What are the primary uses of Keppra. How should patients take Keppra properly. What are the most common side effects of Keppra. Are there any serious side effects to be aware of. What precautions should be taken when using Keppra.

Understanding Keppra: An Anticonvulsant for Seizure Management

Keppra, also known by its generic name levetiracetam, is a widely prescribed medication for the treatment of seizures associated with epilepsy. As an anticonvulsant, its primary function is to reduce the frequency and severity of seizures in patients diagnosed with this neurological disorder. But how exactly does Keppra work to control seizures?

Keppra operates by modulating the activity of certain neurotransmitters in the brain, particularly affecting the release of glutamate, which plays a role in seizure activity. By stabilizing electrical activity in the brain, Keppra helps prevent the abnormal firing of neurons that leads to seizures. This mechanism of action makes it an effective option for many patients, but it’s important to note that its efficacy can vary from person to person.

Proper Administration: How to Take Keppra Effectively

Proper administration of Keppra is crucial for its effectiveness and safety. How should patients take this medication? Keppra is typically prescribed to be taken orally twice daily, with or without food. The dosage is carefully determined by the prescribing physician based on several factors, including the patient’s age, weight, kidney function, and the severity of their condition.

For those using the liquid form of Keppra, accurate measurement is essential. Patients should use a special measuring device or spoon provided by their pharmacist to ensure they’re taking the correct dose. It’s important to note that household spoons are not accurate for measuring medication and should not be used.

Extended-Release Tablets: A Once-Daily Option

Keppra is also available in an extended-release tablet form, which is usually taken once daily. These tablets must be swallowed whole and should not be crushed or chewed. Why is this important? Crushing or chewing extended-release tablets can release the entire dose at once, potentially increasing the risk of side effects and altering the medication’s efficacy.

Navigating Potential Side Effects of Keppra

Like all medications, Keppra can cause side effects. What are the most common side effects patients might experience? The most frequently reported side effects include:

• Drowsiness
• Dizziness
• Unusual tiredness or weakness

These effects are typically more pronounced during the first four weeks of treatment as the body adjusts to the medication. For many patients, these side effects diminish over time. However, if they persist or worsen, it’s crucial to inform the prescribing physician.

Serious Side Effects: When to Seek Medical Attention

While less common, there are serious side effects associated with Keppra that require immediate medical attention. These include:

• Loss of coordination
• Significant mental/mood changes (e.g., irritability, aggression, anxiety)
• Signs of infection (persistent sore throat, fever, chills)
• Symptoms of anemia (unusual fatigue, pale skin, rapid breathing or heartbeat)
• Easy bruising or bleeding

In rare cases, patients taking anticonvulsants like Keppra may experience depression or suicidal thoughts. It’s crucial for patients and their caregivers to be vigilant about any sudden changes in mood or behavior and report them to a healthcare provider immediately.

Keppra and Skin Reactions: Distinguishing Between Common and Serious Rashes

Keppra can commonly cause a rash that is usually not serious. However, distinguishing between a benign rash and a potentially severe allergic reaction can be challenging for patients. What signs indicate a more serious reaction? Symptoms of a severe allergic reaction may include:

• Widespread rash
• Itching or swelling, especially of the face, tongue, or throat
• Severe dizziness
• Difficulty breathing

If any of these symptoms occur, it’s crucial to seek immediate medical attention. While severe allergic reactions to Keppra are rare, they can be life-threatening if not addressed promptly.

Precautions and Considerations Before Starting Keppra

Before initiating treatment with Keppra, patients should have a thorough discussion with their healthcare provider about their medical history and any current medications. What specific information should patients share with their doctor?

• Any known allergies, especially to medications
• History of kidney disease or current dialysis treatment
• Presence of mental health conditions, particularly depression
• All current medications, including over-the-counter drugs and supplements

This information is crucial for the healthcare provider to assess the appropriateness of Keppra and determine the correct dosage. It also helps in identifying potential drug interactions or contraindications that could affect the safety and efficacy of the treatment.

Special Considerations for Specific Patient Groups

Certain patient groups may require special consideration when using Keppra. For instance, elderly patients may be more sensitive to the side effects of the medication, particularly dizziness and drowsiness. Pregnant women or those planning to become pregnant should discuss the potential risks and benefits of Keppra with their healthcare provider, as the effects of the medication on fetal development are not fully understood.

Keppra’s Impact on Daily Activities: Driving and Operating Machinery

One of the notable side effects of Keppra is its potential to cause drowsiness and dizziness. How does this impact a patient’s daily activities? Patients starting Keppra treatment should be cautious when engaging in activities that require alertness, such as driving or operating heavy machinery. The degree of impairment can vary from person to person, and some individuals may find that these effects diminish over time as their body adjusts to the medication.

It’s advisable for patients to assess their individual response to Keppra before engaging in potentially dangerous activities. If drowsiness or dizziness persists or significantly impacts daily functioning, patients should consult their healthcare provider. In some cases, adjusting the dosage or timing of the medication may help mitigate these effects.

Interactions: Keppra and Other Substances

While Keppra has fewer drug interactions compared to some other anticonvulsants, it’s still important to be aware of potential interactions. What substances might interact with Keppra?

