levetiracetam (Rx)

Brand and Other Names:Keppra, Keppra XR, more...Spritam, Elepsia
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet, immediate-release (Keppra, generic)

  • 250mg
  • 500mg
  • 750mg
  • 1000mg

3-D tablet, immediate-release (Spritam)

  • 250mg
  • 500mg
  • 750mg
  • 1000mg

tablet, extended-release

  • 500mg (Keppra XR)
  • 750mg (Keppra XR)
  • 1000mg (Elepsia XR)
  • 1500mg (Elepsia XR)

oral solution (Keppra, generic)

  • 100mg/mL

injectable solution

  • 5mg/mL
  • 10mg/mL
  • 15mg/mL
  • 100mg/mL

Myoclonic Seizures

Immediate-release (Keppra, Spritam): 500 mg IV/PO q12hr; may increase q2week by 500 mg/dose to recommended dose of 1500 mg q12hr

Effectiveness of doses >3000 mg/day has not been adequately studied

Partial Onset Seizure

Indicated for treatment of partial onset seizures

Immediate-release (Keppra, Spritam): 500 mg PO q12hr; may increase q2week by 500 mg/dose; not to exceed 3000 mg/day

Extended-release (Keppra XR or Elepsia XR): 1000 mg PO qDay; may increase q2week by 1000 mg/day; not to exceed 3000 mg/day

IV: 500 mg q12hr; may increase q2week by 500 mg/dose; not to exceed 3000 mg/day

Primary Generalized Tonic Clonic Seizures

Immediate-release (Keppra, Spritam): 500 mg IV/PO q12hr; may increase q2week by 500 mg/dose to recommended dose of 1500 mg q12hr

Effectiveness of doses >3000 mg/day has not been adequately studied

Dosage Modifications

Renal impairment

  • Immediate release and IV formulations
    • CrCl >80 mL/min/1.73 m²: Dose adjustment not required
    • CrCl 50-80 mL/min/1.73 m²: 500-1000 mg PO q12hr
    • CrCl 30-50 mL/min/1.73 m²: 250-750 mg PO q12hr
    • CrCl <30 mL/min/1.73 m²: 250-500 mg PO q12hr
    • Dialysis (conventional): 500-1000 mg PO qDay, THEN 250-500 mg supplemental dose after dialysis
  • Extended release tablets (Keppra XR)
    • CrCl >80 mL/min/1.73 m²: Dose adjustment not required
    • CrCl 50-80 mL/min/1.73 m²: 1000-2000 mg PO q24hr
    • CrCl 30-50 mL/min/1.73 m²: 500-1500 mg PO q24hr
    • CrCl <30 mL/min/1.73 m²: 500-1000 mg PO q24hr
    • End-stage renal disease requiring hemodialysis: Immediate release formulation recommended
  • Extended release tablets (Elepsia XR)
    • CrCl >80 mL/min/1.73 m²: Dose adjustment not required
    • CrCl 50-80 mL/min/1.73 m²: 1000-2000 mg PO q24hr
    • CrCl <50 mL/min/1.73 m²: Not recommended
    • End-stage renal disease requiring hemodialysis: Immediate release formulation recommended

Dosing Considerations

Avoid abrupt withdrawal to reduce the risk of increased seizure frequency and status epilepticus

Dosage Forms & Strengths

tablet, immediate-release (Keppra, generic)

  • 250mg
  • 500mg
  • 750mg
  • 1000mg

disintegrating tablet, immediate-release (Spritam)

  • 250mg
  • 500mg
  • 750mg
  • 1000mg

tablet, extended-release

  • 500mg (Keppra XR)
  • 750mg (Keppra XR)
  • 1000mg (Elepsia XR)
  • 1500mg (Elepsia XR)

oral solution (Keppra, generic)

  • 100mg/mL

injectable solution

  • 5mg/mL
  • 10mg/mL
  • 15mg/mL
  • 100mg/mL

Partial Onset Seizures

Immediate-release tablets (Keppra)

  • Indicated for monotherapy or adjunctive treatment of partial-onset seizures in patients aged ≥1 month
  • <1 month: Safety and efficacy not established
  • 1-6 months: 7 mg/kg PO q12hr; increase by increments of 7 mg/kg q12hr q2weeks to recommended dose of 21 mg/kg q12hr  
  • 6 months-4 years: 10 mg/kg PO q12hr, increase in increments of 10 mg/kg q12hr q2weeks to recommended dose of 25 mg/kg q12hr
  • 4-16 years: 10 mg/kg PO q12hr; increase q2week by 10 mg/kg/dose to 30 mg/kg q12hr
  • >16 years: 500 mg PO q12hr, increase by 500 mg q12hr q2weeks to recommended dose of 1500 mg q12hr

