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Levetiracetam Brand Names
ELEPSIA XR | Keppra | Keppra XR | Roweepra | Spritam
What is Levetiracetam
Levetiracetam is a pyrrolidine derivative anticonvulsant used for the treatment of a variety of seizures types (partial onset, primary generalized tonic-clonic, myoclonic).
Guidelines recommend levetiracetam as a reasonable second-therapy option for convulsive status epilepticus (after a benzodiazepine).
Interactions with concomitantly administered antiepileptic drugs are minimal, and it has minimal adverse effects.
Both the oral solution and the IV formulation are FDA-approved for the treatment of partial seizures in patients as young as 1 month of age, the adjunctive treatment of myoclonic seizures in patients as young as 12 years with juvenile myoclonic epilepsy, and the adjunctive treatment of primary generalized tonic-clonic seizures in patients as young as 6 years with idiopathic generalized epilepsy; fixed-dose immediate-release tablets are labeled for patients weighing at least 20 kg.
The extended-release tablets are approved for the treatment of partial seizures in patients as young as 12 years.
Antiepileptic drugs (AEDs) such as levetiracetam increase the risk of suicidal ideation and behavior; monitor all patients receiving levetiracetam for emerging or worsening suicidal thoughts/behavior or depression.
Indications
- acute repetitive seizures
- myoclonic seizures
- partial seizures
- seizure prophylaxis
- status epilepticus
- tonic-clonic seizures
For the treatment of partial seizures
Side Effects
- abdominal pain
- acute generalized exanthematous pustulosis (AGEP)
- agitation
- agranulocytosis
- alopecia
- amnesia
- anaphylactic shock
- anaphylactoid reactions
- anemia
- angioedema
- anorexia
- anxiety
- arthralgia
- asthenia
- ataxia
- choreoathetosis
- confusion
- conjunctivitis
- constipation
- cough
- dehydration
- depression
- diarrhea
- diplopia
- dizziness
- drowsiness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dyskinesia
- ecchymosis
- elevated hepatic enzymes
- emotional lability
- eosinophilia
- erythema multiforme
- fatigue
- hallucinations
- headache
- hepatic failure
- hepatitis
- hostility
- hyperkinesis
- hyperreflexia
- hypertension
- hyponatremia
- infection
- influenza
- insomnia
- irritability
- lethargy
- leukopenia
- musculoskeletal pain
- myasthenia
- nasal congestion
- nausea
- neutropenia
- otalgia
- pancreatitis
- pancytopenia
- paranoia
- paresthesias
- pharyngitis
- pneumonitis
- proteinuria
- pruritus
- psychosis
- rash
- rhabdomyolysis
- rhinitis
- seizures
- sinusitis
- Stevens-Johnson syndrome
- suicidal ideation
- thrombocytopenia
- toxic epidermal necrolysis
- urticaria
- vertigo
- vomiting
- weight loss
Monitoring Parameters
- serum creatinine/BUN
Contraindications
- abrupt discontinuation
- breast-feeding
- children
- depression
- dialysis
- driving or operating machinery
- geriatric
- infants
- neonates
- pregnancy
- psychosis
- renal disease
- renal failure
- renal impairment
- schizophrenia
- suicidal ideation
Interactions
- Alprazolam
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amphetamines
- Azelastine; Fluticasone
- Beclomethasone
- Betamethasone
- Budesonide
- Budesonide; Formoterol
- Bupropion
- Bupropion; Naltrexone
- Carbamazepine
- Chlorpromazine
- Ciclesonide
- Clomipramine
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Colchicine; Probenecid
- Colesevelam
- Corticosteroids
- Cortisone
- Deflazacort
- Desipramine
- Dexamethasone
- Dextromethorphan; Promethazine
- Doxepin
- Fludrocortisone
- Flunisolide
- Fluphenazine
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Formoterol; Mometasone
- Hydrocortisone
- Hydroxychloroquine
- Imipramine
- Isocarboxazid
- Lithium
- Maprotiline
- Mefloquine
- Meperidine; Promethazine
- Mesoridazine
- Methylprednisolone
- Molindone
- Mometasone
- Monoamine oxidase inhibitors
- Nortriptyline
- Pemoline
- Perphenazine
- Perphenazine; Amitriptyline
- Phenelzine
- Phenothiazines
- Phentermine; Topiramate
- Phenylephrine; Promethazine
- Prednisolone
- Prednisone
- Probenecid
- Prochlorperazine
- Promethazine
- Protriptyline
- Selegiline
- Thiethylperazine
- Thioridazine
- Tolvaptan
- Topiramate
- Tranylcypromine
- Triamcinolone
- Tricyclic antidepressants
- Trifluoperazine
- Trimipramine