• Alcohol: Can increase drowsiness and dizziness
• Other medications that cause drowsiness: May have an additive effect
• Certain antibiotics: May affect Keppra’s effectiveness
• Oral contraceptives: Keppra may reduce their effectiveness

Patients should always inform their healthcare provider about all medications, supplements, and herbal products they are taking to avoid potential interactions. This includes over-the-counter medications and recreational substances.

The Importance of Medication Adherence

Consistent adherence to the prescribed Keppra regimen is crucial for effective seizure control. Why is it important not to abruptly stop taking Keppra? Suddenly discontinuing Keppra can lead to an increase in seizure frequency or severity. If a patient wishes to stop taking Keppra, it should be done gradually under the supervision of a healthcare provider. The dosage is typically tapered down slowly to minimize the risk of withdrawal seizures.

Monitoring and Follow-up: Ensuring Optimal Treatment with Keppra

Regular monitoring is an essential aspect of Keppra treatment. What should patients expect in terms of follow-up care? Healthcare providers typically schedule regular check-ups to assess the medication’s effectiveness and monitor for any side effects. These appointments may include:

1. Blood tests to check kidney function and medication levels
2. Neurological exams to evaluate seizure control
3. Discussions about any side effects or concerns
4. Adjustments to the treatment plan if necessary

Patients should keep a seizure diary to track the frequency, duration, and characteristics of any seizures they experience. This information can be invaluable to healthcare providers in assessing the effectiveness of the treatment and making any necessary adjustments.

Long-term Outlook for Patients on Keppra

For many patients, Keppra provides effective long-term seizure control with manageable side effects. However, the response to the medication can vary significantly from person to person. Some patients may achieve complete seizure freedom, while others may experience a reduction in seizure frequency or severity. In some cases, combination therapy with other anticonvulsants may be necessary to achieve optimal seizure control.

It’s important for patients to maintain open communication with their healthcare providers throughout their treatment journey. Any changes in seizure patterns, new side effects, or concerns should be promptly reported to ensure the best possible outcomes.

Keppra in Special Populations: Pediatric and Geriatric Use

Keppra is approved for use in both children and adults, but dosing and considerations may differ for these populations. How is Keppra used in pediatric patients? In children, Keppra is often used as an adjunctive therapy for partial-onset seizures. The dosage is carefully calculated based on the child’s weight and adjusted as they grow. Parents and caregivers should be particularly vigilant about monitoring for side effects, as children may not always be able to articulate changes in how they feel.

In geriatric patients, Keppra use requires special consideration due to the higher likelihood of decreased kidney function in this population. How does this affect Keppra treatment in older adults? Dosage adjustments may be necessary, and healthcare providers typically start with lower doses, gradually increasing as tolerated. Regular monitoring of kidney function is particularly important in this age group.

Keppra and Pregnancy: Balancing Risks and Benefits

For women of childbearing age, the use of Keppra during pregnancy is a complex decision that requires careful consideration. While uncontrolled seizures during pregnancy can pose significant risks to both mother and fetus, there are also potential risks associated with anticonvulsant use during pregnancy. What approach do healthcare providers typically take? The general approach is to use the lowest effective dose of Keppra to control seizures while minimizing potential risks to the developing fetus. Close monitoring and prenatal care are essential for pregnant women taking Keppra.

Beyond Seizure Control: Keppra’s Impact on Quality of Life

While the primary goal of Keppra treatment is seizure control, it’s important to consider its broader impact on a patient’s quality of life. How does effective seizure management with Keppra affect daily living? For many patients, achieving better seizure control can lead to significant improvements in various aspects of life, including:

• Increased independence
• Improved ability to work or study
• Enhanced social interactions
• Reduced anxiety about seizure occurrence
• Ability to participate in a wider range of activities

However, it’s also important to acknowledge that side effects of Keppra, particularly those affecting mood or cognition, can impact quality of life for some patients. Finding the right balance between seizure control and manageable side effects is a key goal of treatment.

Complementary Approaches to Seizure Management

While Keppra is a powerful tool in seizure management, many healthcare providers advocate for a comprehensive approach to epilepsy treatment. What complementary strategies can support Keppra therapy? Some approaches that may be beneficial include:

• Maintaining a regular sleep schedule
• Stress reduction techniques such as meditation or yoga
• Avoiding known seizure triggers
• Following a ketogenic diet (under medical supervision)
• Regular exercise, as approved by a healthcare provider

These complementary approaches, when combined with Keppra treatment, may help improve overall seizure control and quality of life for some patients. However, it’s crucial that any additional treatments or lifestyle changes are discussed with and approved by the treating healthcare provider to ensure they are safe and appropriate for the individual patient.

Keppra Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

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 Keppra

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. Swallow the extended-release tablets whole. Do not crush or chew the tablets. Doing so can release all of the drug at once, increasing the risk of side effects.

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.

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.

Does Keppra interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

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.

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.

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.

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.

Images

Keppra 1,000 mg tablet

Color: whiteShape: oblongImprint: ucb 1000

This medicine is a white, oblong, scored, film-coated, tablet imprinted with “ucb 1000”.

Keppra 750 mg tablet

Color: orangeShape: oblongImprint: ucb 750

This medicine is a white, oblong, scored, film-coated, tablet imprinted with “ucb 1000”.