Immediate-release 3-D tablets (Spritam)

  • Indicated for treatment of partial-onset seizures in patients aged >4 years
  • <4 years: Safety and efficacy not established
  • ≥4 years weighing 20-40 kg: 250 mg PO BID initially; increase daily dose q2wk by increments of 500 mg (250 mg BID) to a maximum daily dose of 1500 mg (750 mg BID)
  • ≥4 years weighing >40 kg: 500 mg PO BID initially; increase daily dose q2wk by increments of 1000 mg (500 mg BID) to a maximum daily dose of 3000 mg (1500 mg BID)

Extended-release tablets (Keppra XR or Elepsia XR)

  • Indicated as adjunctive therapy for treatment of partial-onset seizures in patients ≥12 years
  • <12 years: Safety and efficacy not established
  • &12 years: 1000 mg PO qDay initially; may adjust dose by 1000 mg increments q2wk to a maximum of 3000 mg/day

Primary Generalized Tonic-Clonic Seizures

<6 years: Safety and efficacy not established

Keppra

  • 6-16 years: 10 mg/kg PO q12hr; increase q2week by 10 mg/kg/dose to recommended dose of 30 mg/kg q12hr; efficacy of doses <60 mg/kg/day not established  
  • >16 years: 500 mg PO q12hr, increase by 500 mg q12hr q2weeks to recommended dose of 1500 mg q12hr

Spritam

  • ≥6 years weighing 20-40 kg: 250 mg PO BID initially; increase the daily dose q2wk by increments of 500 mg (250 mg BID) to a maximum recommended daily dose of 1500 mg/day (750 mg BID) ≥6 years weighing
  • >40 kg: 500 mg PO BID initially; increase the daily dose q2wk by increments of 1000 mg (500 mg BID) to a maximum recommended daily dose of 3000 mg (1500 BID)
  • Effectiveness of doses >3000 mg/day has not been adequately studied

Myoclonic Seizures

Keppra, Spritam

<12 years: Safety and efficacy not established

≥12 years: 500 mg PO q12hr; increase by 500 mg q12hr q2week to recommended dose of 1500 mg q12hr

Effectiveness of doses >3000 mg/day has not been studied

Neonatal Seizures (Orphan)

Orphan indication sponsor

  • University of California; UCSD Medical Center 0935; La Jolla, CA 92093-0935

Dosing Considerations

Avoid abrupt withdrawal to reduce the risk of increased seizure frequency and status epilepticus

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Interactions

Interaction Checker

and levetiracetam

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (2)

              • deferiprone

                deferiprone, levetiracetam. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid use of deferiprone with other drugs known to be associated with neutropenia or agranulocytosis; if an alternative is not possible, monitor absolute neutrophil count more frequently.

              • metoclopramide intranasal

                levetiracetam, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

              Monitor Closely (12)

              • acalabrutinib

                acalabrutinib, levetiracetam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may increase risk of myelosuppressive effects.

              • brexanolone

                brexanolone, levetiracetam. Either increases toxicity of the other by sedation. Use Caution/Monitor.

              • brivaracetam

                brivaracetam, levetiracetam. Other (see comment). Use Caution/Monitor. Comment: Coadministration provided no added therapeutic benefit and may cause additive/synergistic adverse effects.

              • deutetrabenazine

                levetiracetam and deutetrabenazine both increase sedation. Use Caution/Monitor.

              • esketamine intranasal

                esketamine intranasal, levetiracetam. Either increases toxicity of the other by sedation. Use Caution/Monitor.

              • lasmiditan

                lasmiditan, levetiracetam. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.

              • lemborexant

                lemborexant, levetiracetam. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.

              • lurasidone

                lurasidone, levetiracetam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.

              • midazolam intranasal

                midazolam intranasal, levetiracetam. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

              • orlistat

                orlistat decreases levels of levetiracetam by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Risk of convulsions.

              • sevelamer

                sevelamer decreases levels of levetiracetam by increasing elimination. Use Caution/Monitor.

              • stiripentol

                stiripentol, levetiracetam. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.

