Medication Pearl of the Day: Levetiracetam (Keppra)
Indication: Levetiracetam (Keppra) is indicated for adjunctive therapy in the treatment of partial onset seizures in patients 1 month of age and older with epilepsy; for myoclonic seizures in patients 12 years of age and older with juvenile myoclonic epilepsy; and for primary generalized tonic-clonic seizures in patients 6 years of age and older with idiopathic generalized epilepsy.
- Dosing: 500 mg twice daily; increase by 500 mg twice daily every 2 weeks to recommended dose of 1500 mg twice daily. For 6 years to < 16 years: 10 mg/kg twice daily, increase in increments of 10 mg/kg twice daily every 2 weeks to recommended dose of 30 mg/kg twice daily.
- Dosage forms: 250 mg, 500 mg, 750 mg, and 1000 mg film-coated, scored tablets—100 mg/mL solution.
- Adverse events: Most common adverse reactions (incidence ≥ 5% more than placebo) include somnolence, asthenia, infection and dizziness in adult patients and fatigue, aggression, nasal congestion, decreased appetite, and irritability in pediatric patients.
- Mechanism of action: The antiepileptic activity of levetiracetam was assessed in a number of animal models of epileptic seizures. Levetiracetam did not inhibit single seizures induced by maximal stimulation with electrical current or different chemoconvulsants and showed only minimal activity in submaximal stimulation and in threshold tests.
Reference: label (fda.gov)