Keppra 250 mg tablet

Color: blueShape: oblongImprint: ucb 250

This medicine is a white, oblong, scored, film-coated, tablet imprinted with “ucb 1000”.

Keppra 500 mg tablet

Color: yellowShape: oblongImprint: ucb 500

This medicine is a white, oblong, scored, film-coated, tablet imprinted with “ucb 1000”.

Keppra 100 mg/mL oral solution

Color: colorlessShape: Imprint:

This medicine is a white, oblong, scored, film-coated, tablet imprinted with “ucb 1000”.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Levetiracetam | Epilepsy Foundation

How to take and store [node:title]?

How to take:

Take levetiracetam exactly as your health care provider prescribes it. Do not change your dose without talking to your provider first. Stopping a seizure medicine suddenly can cause seizures that will not stop (status epilepticus). 

• Check the number of tablets and the strength of pills you get from the pharmacy. If your provider changes the dose, the strength of pills may be different. 
• Levetiracetam is usually taken twice a day, about 12 hours apart. 
• Swallow the tablets whole. They may have a bitter taste when the pill is crushed.  
• People who have trouble swallowing the pills whole can break the tablets in half, mix the tablet with food, or use the liquid form. 
• It can be taken with or without food, but it’s best to take it the same way every day.  
• For the liquid form, always check the bottle for the amount to take and the strength. Levetiracetam liquid comes as 100 mg in every ml. 
  • Shake the bottle well before measuring a dose. 
  • Always use an accurate measuring spoon or syringe to make sure the amount is correct. Do not use a regular teaspoon. 
• Take only the amount that your provider tells you to take. If you take an extra dose, call your provider for advice. If you take a larger number of pills or overdose, call the poison control center (800-222-1222) or call your hospital emergency room. 

How to store:

• Store at room temperature (below 86^oF, 30^oC).
• Keep away from light and moisture.
• Keep all medicines out of reach of children. 

What if I forget?

Taking the right amount of seizure medicine on time every day is the most important way to control seizures. Try these steps to help you remember when to take seizure medicine.  

• If you miss a dose, take it as soon as you remember it. If it is almost time for the next dose, skip the missed dose and go back to your usual schedule. 
• Avoid taking 2 doses at the same time or taking extra doses.
• If you are not sure about what to do, call your health care provider’s office for advice. Do your best to follow their directions. 
• To avoid missed doses, use a pillbox or set an alarm on your watch or phone. 
• Send reminders to yourself with an online seizure diary or text message system like Texting 4 Control.
• Ask your pharmacist to prefill the medicine in blisterpaks.
• Write down any missed doses in your seizure calendar. Share this with your health care provider at each visit. 

How does [node:title] affect the brain?

Brain cells normally talk to each other using electrical signals and chemicals. Seizures can happen when the brain cells are not working or firing normally or working faster than normal.  Most seizure medicines slow down these electrical discharges to stop seizures. 

• Levetiracetam works differently from most seizure medicines. It joins with a protein (called SV2A) that is involved with the release of certain chemicals called neurotransmitters in the brain. The exact way that these actions lead to decreased seizures is not fully known. 

How does the body digest [node:title]?

How the body absorbs, digests, and breaks down or gets rid of a medicine is called metabolism. The way the body metabolizes a medicine affects how often it must be taken. This process can also affect if it will interact with other medicines. If a person has liver or kidney problems, a person’s metabolism may be affected. 

Some important points about levetiracetam:

• The tablets and liquid take the same amount of time to be absorbed.
• Taking levetiracetam with food may slow down the time it takes for the body to absorb the drug by about 1 hour. 
• The highest blood levels are reached in 1 to 2 hours after taking a dose of this medicine.  
• The liver does not affect how levetiracetam works in the body. 
• The body gets rid of the drug through the kidneys. This may affect how much levetiracetam a person with kidney problems takes and how often they take it.  

How well does the [node:title] work?

Not all seizure medicines work for everyone. Your health care provider may try a series of seizure medicines or combination of medicines to find one that works best for you. 

• In most studies of levetiracetam when given with other seizure medicines, 20 to 40% of people had at least a 50% decrease in their seizures. (This means that the number of seizures each month was at least cut in half.)
• Most people did not have many problems with side effects in these studies. 
• At least one study found that levetiracetam may be helpful when used alone in people with focal (partial) seizures.
• Since this medicine does not interact with other seizure medicines, it is easier to use with other seizure medicines.   

What are the most common side effects of [node:title]?

In the early tests of levetiracetam, people who took this medicine were only slightly more likely to stop the drug because of side effects than people taking a placebo (inactive drug).

Some side effects may include:

• Dizziness
• Headache
• Irritability
• Loss of strength and energy
• Mood and behavior changes 
• Sleepiness

Some tips:

• Some side effects are more likely to happen in the first month of taking the drug. Some may go away on their own.
• If you notice any of these problems, call your health care provider. Changing the amount or way the drug is taken may help. Do not stop taking levetiracetam or the way it is taken without your doctor’s advice.
• Some people report that levetiracetam has had positive effects – such as feeling more alert, thinking clearer, and better concentration. It is hard to know whether these effects are from the medicine or from having less seizures.
• Avoid dangerous activities when first starting this medicine or if taking a larger dose, untill you see If you have any side effects.
• Long-term side effects of levetiracetam have not been reported.

