Levetiracetam Drug Interactions — ORE Part 1 MCQ

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ModeratePharmacology & TherapeuticsLevetiracetam Drug InteractionsORE Part 1

An adult with well-controlled epilepsy takes levetiracetam monotherapy and has no relevant medical contraindications to the proposed dental medicines. Which statement best describes levetiracetam-specific interactions relevant to routine dental prescribing?

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Correct answer: B — Clinically significant interactions with routine dental medicines are unlikely

Explanation lettering: C = shown as A · A = shown as B · E = shown as C · B = shown as E

**A is correct.** The UK levetiracetam SmPC states that clinically important interactions with other substances are unlikely. Levetiracetam is not extensively metabolised by hepatic CYP enzymes and does not significantly induce drug-metabolising enzymes in vivo. Therefore, there is no levetiracetam-specific reason to avoid standard dental medicines such as amoxicillin, metronidazole, paracetamol or ibuprofen, provided each medicine is otherwise appropriate for the individual patient. Options B and E incorrectly assert predictable interactions with antibiotics or ibuprofen. Option C is wrong: levetiracetam itself does not contraindicate use of dental local anaesthesia. Option D is wrong because topical fluoride has no relevant interaction with levetiracetam. This does not remove the need to check other medicines, comorbidities, renal function where relevant, allergy history and usual prescribing contraindications.

Reference: electronic Medicines Compendium (eMC). Levetiracetam Milpharm 500 mg film-coated tablets: Summary of Product Characteristics, section 4.5 “Interaction with other medicinal products and other forms of interaction”, updated 14 April 2026. https://www.medicines.org.uk/emc/product/3073/smpc