levetiracetam at a glance
Medicine class
Anti-seizure medicine, also called an antiepileptic medicine.
Food
Oral levetiracetam can be taken with or without food.
Stopping treatment
Do not stop levetiracetam suddenly unless a clinician directs you to, because seizures may return or worsen.
Driving and machinery
Do not drive, cycle or operate machinery if it causes sleepiness, tiredness, dizziness or coordination problems.
What is levetiracetam used for?
Selected UK products are licensed for epilepsy, with permitted ages and routes differing between products.
Used alone for newly diagnosed partial-onset seizures, with or without secondary generalisation, in adults and adolescents from 16 years.
Used with other epilepsy medicines for partial-onset seizures, including in children and infants where the selected oral product permits.
Used with other epilepsy medicines for myoclonic seizures associated with juvenile myoclonic epilepsy in adults and adolescents from 12 years.
Used with other epilepsy medicines for primary generalised tonic-clonic seizures associated with idiopathic generalised epilepsy in adults and adolescents from 12 years.
The selected intravenous product is an alternative when oral administration is temporarily not feasible; its paediatric licence begins at a different age from selected oral products.
How does levetiracetam work?
The exact mechanism is not fully understood. Levetiracetam binds to synaptic vesicle protein 2A, which is involved in releasing chemical signals between nerve cells. This is thought to help stabilise abnormal electrical activity that can cause seizures.
levetiracetam preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 100 mg/mL
Dispersible tablet
Route: Oral
Strengths: 500 mg
Oral solution
Route: Oral
Strengths: 100 mg/mL, 250 mg, 500 mg, 750 mg, 1000 mg, 1500 mg
How to take levetiracetam
Follow the instructions for the specific formulation supplied and check its leaflet if its appearance or instructions change.
Swallow film-coated tablets with liquid; do not chew or crush them.
Place orodispersible tablets on the tongue and allow them to break down before swallowing, with or without water.
Dissolve Neuraxpharm granules in water and take immediately after preparation.
Desitrend coated granules may be swallowed with liquid and have specific feeding-tube instructions.
Use the supplied oral syringe or measuring device for liquids, not a kitchen teaspoon.
Intravenous concentrate must be prepared and administered by a healthcare professional.
levetiracetam side effects
Common or expected effects
- Sleepiness or tiredness
- Dizziness or headache
- Nausea or vomiting
- Shaking or difficulty controlling movements
- Agitation, irritability or aggression
Get urgent medical advice
- Swelling, breathing difficulty or other signs of a severe allergic reaction
- Painful blistering, widespread or peeling skin rash
- New suicidal thoughts, psychotic symptoms or major behavioural change
- Very little urine, confusion or swelling that may indicate kidney injury
- Fever, recurrent infections, unusual bleeding or profound weakness that may indicate altered blood-cell counts
- A marked increase in seizure frequency or severity
levetiracetam in pregnancy
Levetiracetam can be used during pregnancy when a specialist considers it necessary. UK safety reviews do not suggest an increased risk of major congenital malformations with monotherapy. Do not stop it after becoming pregnant because uncontrolled seizures can harm mother and baby. Arrange an early review when planning pregnancy or after an unplanned pregnancy because clinical response and levetiracetam concentrations can change.
levetiracetam while breastfeeding
Levetiracetam passes into breast milk and is not usually used while breastfeeding. It may be continued after an individual benefit–risk discussion when seizure control requires it. Contact a healthcare professional if there are concerns about the baby.
levetiracetam interactions
Levetiracetam has relatively few enzyme-mediated interactions, but some combinations need precautions or monitoring.
Methotrexate
Levetiracetam may reduce methotrexate clearance and prolong potentially toxic concentrations, requiring specialist monitoring.
Macrogol laxatives
Macrogol may reduce the effect of oral levetiracetam.
Sedating medicines, remedies or supplements
These may add to sleepiness or dizziness; check with a pharmacist before combining them.
Common questions about levetiracetam
Answers are fully visible for fast scanning and source review.
Are levetiracetam, Keppra, Desitrend and Zolvum the same medicine?
They contain levetiracetam, but their formulations, excipients and administration instructions differ. Check the packet and leaflet whenever the supplied product changes.
Can levetiracetam tablets be crushed or chewed?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.