What are the most serious side effects of [node:title]?

Very few people have serious side effects from levetiracetam. It is important to be aware of possible reactions and what to do if they happen. 

• Read the package insert for more information.
• Call your provider’s office right away if any of these problems occur.

Allergic reactions: Allergic reactions happen rarely, but can cause symptoms such as low blood pressure, hives, rash, breathing difficulties, and swelling. It can happen after the first dose or any time when taking levetiracetam. Since this can be life-threatening, if these symptoms occur, get immediate medical help.  

Coordination problems: A small number of people may have unsteady walking or coordination problems when taking levetiracetam. This medicine may also worsen coordination or walking problems that were present before starting the drug. Adjusting the dose of levetiracetam may help. 

Changes in behavior, mood, or thoughts: Levetiracetam may cause changes in behavior, mood, or thoughts. This has been seen more often in young children than in adults taking this medicine. The dose of levetiracetam may need to be lowered or stopped. Examples of changes seen include:

• Anger, aggression
• Decreased ability to cope with daily life
• Depression
• Excessive emotional reactions or frequent mood swings or changes
• Severe anxiety, agitation, or confused thoughts
• Thoughts of suicide

Severe skin reactions: Rare but serious skin reactions, such as Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN), have been reported with levetiracetam. These conditions may start with a fever and flu-like symptoms. Then a rash develops. Ulcers or lesions of the mucous membranes may be seen and develop into painful blisters. 

• Report any fever or rash to a health care provider as this can be a life-threatening condition. 
• These types of skin reactions happen most commonly in the second or third week after starting the medicine, though it can happen at other times too.  

Suicidal thoughts and behavior:  In 2008, the Food and Drug Administration (FDA) reviewed data from drug studies that showed a possible relationship between many seizure medicines and suicidal thoughts and behavior. Together, these thoughts and behavior are called suicidality. According to the FDA’s Alert, among the patients with epilepsy in these drug studies, more had symptoms of suicidality than people taking a placebo or inactive substance – 3.5 of 1,000 people taking a seizure medicine had suicidality compared to 1 of 1,000 people taking a placebo.

• Taking seizure medicines may increase the risk of having suicidal thoughts or actions.
• Do not make any changes to the medicines without first talking to the prescribing health care provider.
• Pay close attention to any day-to-day changes in mood, behavior and actions. These changes can happen very quickly so it is important to be mindful of any sudden differences.
• Be aware of common warning signs that might be a signal for risk of suicide. Some of these are:
  • Talking or thinking about wanting to hurt yourself or end your life
  • Withdrawing from friends and family
  • Becoming depressed or having your depression get worse
  • Becoming preoccupied with death and dying
  • Giving away prized possessions
• Contact your health care provider before stopping any seizure meicine. This could possibly lead to worsening of seizure and mood. 

What else is [node:title] used for?

Often medicines may be used for more than one purpose. It is legal to prescribe medicines for “off-label uses” even though the FDA has not formally approved such use.  

• There are no specific reports of off-label use of levetiracetam. 

Who should not take [node:title]?

People should not take levetiracetam if they have had an allergic reaction to the drug or any of its inactive ingredients. 

People with kidney disorders need to be extra careful, however. Levetiracetam may be given at a lower dose to prevent build up to a high level.

Can [node:title] be taken with other medicines?

Sometimes one kind of medicine changes the way another kind of medicine works in the body. Taking levetiracetam does not seem to cause this kind of problem.

• Levetiracetam does not affect the level of other medicines in the body, and other medicines do not affect levetiracetam.

What are the effects of [node:title] on Children?

• The dose of levetiracetam used in children is based on their weight and age. It is usually started at a low dose and may be increased slowly to limit side effects. 
• This medicine is usually given in two doses about 12 hours apart.  
• Children’s bodies handle medicines differently than teenagers and adults. The dose in a young child may be different and will need to be adjusted as they get older. 
• See the package insert for details on how to start a child on levetiracetam and the recommended dose for their age and weight. 

If a woman takes [node:title] during pregnancy will it hurt the baby?

Effect of seizure medicines during pregnancy: In the United States, the FDA assigns each medication to a Pregnancy Category according to whether it has been proven to be harmful in pregnancy. Levetiracetam is listed in Pregnancy Category C. This means that caution is advised, but the benefits of the medicine may outweigh the potential risks.

• Studies in animals show possible harmful effects of levetiracetam to the developing fetus. Yet this needs to be studied in humans as more women use the drug.
• Talk to your health care providers if you are pregnant or plan to become pregnant.
• The risk of birth defects is generally higher in children of women who:
  • Take more than one seizure medicine at the same time 
  • Have a family history of birth defects

All women who are capable of becoming pregnant should take at least 0.4 mg (400 mcg) each day of the vitamin called folic acid (also called folate). This vitamin is thought to help prevent birth defects affecting the brain and spinal cord, called neural tube defects. The most common of these is known as spina bifida.  

