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Levetiracetam (LEE ve tye RA se tam) has been approved by the FDA to treat focal-onset seizures in patients 1 month and older, myoclonic seizures in patients 12 years and older with juvenile myoclonic epilepsy, and primary generalized tonic-clonic seizures in patients 6 years and older with idiopathic generalized epilepsy.

Your epilepsy treatment should always be discussed with your healthcare provider before use. Based on their judgment and knowledge, a drug may be prescribed for other epilepsy types not included in the indications. For more information, please see the prescribing information.

How can you take levetiracetam? (Available formulations)

Levetiracetam is available as a tablet, oral solution, and intravenous injection. Levetiracetam tablets can be taken whole with or without food. Use the levetiracetam oral solution if you cannot swallow tablets.

Who should not take levetiracetam?

If you are allergic to levetiracetam or any of the inactive ingredients, then you should not take it.

Other considerations may influence whether you should take levetiracetam. Tell your healthcare provider if you:

  • have or have had depression, mood problems, or suicidal thoughts or behavior.
  • have kidney problems.
  • are pregnant or plan to become pregnant.
  • are breastfeeding or plan to breastfeed.

What is important to know about taking levetiracetam?

Do not stop taking levetiracetam suddenly unless directed to do so by your healthcare provider.

As with all antiseizure medications, levetiracetam should be withdrawn gradually to minimize the risk of causing or worsening seizures or status epilepticus. You should not stop using levetiracetam suddenly unless your healthcare provider tells you to stop the medicine because of a serious side effect.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Taking levetiracetam with certain other medicines may cause side effects or affect how well they work. Do not start or stop other medicines without talking to your healthcare provider.

Women or those who are/plan to become pregnant
Use in pregnancy

While levetiracetam blood levels may decrease during pregnancy, there are no adequate and controlled studies in pregnant people. In animal studies, there were instances of developmental issues at clinically relevant doses. However, having a seizure during pregnancy could harm both the pregnant individual and the baby. Tell your healthcare provider right away if you become pregnant. Do not start or stop taking seizure medication during pregnancy without your healthcare provider’s advice.

If you become pregnant while taking levetiracetam, talk to your healthcare provider about registering with the North American Antiepileptic Drug (NAAED) Pregnancy Registry. The purpose of this registry is to collect information about the safety of antiseizure medicine during pregnancy. You can enroll in this registry by calling 1-888-233-2334.

Use during breastfeeding

Levetiracetam is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from levetiracetam, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the pregnant individual. Talk to your healthcare provider about the risks. Your healthcare provider will consider the developmental and health benefits of breastfeeding along with your need for levetiracetam and the potential effect on the infant from levetiracetam or from your epilepsy.

What are the side effects of levetiracetam?

Levetiracetam is approved by the FDA because it is safe and effective for the majority of people who take it. However, there are risks associated with all medicines. Some side effects caused by levetiracetam can be very serious, and even life-threatening. It is important to be informed about these serious reactions and to be aware of their symptoms.

Common side effects

The most common side effects that were reported in studies of levetiracetam are:

  • somnolence, asthenia, infection, and dizziness in adult patients.
  • fatigue, aggression, nasal congestion, decreased appetite, and irritability in pediatric patients.
Rare, but serious side effects
Suicidal thoughts or behaviors

Studies have found that people who take antiseizure medications including levetiracetam may have suicidal thoughts or behaviors, which occur in approximately 1 in 500 patients. If you experience any thoughts or impulses to hurt yourself, you should contact your healthcare provider immediately.

Behavioral abnormalities and psychotic symptoms

Behavioral abnormalities including psychotic symptoms, irritability, and aggressive behavior have been observed. You should monitor for psychiatric signs and symptoms.

Somnolence and fatigue

Levetiracetam can make you feel fatigued or drowsy (somnolence). Do not drive, operate heavy machinery, or do other dangerous activities until you know how levetiracetam affects you.

Do not drive or operate machinery until you have gained sufficient experience on levetiracetam to gauge whether it adversely affects your abilities.

Serious dermatological reactions

Serious dermatological reactions, including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis, have been reported in both children and adults in association with levetiracetam use. Such serious skin reactions may be life-threatening, and some patients have required hospitalization with very rare reports of fatal outcomes. The median time of onset for reported cases was 14 to 17 days after treatment initiation. Recurrence of the serious skin reactions following rechallenge with levetiracetam has also been reported. You should discontinue levetiracetam at the first sign of rash unless the rash is clearly not drug-related.

Anaphylaxis and angioedema

Levetiracetam can cause anaphylaxis (allergic reaction) or angioedema (e.g., swelling of the throat, head, and neck) after the first dose or at any time during treatment. Signs and symptoms have included hypotension, hives, rash, respiratory distress, and swelling of the face, lip, mouth, eye, tongue, throat, and feet. Some reactions were life-threatening and required emergency treatment. If you develop any signs or symptoms of allergic reactions or swelling, levetiracetam should be discontinued and you should seek immediate medical attention. Levetiracetam should be discontinued permanently it cannot be cleared of the cause of the reaction.

Coordination difficulties

Levetiracetam may cause coordination difficulties including problems with movement and balance (ataxia), abnormal gait, or incoordination. In clinical trials, these events occurred most frequently within the first 4 weeks of treatment. You should monitor closely for these signs and symptoms and avoid driving or operating machinery until you know how levetiracetam can affect your abilities.