              Minor (16)

              • acetaminophen

                levetiracetam decreases levels of acetaminophen by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • acetaminophen IV

                levetiracetam decreases levels of acetaminophen IV by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • acetaminophen rectal

                levetiracetam decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • atracurium

                levetiracetam decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.

              • biotin

                levetiracetam decreases levels of biotin by unspecified interaction mechanism. Minor/Significance Unknown. Biotin supplementation may be necessary.

              • cisatracurium

                levetiracetam decreases effects of cisatracurium by pharmacodynamic antagonism. Minor/Significance Unknown.

              • cyanocobalamin

                levetiracetam decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • dexmethylphenidate

                dexmethylphenidate increases effects of levetiracetam by decreasing metabolism. Minor/Significance Unknown.

              • levocarnitine

                levetiracetam decreases levels of levocarnitine by unspecified interaction mechanism. Minor/Significance Unknown.

              • onabotulinumtoxinA

                levetiracetam decreases effects of onabotulinumtoxinA by pharmacodynamic antagonism. Minor/Significance Unknown.

              • pancuronium

                levetiracetam decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

              • rapacuronium

                levetiracetam decreases effects of rapacuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

              • rocuronium

                levetiracetam decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

              • sage

                sage decreases effects of levetiracetam by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical interaction; some species of sage may cause convulsions.

              • succinylcholine

                levetiracetam decreases effects of succinylcholine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • vecuronium

                levetiracetam decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

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              Adverse Effects

              >10%

              Asthenia (11-15%)

              Headache (14-19%)

              Infection (11-15%)

              Increased blood pressure (17% in children < 4 years)

              Somnolence (11-15%)

              Drowsiness (2-23%)

              Fatigue (10-11%)

              Anorexia (3-13%)

              Weakness (9-15%)

              Nasopharyngitis (7-15%)

              Cough (2-11%)

              1-10%

              Viral infection (2%)

              Asthma (2%)

              Dizziness (5-9%)

              Nervousness (2-10%)

              Amnesia (2%)

              Anxiety (2-3%)

              Ataxia (3%)

              Depression (2-5%)

              Hostility (10%)

              Paresthesia (2%)

              Sinusitis (2%)

              Diplopia (2%)

              Amblyopia (2%)

              Conjunctivitis (2-3%)

              Albuminuria (4%)

              <1%

              Abnormal hepatic function tests

              Dyskinesia

              Eczema

              Neutropenia

              Decreased hematocrit

              Leukopenia

              Suicidal tendencies

              Hepatitis

              Pancreatitis

              Bone marrow suppression

              Epidermal necrolysis

              Postmarketing Reports

              Hepatic: Abnormal liver function tests, hepatic failure, hepatitis, pancreatitis

              Skin: Alopecia, erythema multiforme; drug rash with eosinophilia and systemic syndrome (DRESS)

              Neurologic: Choreoathetosis, dyskinesia, worsening of seizures

              Hematology: Leukopenia, neutropenia, pancytopenia, thrombocytopenia, agranulocytosis

              Skeletomuscular: Muscle weakness

              Psychological: Panic attack

              General: Weight loss

              Hyponatremia

              Acute kidney injury

              Anaphylaxis and angioedema

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              Warnings

              Contraindications

              Hypersensitivity

              Cautions

              Somnolence and asthenia occurred most frequently within first 4 weeks of treatment; patients should be monitored for signs and symptoms and advised not to drive or operate machinery until they have gained sufficient experience on levetiracetam to gauge whether it adversely affects ability to drive or operate machinery

              As with most antiepileptic drugs, drug should generally be withdrawn gradually because of risk of increased seizure frequency and status epilepticus; if withdrawal needed because of serious adverse reaction, rapid discontinuation can be considered

              Psychiatric reactions: 13.3% of adults and 37.6% of children treated with levetiracetam reported nonpsychotic behavioral symptoms (eg, aggression, agitation, anger, anxiety, apathy, depersonalization, lability, hostility, hyperkinesis, irritability, nervousness, neurosis, and personality disorder) compared to 6.2% and 18.6% of adult and pediatric placebo patients respectively; dose reduction or discontinuation may be required

              Monitor patients for behavioral abnormalities including psychotic symptoms, suicidal ideation, irritability, aggressive behavior, and for new or worsening depression, suicidal thoughts/behavior, and/or unusual changes in mood or behavior

              Serious dermatological reactions, including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) reported; median time of onset is reported to be 14-17 days; if signs or symptoms suggest SJS/TEN, use of this drug should not be resumed and alternative therapy should be considered