• Women at high risk of having a child with a birth defect (such as those with a birth defect in a previous pregnancy or taking certain seizure medicines) may be asked to take 4 mg (4000 mcg) daily before and during pregnancy. 
• Talk to your health care provider about using folic acid and how much to take.
• Start taking this vitamin before you become pregnant. 

If you were taking levetiracetam while pregnant, consider enrolling in the North American Antiepileptic Drug (NAAED) Pregnancy Registry by calling 1-888-233-2334 (www. aedpregnancyregistry.org).

Seizures during pregnancy: Some women may have more seizures during pregnancy, because of hormone changes and how seizure medicine is handled by your body. 

• Talk to your health care provider before pregnancy about seizures and if medicine changes may be needed.
• Know when to check blood levels of medicine during and after pregnancy.
• The dose of seizure medicine may need to be adjusted during and after pregnancy. 

Breastfeeding: Low levels of levetiracetam have been found in breast milk when normal doses of the drug are given. This would not be expected to cause problems in a baby, especially those over 2 months old. Levetiracetam could affect a woman’s supply of breast milk. 

• Women who wish to breastfeed should talk to their doctor about the best medicine to use during pregnancy and when breastfeeding. 
• If you choose to breastfeed, check the baby for drowsiness and keep track of their weight gain and development, especially if you are taking more than one seizure medicine.  
• Talk to your health care team about any concerns that arise and if you have any problems with breastfeeding. 

Contraception: Levetiracetam does not interfere with hormonal birth control. 

What are the effects of [node:title] on Seniors

Levetiracetam is commonly prescribed for people over 65.  When people are older than 65 or 70, their kidneys usually don’t work as well as before. The kidneys are responsible for removing levetiracetam from the body, so it stays in the body longer if the kidneys aren’t working normally. 

• A very low dose of levetiracetam may need to be used when starting it in older adults. The dose of medicine would then be increased more slowly.
• Sometimes a person may be asked to take levetiracetam just once a day. 
• Seniors may be more sensitive to the side effects of this medicine.
• Common side effects like sleepiness, dizziness, or loss of strength, may be worse when taking levetiracetam.
• Older adults may be at greater risk of injury from falls or other accidents resulting from these problems.
• Levetiracetam does not interact with other medicines commonly used by older adults. 

What are the dose ranges for [node:title]?

The best amount is any seizure medicine is the amount that control seizures without causing bothersome side effects. This depends on many factors, which are different for every individual.

• The approved dose range of levetiracetam is between 1,000 and 3,000 mg daily. The medicine is usually started at lower doses and increased over a couple weeks. 
• Some people may be given higher doses, depending on their individual situation.
• See the package insert for doses used in children. 

Read About [node:title] studies

Experience with levetiracetam (keppra) in the treatment of post-stroke epilepsy

Epilepsy is one of the most common neurological and socially significant forms of neurological pathology, the incidence of which is higher in the elderly and senile age [1, 19]. According to epidemiological studies [2], the incidence of epilepsy in patients over 60 years of age ranges from 104 to 127.2 cases per 100,000 population. Among the reasons for this, it should be noted the high incidence of cerebrovascular pathology in the elderly, which is one of the leading risk factors for the development of epilepsy [18-20]. W. Hauser et al. [19] revealed that in 30% of cases, epileptic seizures in patients over 60 years of age were associated with impaired cerebral circulation, the same figures were presented by K. Luhdorf et al. [24]. As a result of prospective studies [1, 2, 4], epilepsy was detected in 8.3% of 1200 patients with ischemic stroke.

Among cerebrovascular disorders, the most common cause of epilepsy in the elderly is cerebral stroke [2, 4, 13, 18, 19]. According to E.S. Prokhorova [7], in hemorrhagic stroke, epileptic seizures occurred in 8.69% of cases, with ischemic stroke – in 4.12%.

Y. Lo et al. [23] give almost equal rates of seizures after stroke of different types: 2. 3% after ischemic, 2.8% after hemorrhagic, 2.7% after subarachnoid hemorrhage. L. Forsgren et al. [15] stated that the cause of epileptic seizures in 30% of cases was a cerebral stroke, and the risk of seizures increased by 3% at the age of 17-39 years and by 45% after 60 years.

Difficulties in the pharmacotherapy of epilepsy in the elderly are associated with the diseases that cause it, comorbidities, the interaction of antiepileptic (AED) and other drugs taken by patients for somatic disorders, age-related physiological changes in the body with impaired absorption of drugs, specific pharmacokinetics and altered sensitivity to AEDs.

Means of choice for focal epilepsy, including in elderly patients, are carbamazepines (finlepsin, tegretol) and preparations of valproic acid (convulex), its sodium (convulsofin) and calcium (convulsofin) salts. Valproates and carbamazepines are no less effective in elderly patients than in young ones [2, 4].

The main task in the treatment of epilepsy is the effective control of seizures while maintaining a high quality of life for the patient. This is possible with the use of a new generation of AEDs, which include the drug levetiracetam (Keppra). The drug was released by UCB (Belgium) as a new effective AED in 1999. The drug is characterized by complete absorption after oral administration, linear pharmacokinetics, no effect on microsomal liver enzymes and thus on the metabolism of other drugs (including AEDs and oral contraceptives), which is also facilitated by low binding to blood proteins [5, 6, 21]. The unique mechanism of action of the drug is that it binds to the SV2A glycoprotein of synaptic vesicles (this protein is necessary for normal neurotransmission), regulating the release of neurotransmitters and reducing the epileptic activity of the neuron [26].

