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Home > Drug Category > Antiepileptic Medication > Keppra and Equivalent

Keppra (Levetiracetam) Information

Keppra (levetiracetam) is a prescription antiepileptic drug (AED) used to treat epilepsy by controlling and reducing the occurrence of seizures. It is indicated for use alone (monotherapy) or as an add-on therapy (adjunctive) for a broad range of seizure types: Partial-Onset Seizures, Myoclonic Seizures (in patients with Juvenile Myoclonic Epilepsy), and Primary Generalized Tonic-Clonic Seizures. Levetiracetam is chemically distinct from other existing AEDs. It is generally well-regarded for its predictable pharmacokinetics and minimal drug-drug interactions. Its half-life is relatively short, approximately six to eight hours in adults with normal kidney function, which necessitates twice-daily dosing to maintain steady-state concentrations.

Keppra is rapidly and almost completely absorbed after oral administration, with a bioavailability of nearly 100%. The drug is primarily eliminated unchanged by the kidneys, which is a key consideration for dosing in patients with renal impairment. The precise, complete mechanism of action for levetiracetam is not entirely understood. However, its main therapeutic effect is thought to be mediated by its high-affinity binding to the Synaptic Vesicle Protein 2 A (SV2A). SV2A is a protein found on synaptic vesicles. It is believed to be involved in the regulation of neurotransmitter release in the central nervous system. By binding to SV2A, levetiracetam is thought to modulate synaptic transmission and inhibit hypersynchronization of neuronal activity, thereby stabilizing brain electrical activity and preventing the initiation and spread of seizures. Keppra is available as a prescription-only medication in immediate-release tablets, extended-release tablets, an oral solution, and a concentrate for intravenous infusion. For immediate-release formulations, the typical starting dose for adults with partial-onset seizures is 500 mg twice daily, with a maximum recommended daily dose of 3000 mg. The dosage for children is based on body weight and age.

Keppra Side Effects

While Keppra is generally well-tolerated, some individuals may still experience side effects, many of which are related to the central nervous system. The most common effects reported, particularly in the initial phase of treatment, include somnolence (sleepiness), asthenia (weakness/fatigue), headache, and dizziness. Due to its effect on the central nervous system, Keppra is also frequently associated with mood and behavioral changes, which can range from mild to severe, including irritability, aggression, hostility, depression, anxiety, and emotional lability (rapidly changing moods). Other common effects include infection, nasopharyngitis (common cold), and loss of appetite. However, more serious side effects can occur. If any of the following symptoms are experienced, a patient should seek immediate medical attention:

• Allergic/Hypersensitivity Reactions: Symptoms such as Anaphylaxis and Angioedema (e.g., swelling of the face, throat, tongue, or lips) can occur, which may be life-threatening and require emergency medical treatment.

• Hematologic Abnormalities: Keppra can cause decreased white blood cell count (neutropenia) and anemia, which may require periodic blood count monitoring.

• Severe Dermatological Reactions: Although rare, levetiracetam can cause severe and potentially life-threatening skin reactions, including Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). Symptoms may include a spreading rash, fever, blistering, and swelling, which may require the immediate discontinuation of the drug.

• Suicidal Thoughts and Behaviour (AED Class Warning): Like all antiepileptic drugs, Keppra carries a strong risk warning for increasing the risk of suicidal thoughts or behaviour, particularly during the initial phase of treatment or following a dose change. Patients and caregivers must monitor closely for any emergence or worsening of depression or unusual behavioural changes.

• Worsening of Seizures/Status Epilepticus: Abrupt discontinuation of the medication can lead to an increase in seizure frequency or precipitate status epilepticus.

Keppra Precautions

Before taking Keppra, it is essential to have a thorough discussion with a healthcare provider about your medical history and any other medications you are taking. Keppra is contraindicated only in patients with a known hypersensitivity to the drug or any component of the formulation. Due to the risk of increased seizure frequency, Keppra must be gradually withdrawn rather than stopped abruptly. Caution is required in patients with a history of depression or other psychiatric illnesses, and they should be monitored closely for new or worsening symptoms. Since the kidneys primarily eliminate levetiracetam, dose adjustment is necessary for patients with reduced renal function. Furthermore, because the drug can cause somnolence, dizziness, and coordination difficulties, patients should exercise caution when driving or operating heavy machinery until they understand how the medication affects them. If you are pregnant or breastfeeding, the risks and benefits must be carefully weighed with your doctor.

Do I need a prescription to order Keppra?

Yes, a prescription is required from your physician to order Keppra.