Classifications: anticonvulsant; Therapeutic: anticonvulsant
Pregnancy Category: C
250 mg, 500 mg, 750 mg tablets; 100 mg/mL oral solution
The precise mechanism of antiepileptic effects is unknown. It is a broad spectrum antiepileptic agent, which does not involve
GABA inhibition. It prevents epileptiform burst firing and propagation of seizure activity.
Inhibits complex partial seizures and prevents epileptic and seizure activity.
Adjunctive therapy for partial onset, myoclonic, tonic clonic seizures.
Hypersensitivity to levetiracetam; labor; pregnancy (category C), lactation; children <4 y; suicidal ideation.
Renal impairment; renal disease; renal failure; older adults; history of psychosis or depression, suicidal tendencies.
Route & Dosage
|Partial Onset Seizures
Adult: PO 500 mg b.i.d., may increase by 500 mg b.i.d. q2wk (max: 3000 mg/d)
Child (416 y): PO 20 mg/kg/d in 2 divided doses; may increase by 20 mg/kg q2wk up to 60 mg/kg/d
Tonic Clonic Seizures
Adult/Adolescent (>16 y): PO 500 mg b.i.d., increase by 1000 mg q2wk to dose of 3000 mg/d
Child (>6 y): PO 10 mg/kg b.i.d., increase by 20 mg/kg q2wk to dose of 60 mg/kg/d in 2 doses
Clcr 5080 mL/min: 5001000 mg q12h; 3050 mL/min: 250750 mg q12h; <30 mL/min: 250500 mg q12h
Hemodialysis: 5001000 mg q24h
- Reduced doses are indicated when creatinine clearance is <80 mL/min.
- Make dosage increment changes at 2-wk intervals.
- Taper dose if discontinued.
- Give supplemental doses to dialysis patients after dialysis.
- Store at 15°30° C (59°86° F).
Adverse Effects (≥1%)Body as a Whole: Asthenia, headache, infection,
pain. CNS: Somnolence,
amnesia, anxiety, ataxia, depression
, dizziness, emotional lability, hostility, nervousness, vertigo, paradoxical increase
in seizures (as add-on therapy). GI:
Cough, pharyngitis, rhinitis, sinusitis
. Special Senses:
Increased symptoms of depression; suicidal ideation.
Levetiracetam does not decrease estrogen, warfarin,
levels or affect levels of other antiepileptic drugs.
Rapidly and almost completely absorbed. Peak:
1 h; steady-state 2 d. Distribution:
<10% protein bound. Metabolism:
Minimal hepatic metabolism. Elimination:
Renally eliminated. Half-Life:
7.1 h (9.6 h in older adults).
Assessment & Drug Effects
- Monitor individuals with a history of psychosis or depression for signs and symptoms of suicidal tendencies, suicidal ideation,
and suicidality. Report any of these symptoms to the physician.
- Monitor & notify physician of difficulty with gait or coordination.
- Lab tests: Periodic CBC with differential, Hct & Hgb, LFTs.
- Monitor for changes in phenytoin blood levels with coadministered drugs.
Patient & Family Education
- Monitor for signs and symptoms of suicidality, especially in children with a history of depression or psychosis.
- Do not drive or engage in potentially hazardous activities until response to drug is known.
- Do not abruptly discontinue drug. MUST use gradual dose reduction/taper.
- Notify physician of intention to become pregnant.