In addition, other additional mechanisms of action have been proven for levetiracetam. These include increased GABAergic and glycinergic inhibition, with the GABAergic interaction being the main inhibitory mechanism in the brain that provides the therapeutic effect of many AEDs. The inhibitory effect of GABA and glycine is carried out to a large extent due to the activation of the influx of chloride ions into the neuron, which achieves the effect of inhibitory hyperpolarization [5, 13].

Pharmacological studies show that levetiracetam blocks epileptic discharges in the culture of nervous tissue caused by bicuculline and activation of NMDA receptors, without affecting the normal conduction of excitation [5, 9], stabilizes the membrane of neurons, causing inhibition of high-voltage Ca ²⁺ – and K ⁺ channels and limiting the excitotoxic effect of NMDA receptor activation (neuroprotective effect).

The purpose of this work is to study the use of levetiracetam (Keppr) in patients with post-stroke epilepsy both in monotherapy and in combination with traditional AEDs.

Material and methods

The selection of patients was carried out by applying to the Republican Clinical Hospital and the Republican Epileptological Center of the Republic of Dagestan. Inclusion criteria were: diagnosis of symptomatic (post-stroke) epilepsy in accordance with the classification proposed in 1962 G. Barolin and E. Scherzer [9], who divided epileptic seizures in cerebrovascular pathology depending on their onset in relation to the development of a stroke.

Determination of the type of seizures and syndromes of epilepsy was carried out in accordance with the International Classification of Epileptic Seizures (1981) and Syndromes of Epilepsy (1989).

Therapy with levetiracetam (kepra) was received by 39 patients with symptomatic post-stroke epilepsy aged 47 to 69 years with seizures resistant to conventional antiepileptic therapy. Among the patients, men predominated – 24 (61.5%) people.

A complex of clinical, electrophysiological, neuroradiological methods was used in the work. Patients with ischemic stroke with epileptic seizures underwent a clinical and neurological examination using the “System for assessing the degree of movement disorders, tone, sensitivity and skills” L. G. Stolyarova [8]. Electroencephalographic studies were carried out according to the standard scheme “10 × 20” using a 21-channel computer electroencephalograph “Encephalan-121-03” (NPKF “Medikom MTD”, Taganrog), with a recording duration of 30 minutes and the use of functional tests (rhythmic fractional photostimulation at frequencies 3, 6, 10, 15, 20, 25 Hz and hyperventilation for 5 minutes). EEG registration was carried out in the interictal period in a state of passive wakefulness. U 27(69.2%) of patients, pronounced violations of the background rhythm were detected. Characteristic was the presence of disorganization (α and β) with a violation of their zonal distribution. Interhemispheric asymmetry was registered in more than half (79.4%) of cases.

Magnetic resonance imaging was performed on a GE “Signa” apparatus with a magnetic field strength of 1.5 T in standard modes.

All patients included in the study had focal epilepsy. 3 patients had not previously received AEDs, 25 received carbamazepine therapy, 11 – benzonal. Levetiracetam (Keppra) was prescribed as monotherapy or as an additional drug to basic therapy. Levetiracetam therapy was initiated at a daily dose of 20 mg/kg, slowly titrated to 250 mg per week.

Patients were followed up for 6-16 months. Clinical efficacy was assessed by the effect of the drug on the frequency of seizures: no seizures, a decrease in the frequency of seizures by more than 50%; less than 50% reduction in seizure frequency or no effect; increase (aggravation) of seizures. The frequency and nature of adverse events were analyzed

Results

Mean patient age was 58.6 years (95% CI: 56.5–60.8 years). The distribution of patients by age and sex is presented in Table. 1. Analyzing the age of patients with ischemic stroke, it can be noted that the onset of epileptic seizures in this group occurred mainly at the age of 60-69years (in 20 patients), and mostly in men. The greater likelihood of epileptic seizures in patients at this age, mainly in men, is most likely due to age and gender characteristics of the development of ischemic stroke and its course, as well as an increase in the cumulative effect of provoking and predisposing risk factors, such as cardiovascular pathology, atherosclerotic lesions of the vessels of the brain and heart, dysmetabolic disorders, hyperlipidemia, etc. The above data are consistent with the data of other authors [7, 13, 19].

Out of 39 patients with epileptic syndrome, 36 (92.3%) suffered a stroke once: 21 (53.8%) of them with the left hemispheric focus and 17 (43.6%) with the right hemisphere; 1 (2.6%) patient suffered a cerebrovascular accident in the vertebrobasilar system. Repeated strokes were observed in 3 (7.7%) patients. Of these, 2 had left-hemispheric strokes, 1 had right-hemispheric strokes.

Partial seizures with secondary generalization largely prevailed – 22 (56.4%). In 5 (12.8%) cases, patients had simple motor partial seizures, complex partial seizures in 12 (30.7%) cases (Table 2).

Seizures-precursors in the period from 0 to 7 days after the stroke developed in 3 patients, in 3 patients the seizures first appeared even before the development of the stroke, in the period from several years to several days before the stroke, in the rest – a week or more after the stroke. In the first 7 days, seizures developed in 4 patients.

