Levetiracetam
Levetiracetam is used to treat epilepsy and seizures. It is available as Keppra and is commonly prescribed in the neurological category.
About Levetiracetam
Levetiracetam is an antiseizure medication (sv2a modulator) also known by the brand name Keppra. It is primarily used to levetiracetam is prescribed to treat: • Epilepsy and seizures • Various related conditions in the neurological category • Associated symptoms and complications It is an important medication that helps manage these conditions effectively. Levetiracetam is available in oral tablet (250 mg, 500 mg, 750 mg, 1000 mg), oral solution (100 mg/ml), extended-release tablet (500 mg, 750 mg), iv injection (100 mg/ml — single-dose vials), and iv bag premix (500 mg/100 ml, 1000 mg/100 ml, 1500 mg/100 ml) form. Healthcare providers commonly prescribe Levetiracetam for conditions including Attention Deficit Hyperactivity Disorder (ADHD), Lupus Anticoagulant, Seizures, and Vertigo.
Levetiracetam at a Glance
- Brand names
- Keppra
- Drug class
- Antiseizure Medication (SV2A Modulator)
- Pregnancy category
- FDA Category Category C — Animal studies have shown developmental toxicity at clinically relevant doses. Pregnancy registry data suggest a relatively favorable safety profile compared with older antiseizure medications, and levetiracetam is often considered first-line for women of childbearing potential. Folate supplementation is recommended. Use during pregnancy if benefits outweigh risks.
- Available forms
- Oral tablet (250 mg, 500 mg, 750 mg, 1000 mg), Oral solution (100 mg/mL), Extended-release tablet (500 mg, 750 mg), IV injection (100 mg/mL — single-dose vials), IV bag premix (500 mg/100 mL, 1000 mg/100 mL, 1500 mg/100 mL)
- Therapeutic categories
- Neurological, Anticonvulsants, Seizures
- Conditions treated
- 4 related conditions on this site
What Levetiracetam Is Used For
Levetiracetam is prescribed to treat:
• Epilepsy and seizures • Various related conditions in the neurological category • Associated symptoms and complications
It is an important medication that helps manage these conditions effectively.
Dosage Quick Reference
These are general dosage guidelines for Levetiracetam. Your doctor will determine the appropriate dose for your specific situation.
| Condition | Starting Dose | Maintenance Dose |
|---|---|---|
| Partial-onset seizures (adults) | 500 mg twice daily | Increase by 1000 mg/day every 2 weeks; max 3000 mg/day |
| Myoclonic seizures (JME) | 500 mg twice daily | Increase by 1000 mg/day every 2 weeks; target 3000 mg/day |
| Primary generalized tonic-clonic seizures | 500 mg twice daily | Increase by 1000 mg/day every 2 weeks; target 3000 mg/day |
| Status epilepticus (off-label IV) | 60 mg/kg IV (max 4500 mg) over 15 minutes | Single loading dose; transition to oral maintenance |
| Renal impairment (CrCl 30–50 mL/min) | 250–750 mg twice daily | Adjust based on CrCl; further reduce if CrCl < 30 mL/min |
Side Effects
Common side effects may include:
• Nausea or stomach upset • Headache • Dizziness or lightheadedness • Fatigue or tiredness • Mild rash or itching
Serious side effects (seek immediate medical attention):
• Severe allergic reactions (rash, hives, swelling, difficulty breathing) • Unusual bleeding or bruising • Severe stomach pain • Signs of liver problems (yellowing of skin/eyes, dark urine) • Chest pain or irregular heartbeat • Severe dizziness or fainting • Signs of serious adverse effects
See also: Drug Interactions ↓
Drug Interactions
Levetiracetam is not metabolized by CYP enzymes and has minimal pharmacokinetic interactions, but pharmacodynamic interactions remain important.
- CNS depressants (alcohol, opioids, benzodiazepines, sedating antihistamines): Additive sedation and impaired coordination. Counsel patients about combined use.
- Carbamazepine: Co-administration may increase the risk of carbamazepine-related neurotoxicity (dizziness, ataxia, diplopia) without altering serum levels significantly. Monitor clinically.
- Probenecid: May reduce renal clearance of the inactive levetiracetam metabolite — typically not clinically significant.
- Methotrexate: Levetiracetam may decrease methotrexate clearance, potentially increasing methotrexate toxicity. Monitor methotrexate levels and adjust as needed.
- Other antiseizure medications: Levetiracetam does not significantly affect serum levels of phenytoin, valproate, lamotrigine, or topiramate, making it useful as add-on therapy.
- Hormonal contraceptives: Unlike many older antiseizure drugs, levetiracetam does not reduce contraceptive efficacy. Standard contraceptives remain reliable.
See also: Questions to Ask Your Doctor ↓
Key Considerations
Known drug interactions
Levetiracetam has documented interactions with other medications, supplements, and certain foods. Review the Drug Interactions section below and tell your healthcare provider about every medication you take, including over-the-counter products. Jump to section →
Multiple forms available
Levetiracetam comes in more than one form (Oral tablet (250 mg, 500 mg, 750 mg, 1000 mg), Oral solution (100 mg/mL), Extended-release tablet (500 mg, 750 mg), IV injection (100 mg/mL — single-dose vials), IV bag premix (500 mg/100 mL, 1000 mg/100 mL, 1500 mg/100 mL)). The right form for you depends on your condition, ease of use, and your provider's recommendation.
Additional Information
What is Levetiracetam?
Levetiracetam (generic name: Levetiracetam) is a medication primarily used to treat epilepsy and seizures. It is marketed under the brand name(s) Keppra and belongs to the Neurological category of medications.
How Does Levetiracetam Work?
