Levetiracetam

Side effects

Notable side effects

• Drowsiness or somnolence.
• Disturbed behaviour, agitation or emotional lability, or mood changes can occur. Aggressiveness may be as frequent as 1 in 5.
• Drug withdrawal must be strongly considered if suicidal ideation occurs.
• Rash is uncommon.
• Rarely, a neutropenia, thrombocytopenia or liver dysfunction may occur.
• All anticonvulsants are potentially teratogenic and this is often dose related (see section: AED Prescribing - Pregnancy)

For a complete list of adverse effects, appropriate formularies should be consulted.

Dosage

• The initiation and escalation dose depends upon age, weight, syndrome, seizure frequency and intensity, and side effect profile.
• Unfortunately, a one dose regime does not fit all.
• A Paediatric Neurologist should be consulted if there is uncertainty.
• Using intravenous formulation, levetiracetam can be used in emergency situations, e.g. status epilepsy. Similar dosage is used for intravenous administration if patient is already on oral levetiracetam.

Commonly used regime

• Target dose 20-40mg/kg/day in two divided doses. Higher doses may be used (for example up to 60mg/kg).
• Start 10-20mg/kg/day in two divided doses, increasing each 2 weeks by 10mg/kg/day.
• Dosages per kilogram can only be used in children of weight approximately up to 30-40kgs. Consult appropriate formularies for higher weights and in the adult range.
• These dosages are only a guideline and appropriate formularies should be consulted as needed.

Preparations

• Oral solution 100mg/ml or Tablet 250mg, 500mg, 1,000mg.
• There is an intravenous form.

Monitoring

• No drug level monitoring is currently available.

Interactions | Precautions

There are minimal drug interactions.