Levetiracetam : uses, dosage, side effects and composition

Description of Levetiracetam

Levetiracetam is a drug used for the treatment of seizure and epilepsy both in humans and animals. It belongs to a class of drugs called anticonvulsants.

In humans, it is used for seizure and epilepsy treatment in both adults and children.

It contains Levetiracetam as its active ingredient. It also contains inactive ingredients called excipients in sufficient quantities.

Levetiracetam comes in different dosage forms and strengths. The most come among them being:

  • Tablets: 250mg, 500mg, 750mg, and 1000mg
  • Syrup (oral solution): 125mg/5ml, 250mg/5ml, 500mg/5ml and 100mg/ml
  • Extended release tablets: 500mg, 750mg, 1000mg and 1500mg
  • Injectable solutions: 5mg/ml, 10mg/ml, 15mg/ml and 100mg/ml

What is Levetiracetam used for?

Levetiracetam is used, either alone or in combination with other anticonvulsants, for the treatment of seizure and epilepsy in both humans and animals.

Levetiracetam has shown to be effective for use in the treatment of some psychiatric disorders such as anxiety, panic attacks, stress, mood and bipolar disorders, autism, and Tourette’s syndrome.

How to use Levetiracetam

Your doctor or pharmacist will guide you on how best to use Levetiracetam. This is because medications are better individualized.

Your doctor or pharmacist will use your age, body weight, and seizure frequency to determine the best way you are to use Levetiracetam.

Generally, it is taken by mouth 12 hourly.

Dosage of Levetiracetam

Age, body weight, side effects tolerance and seizure frequency are factored in when determining Levetiracetam dosage for patients.

However, these are the conventional dosage of Levetiracetam:

  • Adults: 500mg per dose 12 hourly. This can be increased by 500mg Per dose every 2 weeks to recommended dose of 1500 mg per dose.
  • Children:
    • Less than one month: The safety and efficacy of Levetiracetam is not established in infants less than one month of age.
    • 1 to 6 months: 7 mg/kg given by mouth 12 hourly; increase by increments of 7 mg/kg 2 hourly every 2 weeks to recommended dose of 21 mg/kg
    • 6 months to 4 years: 10 mg/kg given by mouth 12 hourly, increase in increments of 10 mg/kg 12 hourly every 2 weeks to recommended dose of 25 mg/kg
    • 4 to 16 years: 10 mg/kg given by mouth 12 hourly; increase every 2 weeks by 10 mg/kg/dose to 30 mg/kg.

Side effects of Levetiracetam

The following are some common side effects associated with Levetiracetam:

  • Abnormal physical weakness or lack of energy. This is medically called asthenia.
  • Headache
  • Increased tendency to have infection, including viral infection. This suggests that Levetiracetam lowers the immune system.
  • Increase in blood pressure, especially that of children who are less than 4 years of age.
  • Drowsiness
  • Excess sleepiness, otherwise called somnolence
  • Fatigue
  • Unwarranted fear of being overweight which consequently leads one to eat less. This is medically known as anorexia
  • Weakness
  • Common cold or nasopharyngitis
  • Cough
  • Dizziness
  • Being nervous

Few percentage of patients on Levetiracetam may experience the following side effects:

  • Asthma
  • Memory loss or amnesia
  • Anxiety
  • Impaired balance or coordination (ataxia)
  • Depression
  • Hostility
  • Pins and needles sensation (tingling and prickly sensation)
  • Double vision (diplopia)
  • Lazy eye or decreased eyesight. This is medically called amblyopia
  • Inflammation of outer membrane of the eyeball and the upper eyelid (conjunctivitis)
  • Inflammation of nasal cavities (sinusitis)
  • Presence of protein called albumin in urine

Please note that an individual may experience other side effects other than those listed above.

Similarly, you may experience few or none of those enlisted above.

Always report serious side effects to your doctor.

When not to take Levetiracetam

Do not use Levetiracetam in the following conditions below:

  • if you are pregnant
  • if you are breastfeeding
  • if you do not have history of seizure or epilepsy
  • if you are hypersensitive to Levetiracetam
  • if you are planning to drive or to operate heavy machinery. This is because it causes drowsiness.
  • if you have kidney dysfunction, except on approval by your doctor
  • if you have anemia
  • if you have low blood platelets counts
  • if you low immunity or low white blood cell called neutrophils
  • if you have psychotic disorder, since the drug itself can cause them as part of its side effects
  • if you have suicidal thoughts
  • if you have depression
  • if you do hallucinate
  • if you have abnormal manner of walking. This is because lack or coordination or balance is one of Levetiracetam’s side effects
  • if you have loss of muscle coordination

Levetiracetam use in pregnancy

  • Levetiracetam is in pregnacy category C drugs.

There is little data with regards to Levetiracetam use in pregnancy. Therefore, it is not known if it is safe to use during pregnancy or not.

Animal studies shows that Levetiracetam is not safe to use during pregnancy. It leads to developmental toxicities and teratogenic effects.

Do not use Levetiracetam during pregnancy unless the benefits outweigh the potential risks of doing so. Your doctor will determine this.

Levetiracetam use during lactation

Levetiracetam is excreted in human milk and there are no data on effects of it on breastfed infant, or on milk production.

Breastfeeding women should not use Levetiracetam, unless the benefits they would get from its use would outweigh the POTENTIAL risks it would pose on their babies.

For women who have been on Levetiracetam prior to delivery, there may be a need to reduce the dose. This to ensure that the breastfed infants do not experience side effects associated with keppra use.

Can missing one dose of Levetiracetam cause seizure?

Missing doses of Levetiracetam can trigger a seizure in both humans and animals.

The reason is this, by the time your next dose is due, the level of Levetiracetam in your blood will be so low such that it cannot effectively prevent you from having seizures.

So, missing the dose will most likely trigger a seizure, since there will be little to no Levetiracetam in your body to protect you.

Therefore, try not to miss your Levetiracetam doses to prevent you from coming down with seizure. You can use alarm device to achieve this.

What to do when you miss a dose of Levetiracetam

The action you’re to take when you miss a dose of Levetiracetam will be dependent on the time that has passed before you remember to take it.

If you take it twice a day, take the missed dose immediately you remember, unless it’s less than 8 hours before the next dose is due. If this is that case, skip the missed dose and take your next dose at the usual time.

Do not take 2 doses at the same time for any reason whatsoever. Doing so will lead to overdosing. In a similar manner, never take an extra dose to make up for a forgotten one.

It’s important to take your medicine regularly. Like we said initially, missing doses of Levetiracetam may trigger a seizure.

what happens if you take Levetiracetam and don’t need it?

You are not required to take any drug, including Levetiracetam, if you don’t need it.

But in a scenario where you take Levetiracetam when you don’t need it, what will happen is dependent on some factors as we would state below.

  • If you’re not epileptic and don’t use to have seizures, taking Levetiracetam mistakenly would not harm you if you didn’t take an overdose of it. You will only experience some side effects associated with its use.
  • If you take it when you don’t need it, probably because you just took a dose of it few minutes or few hours ago (double dosing), you may experience serious side effects as it will be an overdosage.

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