              Drug rash with eosinophilia and systemic syndrome (DRESS) reported

              May impair ability to operate heavy machinery

              Therapy can cause hematologic abnormalities, including decreases in white blood cell (WBC), neutrophil, and red blood cell (RBC) counts; decreases in hemoglobin and hematocrit; and increases in eosinophil counts; cases of agranulocytosis, pancytopenia, and thrombocytopenia reported in postmarketing setting; a complete blood count is recommended in patients experiencing significant weakness, pyrexia, recurrent infections, or coagulation disorders

              Increases in eosinophil counts observed

              Monitor patients 1 month to <4 years of age for increases in diastolic blood pressure

              Seizure control during pregnancy: Physiological changes during pregnancy may gradually decrease therapeutic plasma concentrations, this is particularly pronounced during the 3rd trimester; closely monitor serum levels during pregnancy and through the postpartum period

              Agranulocytosis reported; in pediatric patients (4 to <16 years of age), statistically significant decreases in WBC and neutrophil counts were seen in patients treated with immediate-release levetiracetam; no patient was discontinued secondary to low WBC or neutrophil counts

              One percent of adult patients and 2% of pediatric patients (4 to 16 years of age) treated with immediate-release levetiracetam experienced psychotic symptoms (paranoia)

              Use caution in renal impairment; adjust dose; use immediate release formulation, instead of the extended release formulation, in patients with ESRD requiring hemodialysis

              Can cause anaphylaxis or angioedema after the first dose or at any time during treatment; if patient develops signs or symptoms of anaphylaxis or angioedema, therapy should be discontinued and patient should seek immediate medical attention; therapy should be discontinued permanently if clear alternative etiology for reaction cannot be established

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              Pregnancy & Lactation

              Pregnancy

              There are no adequate and well-controlled studies in pregnant women; prolonged experience in pregnant women has not identified a drug-associated risk of major birth defects or miscarriage, based on published literature, which includes data from pregnancy registries, and reflects experience over two decades

              In animal studies, levetiracetam produced evidence of developmental toxicity, including teratogenic effects, at doses similar to or greater than human therapeutic doses

              Use during pregnancy only if the potential benefit justifies the potential risk to the fetus

              Drug blood levels may decrease during pregnancy; physiological changes during pregnancy may affect drug concentration; decrease in drug plasma concentrations has been observed during pregnancy; this decrease is more pronounced during third trimester; dose adjustments may be necessary to maintain clinical response

              Enroll patients in the North American Antiepileptic Drug pregnancy registry; 1-888-233-2334 or visit http://www.aedpregnancyregistry.org

              Lactation

              Drug is excreted in human milk; there are no data on effects of drug on breastfed infant, or on milk production

              Unknown if distributed in human breast milk

              Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for the drug, and any potential adverse effects on the breastfed infant from the drug or from the underlying maternal conditio

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Antiepileptic mechanism unknown; may inhibit voltage-depedent N-type calcium channels; may bind to synaptic proteins that modulate neurotransmitter release; through displacement of negative modulators may facilitate GABA-ergic inhibitory transmission

              Pyrrolidone derivative

              Absorption

              Bioavailability: 100%

              Peak plasma time: 1 hr (immediate release); 4 hr (extended release)

              Distribution

              Protein bound: <10%

              Metabolism

              Metabolism: Hepatic enzymatic hydrolysis

              Metabolites: Inactive

              Elimination

              Half-life: 6-8 hr (increased in elderly or renal disease)

              Total body clearance: 0.96 mL/min/kg

              Renal clearance: 0.6 mL/min/kg; 4 mL/min/kg (metabolite)

              Clearance ~40% higher in children

              Dialyzable: Yes

              Excretion: Urine (66%)

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              Administration

              IV Use

              IV preparation: Dilute IV solution in 100 mL compatible solution

              IV administration: Infuse IV over 15 minutes

              Compatabilities

              • Solutions: NS, LR, D5W
              • Additive/syringe: lorazepam, diazepam, valproate sodium

              Oral Administration

              May take with or without food

              Use oral solution for children who weigh ≤20 kg

              Elepsia XR, Keppra XR: Swallow tablet whole; do not chew, split, crush, or cut tablets