The main epileptic focus was localized in the temporal zone in 19 (48.7%) patients, in the frontal zone in 6 (15.3%) patients, in the frontotemporal zone in 8 (20.5%) patients, in the central zone in 3 ( 7.9%) and in the occipital – in 1 (2.5%). In 2 (5.1%) patients, identification of the epileptic focus was impossible. In 35% of patients, focal slow waves were detected, corresponding to the focus of the stroke. Regional sharp waves and spikes were detected in 14 patients in the frontotemporal leads. At 79In % of cases, high-amplitude (up to 140 μV) bilateral-synchronous flashes of α-, θ-oscillations were recorded, mainly in the frontotemporal and central-temporal-occipital areas, tending to generalization. Structural changes in the substance of the brain included cicatricial-atrophic changes, the phenomena of replacement hydrocephalus, as well as single and multiple cysts.

The inclusion of levetiracetam (keppra) in the treatment regimen led to the complete elimination of seizures in 4 (10. 3%) patients, a significant decrease in the frequency of seizures (more than 50%) was observed in 33 (84.6%) cases. Little or no effect was noted in 2 (5.1%) patients (Table 3). Aggravation of seizures was not observed during the study.

Complete relief of seizures was achieved with a daily dose of keppra 1000 mg. A decrease in the frequency of seizures by more than 50% was recorded at average daily doses of Keppra 1500-2000 mg, which coincides with the data of other authors [6].

Neurophysiological analysis revealed a decrease in the severity of epileptiform activity. With mathematical mapping in the frequency spectrum, the zone of paroxysmal activity decreased in comparison with background mapping by 1.8-2 times. Amplitude mapping indicated a decrease in irritative manifestations of stem structures by 75%. The phenomenon of “forced normalization” of Landolt’s EEG was not observed. In most cases, generalized epileptiform activity was replaced by focal activity. In 5 cases, after the addition of levetiracetam (keppra), generalized epileptiform activity was reduced to individual focal acute waves of frontotemporal localization. The normalizing effect of keppra on the EEG in patients with epilepsy has been previously reported in the literature [5, 6, 16].

The positive effect of keppra on the behavior of patients observed during the study is of interest: there was a subjective improvement in well-being, as well as a decrease in apathy, depression and drowsiness.

A significant effect was observed in secondary generalized and simple partial seizures.

Side effects occurred in 2 (5.1%) of 39 patients and did not depend on the dose of the drug, they included difficulty falling asleep and impaired concentration.

Discussion

The data obtained due to the small sample of patients and the short duration of follow-up (from 6 to 16 months) should be considered preliminary.

The absence of seizures for more than 6 months was achieved in 10.3% of cases, a decrease in the frequency of seizures by more than 50% – in 84.6%. Insufficient effect was noted in 5. 1% of cases. The data obtained reflect a slightly higher efficacy of the drug compared to the review [16, 25], conducted on the material of a study of 1400 patients with various forms of resistant epilepsy, where complete remission was achieved in 17.2% of patients, a decrease in the frequency of seizures by more than 50 % – 49%. This may partly be explained by the insufficient period of prospective follow-up. A number of authors [11, 27] draw attention to the high efficiency of keppra as an additional treatment for hard-to-treat partial epilepsy. According to their data, the effectiveness of Keppra therapy increased with increasing daily dose.

When summarizing the results of our own study and previously published works on the use of levetiracetam (keppra) in the treatment of epilepsy, we can draw the following conclusions: the drug is effective in all types of seizures and forms of epilepsy. The greatest efficiency was noted in simple partial and secondary generalized seizures. It is important that in most patients its effect is already manifested at low and medium therapeutic doses.

Side effects occurred predominantly during the dose titration period and were manifested mainly by impaired CNS function. The use of levetiracetam (keppra) as part of complex therapy for difficult-to-treat epilepsy was accompanied by good tolerance, which is consistent with the data of other researchers [17].

It is very important that patients noted an improvement in the quality of life, probably associated with the normothymic and nootropic effects of the drug. The positive effect on the affective sphere and behavior, as well as the good tolerability of the drug, indicate the high efficiency of levetiracetam (keppra) in the treatment of symptomatic post-stroke epilepsy.

Keppra – instruction from zastosuvannya, buy Keppra syrup in Ukraine | Price from 586.70 UAH.

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Creation date: 04/27/2021
Update date: 06/16/2023

Keppra in retail and tablets: prescription The drug is used for treatment of epilepsy. The active component of the drug is used to spray the attack.

Pharmacological power

Pharmacodynamics

N-type channels and decreased Ca2 depletion from intraneuronal depots. These results allow us to assume that the interaction between levetiracetam and the protein of synaptic vesicles 2A often explains the mechanism of protiepileptic action of the drug.

Levetiracetam is safe against trial in a wide range of models of partial and primary generalized attacks, without any anti-sumoral effect.

Pharmacokinetics

Levetiracetam is characterized by high versatility and penetration. Pharmacokinetics have a linear character, do not lie down at the hour and are characterized by a low intersubjectivity.