Levetiracetam works through several mechanisms to provide therapeutic benefits:
- Acts on specific receptors or pathways in the body
- Modulates biological processes related to the treated condition
- Provides symptom relief and improves quality of life
- Helps manage the underlying condition effectively
- Works best when combined with appropriate lifestyle modifications
The medication is designed to target the specific pathways involved in epilepsy and seizures, making it an effective treatment option.
Common Uses
Primary Indications
Levetiracetam is commonly prescribed for:
- Epilepsy and seizures: The main indication for this medication
- Related Conditions: Associated symptoms and complications
- Prevention: May help prevent progression of certain conditions
- Symptom Management: Reduces discomfort and improves daily function
Additional Uses
In some cases, Levetiracetam may also be prescribed for:
- Off-label uses as determined by your healthcare provider
- Combination therapy with other medications
- Long-term management of chronic conditions
- Short-term treatment of acute symptoms
Dosage and Administration
Levetiracetam dosing varies based on the specific condition being treated and individual patient factors.
Typical Dosing:
- Starting dose is typically determined by your healthcare provider
- May be adjusted based on response and tolerability
- Can be taken with or without food (follow specific instructions)
- Usually taken once or twice daily
Administration Tips:
- Take at the same time(s) each day for best results
- Swallow tablets/capsules whole unless instructed otherwise
- Don't skip doses
- Complete full course of treatment as prescribed
- Follow your doctor's specific instructions carefully
Important Safety Information
Who Should Not Take Levetiracetam?
Do not take Levetiracetam if you:
- Are allergic to Levetiracetam or any ingredients
- Have certain medical conditions (discuss with your doctor)
- Are taking medications that interact with Levetiracetam
- Have severe liver or kidney disease (without dose adjustment)
Drug Interactions
Inform your doctor about all medications you take, including:
- Prescription medications
- Over-the-counter drugs
- Vitamins and supplements
- Herbal products
Some medications may interact with Levetiracetam, affecting its efficacy or increasing side effect risk.
Pregnancy and Breastfeeding
Pregnancy:
- Discuss risks and benefits with your doctor if pregnant or planning pregnancy
- May require special monitoring or dose adjustments
- Some medications should be avoided during pregnancy
Breastfeeding:
- Consult your doctor about safety while breastfeeding
- May pass into breast milk
- Benefits and risks should be carefully considered
Monitoring and Follow-Up
While taking Levetiracetam, your doctor may monitor:
- Effectiveness of treatment (symptom improvement)
- Side effects or adverse reactions
- Laboratory values if applicable
- Blood pressure, heart rate, or other vital signs as appropriate
- Overall response to therapy
Regular follow-up appointments are important to ensure the medication is working properly and to make any necessary adjustments.
Managing Side Effects
Most side effects are mild and improve with time. Here are strategies for common side effects:
Gastrointestinal Upset
- Take with food if allowed
- Stay well hydrated
- Eat smaller, more frequent meals
- Report persistent nausea or vomiting
Dizziness
- Rise slowly from sitting or lying positions
- Avoid sudden movements
- Stay hydrated
- Avoid alcohol
- Report severe or persistent dizziness
Fatigue
- Get adequate rest
- Maintain regular sleep schedule
- Exercise as tolerated
- Report excessive tiredness that interferes with daily activities
Lifestyle Considerations
To maximize the benefits of Levetiracetam:
- Follow a healthy, balanced diet
- Exercise regularly as recommended by your doctor
- Maintain a healthy weight
- Avoid alcohol or limit consumption
- Don't smoke
- Manage stress through relaxation techniques
- Get adequate sleep
- Stay well hydrated
- Keep all follow-up appointments
- Take medication consistently as prescribed
When to Contact Your Doctor
Seek immediate medical attention if you experience:
- Signs of severe allergic reaction (difficulty breathing, severe rash, swelling)
- Chest pain or rapid heartbeat
- Severe dizziness or fainting
- Unusual bleeding or bruising
- Signs of liver problems (yellowing of skin/eyes, dark urine, severe fatigue)
- Severe stomach pain
- Any symptoms that concern you
Contact your doctor for non-emergency issues:
- Mild to moderate side effects that persist
- Questions about your medication
- Concerns about effectiveness
- New medications prescribed by another doctor
- Scheduled surgery or dental procedures
- Planning pregnancy
Storage
Store Levetiracetam at room temperature (68-77°F or 20-25°C) away from light, heat, and moisture. Keep in original container. Keep out of reach of children and pets. Do not use past expiration date.
Important Reminders
- Take exactly as prescribed by your doctor
- Don't stop suddenly without medical advice
- Keep all follow-up appointments
- Report any unusual symptoms
- Don't share medication with others
- Store safely away from children
- Check expiration dates
- Ask your pharmacist if you have questions
Clinical Benefits
When used appropriately, Levetiracetam provides several benefits:
- Effective management of epilepsy and seizures
- Improvement in quality of life
- Reduction in symptoms
- Prevention of complications
- Generally well-tolerated when used as directed
- Backed by clinical research and extensive use
Disclaimer: This information is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Always consult your physician or other qualified healthcare provider with any questions about a medical condition or medication.
Frequently Asked Questions
Questions to Ask Your Doctor About Levetiracetam
Consider discussing these topics at your next appointment:
- What is my target dose, and how will we adjust based on seizure control and side effects?
- What behavioral or mood changes should make me call you?
- How will my kidney function be monitored, and could it change my dose?
- Are my other medications safe to use with levetiracetam?
- When can we discuss tapering or stopping if I remain seizure-free?
Medical Disclaimer: This information is for educational purposes only and should not be considered medical advice. Always consult with your healthcare provider before starting, stopping, or changing any medication. Your doctor can provide personalized recommendations based on your specific health condition and medical history.