              Spritam

              • Developed with ZipDose technology, which uses 3-dimensional printing to create a porous formulation of the antiepileptic that disintegrates rapidly with a sip of liquid, even at a high dose of up to 1000 mg
              • May take with or without food
              • Place the whole tablet on the tongue with a dry hand and follow with a sip of liquid
              • Swallow only after tablet disintegrates in mouth (mean disintegration time 11 seconds [range 2-27 seconds])
              • Tablet should not be swallowed intact
              • Instruct patients not to push the tablet through the foil; the foil should be peeled from the blister by bending and lifting the peel tab around the blister seal so the table does not break

              Storage

              Unused vials: Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F)

              May store diluted IV solution in PVC bags at 15-30°C (59-86°F) for up to 24 hr

              Extended-release or immediate release tablets: Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F)

              Solution: Store at 20-25°C (68-77°F)

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Keppra XR oral
              -
              750 mg tablet
              Keppra XR oral
              -
              500 mg tablet
              Roweepra XR oral
              -
              750 mg tablet
              Roweepra XR oral
              -
              500 mg tablet
              Keppra oral
              -
              500 mg tablet
              Keppra oral
              -
              250 mg tablet
              Keppra oral
              -
              100 mg/mL solution
              Keppra oral
              -
              1,000 mg tablet
              Keppra oral
              -
              750 mg tablet
              levetiracetam oral
              -
              100 mg/mL solution
              levetiracetam oral
              -
              500 mg tablet
              levetiracetam oral
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              750 mg tablet
              levetiracetam oral
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              500 mg tablet
              levetiracetam oral
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              250 mg tablet
              levetiracetam oral
              -
              250 mg tablet
              levetiracetam oral
              -
              500 mg tablet
              levetiracetam oral
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              750 mg tablet
              levetiracetam oral
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              1,000 mg tablet
              levetiracetam oral
              -
              750 mg tablet
              levetiracetam oral
              -
              500 mg tablet
              levetiracetam oral
              -
              250 mg tablet
              levetiracetam oral
              -
              1,000 mg tablet
              levetiracetam oral
              -
              500 mg tablet
              levetiracetam oral
              -
              500 mg tablet
              levetiracetam oral
              -
              1,000 mg tablet
              levetiracetam oral
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              750 mg tablet
              levetiracetam oral
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              250 mg tablet
              levetiracetam oral
              -
              750 mg tablet
              levetiracetam oral
              -
              500 mg tablet
              levetiracetam oral
              -
              500 mg tablet
              levetiracetam oral
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              750 mg tablet
              levetiracetam oral
              -
              100 mg/mL solution
              levetiracetam oral
              -
              1,000 mg tablet
              levetiracetam oral
              -
              750 mg tablet
              levetiracetam oral
              -
              250 mg tablet
              levetiracetam oral
              -
              750 mg tablet
              levetiracetam oral
              -
              250 mg tablet
              levetiracetam oral
              -
              500 mg tablet
              levetiracetam oral
              -
              1,000 mg tablet
              levetiracetam oral
              -
              500 mg tablet
              levetiracetam oral
              -
              750 mg tablet
              levetiracetam oral
              -
              250 mg tablet
              levetiracetam oral
              -
              500 mg tablet
              levetiracetam oral
              -
              500 mg tablet
              levetiracetam oral
              -
              100 mg/mL solution
              levetiracetam oral
              -
              1,000 mg tablet
              levetiracetam oral
              -
              100 mg/mL solution
              levetiracetam oral
              -
              100 mg/mL solution
              levetiracetam oral
              -
              100 mg/mL solution
              levetiracetam oral
              -
              1,000 mg tablet
              levetiracetam oral
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              750 mg tablet
              levetiracetam oral
              -
              250 mg tablet
              levetiracetam oral
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              500 mg tablet
              levetiracetam oral
              -
              250 mg tablet
              levetiracetam oral
              -
              750 mg tablet
              levetiracetam oral
              -
              1,000 mg tablet
              levetiracetam oral
              -
              100 mg/mL solution
              levetiracetam oral
              -
              100 mg/mL solution
              levetiracetam oral
              -
              100 mg/mL solution
              levetiracetam oral
              -
              750 mg tablet
              levetiracetam oral
              -
              500 mg tablet
              levetiracetam oral
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              750 mg tablet
              levetiracetam oral
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              500 mg tablet
              levetiracetam oral
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              750 mg tablet
              levetiracetam oral
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              500 mg tablet
              levetiracetam oral
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              750 mg tablet
              levetiracetam oral
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              500 mg tablet
              levetiracetam oral
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              250 mg tablet
              levetiracetam oral
              -
              1,000 mg tablet
              levetiracetam oral
              -
              1,000 mg tablet
              levetiracetam oral
              -
              100 mg/mL solution
              levetiracetam intravenous
              -
              500 mg/5 mL vial
              levetiracetam intravenous
              -
              500 mg/5 mL vial
              levetiracetam intravenous
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              500 mg/5 mL vial
              levetiracetam intravenous
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              500 mg/5 mL vial
              levetiracetam intravenous
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              500 mg/5 mL vial
              levetiracetam intravenous
              -
              500 mg/5 mL vial
              levetiracetam intravenous
              -
              500 mg/5 mL vial
              levetiracetam intravenous
              -
              500 mg/5 mL vial
              levetiracetam intravenous
              -
              500 mg/5 mL vial
              levetiracetam intravenous
              -
              500 mg/5 mL vial
              levetiracetam intravenous
              -
              500 mg/5 mL vial
              Roweepra oral
              -
              1,000 mg tablet
              Roweepra oral
              -
              750 mg tablet
              Roweepra oral
              -
              500 mg tablet
              Roweepra oral
              -
              500 mg tablet
              Keppra intravenous
              -
              500 mg/5 mL vial
              Spritam oral
              -
              500 mg tablet
              Spritam oral
              -
              750 mg tablet
              Spritam oral
              -
              1,000 mg tablet
              Spritam oral
              -
              250 mg tablet

