugs, it is important that levetiracetam is not stopped abruptly without medical advice as this can precipitate an epileptic seizure.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Tablets, liquid, injection.

Frequency and timing of doses 1–2 x daily.

Adult dosage range Initially 250mg once daily, increased after 1–2 weeks to 250mg twice daily. If necessary, dosage can be further increased up to a maximum of 1.5g twice daily.

Onset of effect Up to 48 hours.

Duration of action 12 hours.

Diet advice None.

Storage Store in original container at room temperature out of reach of children.

Missed dose Take as soon as you remember. If your next dose is due within 4 hours, take a single dose now and skip the next.

Stopping the drug Do not stop the drug without consulting your doctor; symptoms may recur.

Exceeding the dose An occasional unintentional extra dose is unlikely to cause problems. Large overdoses may cause agitation, impaired consciousness, and coma. Notify your doctor immediately.

POSSIBLE ADVERSE EFFECTS

Most people experience few adverse effects with this drug. The most common are dizziness, headache, drowsiness, gastrointestinal problems, such as nausea, vomiting, indigestion, and abdominal pain, and a cough. Discuss with your doctor if any of these are severe. You should also contact your doctor if you experience itching, a rash, mood changes, or depression. Rarely, levetiracetam may cause suicidal thoughts; if so, consult your doctor immediately.

INTERACTIONS

Antidepressant drugs (MAOIs, tricyclics and SSRIs) and mefloquine may reduce the anticonvulsant effect of levetiracetam.

St John’s wort may reduce the anticoagulant effect of levetiracetam.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have a long-term liver or kidney problem.

· You have a psychotic illness.

· You have a depressive illness.

· You are taking other medicines.

Pregnancy Safety not established. Discuss with your doctor.

Breast-feeding Safety not established. The drug passes into the breast milk. Discuss with your doctor.

Infants and children Reduced dose necessary.

Over 60 No special problems.

Driving and hazardous work Avoid such activities until you have learned how levetiracetam affects you because the drug can cause drowsiness in some people.

Alcohol Avoid. Alcohol may worsen any drowsiness caused by levetiracetam.

PROLONGED USE

Usually no problems, although very rarely it can cause depression and suicidal thoughts.