The level of soaking should not be left in the dose and does not change under the injection. Cmax in plasma is reached 1.3 years after taking the drug.

There is no evidence that the drug has been tested in human tissue.

T½ of plasma in mature adults becomes close to 7 years old and does not fall into the dose, the route of administration or re-infusion. Average outdoor clearance – 0.96 ml / min / kg.

For the identification of the active component of this metabolite, nirks are indicated.

In older children, there was a significant correlation between drug concentrations in blood plasma slugs. Levetiracetam The formula of the component is radically different from analogs, as it is designed to treat epilepsy. Levetiracetam is however effective in focal and generalized attacks.

In pharmacies, Keppra can be bought in two dosage forms:

• oral in a bottle with a 300 ml injection syringe;
• tablets of 250, 500 and 1000 mg in packs of 30 and 60 pieces.

Faces can be fixed from the first fates of life. Oral rozchin zastosovuyut for the delight of children of the monthly age.

Keppra price to fall in the form (various or tablets) and dosage of fluent speech. You can view up-to-date information about the variety on the side of the face on the website of MIS Pharmacy 9-1-1.

Dosing regimen

The additional dose of drugs is divided into two doses.

Zha practically does not contribute to the consideration of medical care.

Rozchin for oral infusion (syrup) should be diluted in the water bottle (for small children – in the water bottle). Wash down the tablets with a great amount of water.

Dosage to be taken according to the diagnosis, age and type of the patient. For older children weighing over 50 kg, doses have grown. The scheme of likuvannya is assigned by the likar. For patients with death and severe impairment of function, the dose should be carefully adjusted depending on the level of creatinine clearance.

Pochatkov’s therapeutic dose is 1000 mg per dose. Z tsієї doses can be rozpochinati at the 1st day of likuvannya. Depending on the clinical tolerance, the dose can be increased up to 3000 mg per doba.

No need for dose adjustment for patients with mild or moderate hepatic impairment.

The dosage form is selected depending on the needs of the patient. For small children and children of a young school age, oral rozchin is recommended. Tablets can be drunk for 4 years.

The maximum allowable dose for mature adults is not to exceed 3 g per doba.

Contraindications before admission

Contraindications before congestion are also nirkova and liver failure. Zasіb z oberezhnіstyu zastosovuyut for the rejoicing of the sick in 65 years.

Side effects Most often, the following reactions may occur in patients:

More likely to break up: anxiety, emotional instability, depression, increased alertness, suicidal thoughts.

Patients with a history of liver disease may develop hepatitis.

Vagity and breastfeeding

In different hospitals, the drug can be taken for an hour of winemaking for a child. Therapy is carried out according to the confession and under the supervision of the doctor.

The breast is blessed for an hour of jubilation.

Interactions with other drugs

It is not recommended to take anti-diabetic drugs at the same time as osmotic transmission In some cases, the drug may not be effective.

Levetiracetam does not interact with the active ingredients of other anti-seizure drugs, so Keppra may be in the warehouse of anti-seizure therapy.

Wicked literature list

1. Compendium – medicinal preparations;
2. Sovereign register of medical supplies;
3. JAMA.

Increasing information about Keppra

Yak Keppra influencing child development?

Based on scientific evidence, the number and severity of side effects in the case of taking an anti-seizure drug for the treatment of epilepsy in children under 7 years of age should not exceed the allowable level. With what posterity is the high efficiency of Keppri used in monotherapy and in combination therapy.

Should Keppra be prescribed again?

Indications for patients with epilepsy. Faces zastosovuyut during partial, myoclonic and tonic-clonic attacks.

Keppra after what hour do the drug?

Anti-sudoma drug, taken from the first day of ingestion. Clinical remission is possible after 3 months of therapy.

Why should Keppra be prescribed?

Likarskiy zasib zastosovuyt іz early vіku. Tablets can be taken in a daily dose for 4 years, oral doses can be taken for 1 month.

Keppra instructions

KEPPRA®
(UA/9155/01/01)

Release form:

tablets, coated with a shell, 250 mg, 10 tablets in a blister; 3 or 6 blisters per cardboard pack

Stock:

1 tablet vengeance levetiracetam 250 mg

Manufacturer:

Belgium

KEPPRA®
(UA/9155/01/02)

Release form:

tablets, covered with shell, 500 mg, 10 tablets in a blister; 3 or 6 blisters per cardboard pack

Stock:

1 tablet vengeance levetiracetam 500 mg

Manufacturer:

Belgium

KEPPRA®
(UA/9155/01/03)

Release form:

tablets, covered with a shell, 1000 mg, 10 tablets in a blister; 3 or 6 blisters per cardboard pack

Stock:

1 tablet vengeance levetiracetam 1000 mg

Manufacturer:

Belgium

KEPPRA®
(UA/9155/02/01)

Release form:

oral, 100 mg/ml, 300 ml per vial; 1 bottle with a peaceful plastic syringe in a pack of cardboard

Stock:

1 ml to replace levetiracetam 100 mg

Manufacturer:

France

KEPPRA®

Release form:

tablets, covered with shell, 500 mg, 10 tablets in a blister; 3 or 6 blisters per cardboard pack

Stock:

1 tablet vengeance levetiracetam 500 mg

Manufacturer:

Belgium

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