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

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              Patient Education
              levetiracetam oral

              LEVETIRACETAM - ORAL

              (lev-eh-turr-RASS-ih-tam)

              COMMON BRAND NAME(S): Keppra

              USES: Levetiracetam is used to treat seizures (epilepsy). It belongs to a class of drugs known as anticonvulsants. Levetiracetam may decrease the number of seizures you have.

              HOW TO USE: Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking levetiracetam and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take the liquid and regular-release tablets by mouth as directed by your doctor, usually twice daily with or without food. Crushing or chewing the tablet may cause a bitter taste.If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.If you are using the extended-release tablets, take this medication as directed by your doctor, usually once daily. Do not crush or chew extended-release tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Do not split tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.The dosage is based on your medical condition and response to treatment. The dosage in children is also based on weight. To reduce your risk of side effects (such as dizziness and drowsiness), your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase.Do not stop taking this medication without consulting your doctor. Your seizures may become worse when the drug is suddenly stopped. Your dose should be gradually decreased.Tell your doctor if your seizures lasts, change, or gets worse.

              SIDE EFFECTS: Drowsiness, dizziness, unusual tiredness, or weakness may occur. These side effects are more common during the first 4 weeks and usually lessen as your body adjusts to the medication. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, such as: loss of coordination (such as difficulty walking and controlling muscles), mental/mood changes (such as irritability, aggression, agitation, anger, anxiety), signs of infection (such as sore throat that doesn't go away, fever, chills), signs of anemia (such as unusual tiredness that doesn't go away, pale skin, fast breathing, fast heartbeat), easy bruising/bleeding.A small number of people who take anticonvulsants for any condition (such as seizures, bipolar disorder, pain) may experience depression, suicidal thoughts/attempts, or other mental/mood problems. Tell your doctor right away if you or your family/caregiver notice any unusual/sudden changes in your mood, thoughts, or behavior including signs of depression, suicidal thoughts/attempts, thoughts about harming yourself.Levetiracetam can commonly cause a rash that is usually not serious. However, you may not be able to tell it apart from a rare rash that could be a sign of a severe reaction. Tell your doctor right away if you develop any rash.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, such as: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking levetiracetam, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease (such as dialysis treatment), mental/mood disorders (such as depression).This drug may make you dizzy or drowsy, especially during the first month of treatment. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, ride a bicycle, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Children may be more sensitive to the side effects of the drug, especially mental/mood changes (such as irritability, aggression, agitation, anger, anxiety, depression, thoughts of suicide). Children younger than 4 years may be at greater risk for increased blood pressure while using this drug (see also Notes section).Older adults may be more sensitive to the side effects of this drug, especially drowsiness, dizziness or loss of coordination. These side effects can increase the risk of falling.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This medication passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.A product that may interact with this drug is: orlistat.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include slow/shallow breathing, loss of consciousness.

              NOTES: Do not share this medication with others.Lab and/or medical tests (such as kidney function, complete blood count) may be done while you are taking this medication. In children younger than 4 years, blood pressure may also be monitored. Consult your doctor for more details.

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
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              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.