Indications
Levetiracetam Tablet is used for:
Partial seizures
Adult Dose
Oral
Adjunct in seizures
Adult: For partial seizures w/ or w/o secondary generalisation; myoclonic seizures (w/ juvenile myoclonic epilepsy); primary generalised tonic-clonic seizures (w/ idiopathic generalised epilepsy): Initially, 500 mg bid on the 1st day. Adjust dose in increments or decrements of 500 mg bid at 2-4 wk intervals.
Max: 1,500 mg bid.
Monotherapy for partial seizures with or without secondary generalisation
Adult: Recommended starting dose is 250 mg bid, increased to an initial therapeutic dose of 500 mg bid after 2 wk. May further increase by 250 mg bid every 2 wk depending upon response.
Max: 1,500 mg bid.
Intravenous
Adjunct in seizures
Adult: For partial seizures w/ or w/o secondary generalisation; myoclonic seizures (w/ juvenile myoclonic epilepsy); primary generalised tonic-clonic seizures (w/ idiopathic generalised epilepsy): Initially, 500 mg bid on the 1st day. Adjust dose in increments or decrements of 500 mg bid at 2-4 wk intervals.
Admin by infusion over 15 min.
Max: 1,500 mg bid. Max duration: 4 days.
Monotherapy for partial seizures with or without secondary generalisation
Adult: Recommended starting dose is 250 mg bid, increased to an initial therapeutic dose of 500 mg bid after 2 wk. May further increase by 250 mg bid every 2 wk depending upon response. Admin by infusion over 15 min.
Max: 1,500 mg bid. Max duration: 4 days.
Hepatic impairment: Severe: Reduce dose by 50%.
Child Dose
Oral
Adjunct in seizures
Child: 1 to <6 mth Initially, 14 mg/kg daily, may adjust in increments of 14 mg/kg at 2-wk intervals.
Max: 42 mg/kg daily;
>6 mth <50 kg: Initially, 20 mg/kg daily, may adjust in increments of 20 mg/kg at 2-wk intervals.
Max: 60 mg/kg daily.
Intravenous
Adjunct in seizures
Child: 1 to <6 mth Initially, 14 mg/kg daily, may adjust in increments of 14 mg/kg at 2-wk intervals.
Max: 42 mg/kg daily;
>6 mth <50 kg: Initially, 20 mg/kg daily, may adjust in increments of 20 mg/kg at 2-wk intervals.
Max: 60 mg/kg daily. To be given via infusion over 15 min.
Renal Dose
Renal impairment: ESRD patients undergoing dialysis: Loading dose of 750 mg, followed by 500-1,000 mg once daily; supplemental dose of 250-500 mg after dialysis.
CrCl (ml/min) Dosage Recommendation
<30 250-500 mg bid.
30-49 250-750 mg bid.
50-79 500-1,000 mg bid.
Administration
May be taken with or without food. Oral soln may be taken directly or diluted in a glass of water.
Contra Indications
Hypersensitivity.
Precautions
Renal and hepatic impairment; pregnancy, lactation; patients undergoing haemodialysis. If psychotic symptoms (eg hallucination) and behavioural symptoms (eg agitation, anxiety) occur, reduce dosage. Abrupt withdrawal may result in increased seizure frequency. May impair ability to drive or operate machinery during initial therapy.
Lactation: Excreted in breast milk; not recommended
Pregnancy-Lactation
Pregnancy
There are no adequate and well-controlled studies in pregnant women; prolonged experience in pregnant women has not identified a drug-associated risk of major birth defects or miscarriage, based on published literature, which includes data from pregnancy registries, and reflects experience over two decades
In animal studies, levetiracetam produced evidence of developmental toxicity, including teratogenic effects, at doses similar to or greater than human therapeutic doses
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus
Drug blood levels may decrease during pregnancy; physiological changes during pregnancy may affect drug concentration; decrease in drug plasma concentrations has been observed during pregnancy; this decrease is more pronounced during third trimester; dose adjustments may be necessary to maintain clinical response
Lactation
Drug is excreted in human milk; there are no data on effects of drug on breastfed infant, or on milk production
Unknown if distributed in human breast milk
Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for the drug, and any potential adverse effects on the breastfed infant from the drug or from the underlying maternal condition
Interactions
Enzyme-inducing antiepiletic drugs.
Side Effects
Side effects of Levetiracetam :
>10%
Asthenia (11-15%), Headache (14-19%), Infection (11-15%), Increased blood pressure (17% in children < 4 years), Somnolence (11-15%), Drowsiness (2-23%), Fatigue (10-11%), Anorexia (3-13%), Weakness (9-15%), Nasopharyngitis (7-15%), Cough (2-11%)
1-10%
Viral infection (2%), Asthma (2%), Dizziness (5-9%), Nervousness (2-10%), Amnesia (2%), Anxiety (2-3%), Ataxia (3%), Depression (2-5%), Hostility (10%), Paresthesia (2%), Sinusitis (2%), Diplopia (2%), Amblyopia (2%), Conjunctivitis (2-3%), Albuminuria (4%)
<1%
Abnormal hepatic function tests, Dyskinesia, Eczema, Neutropenia, Decreased hematocrit, Leukopenia, Suicidal tendencies, Hepatitis, Pancreatitis, Bone marrow suppression, Epidermal necrolysis
Mode of Action
Anticonvulsant used in the treatment of partial seizures. The precise mechanism of anticonvulsant effect is unknown.
Note
Levetiracetam 500 mg Tablet generic name is Levetiracetam. Levetiracetam 500 mg Tablet is manufactured by Incepta Pharmaceuticals Ltd.Levetiracetam is availble in all over Bangladesh.
Mes BD drug index information on Levetiracetam Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.