keppra

Keppra (levetiracetam) is an anti-epileptic drug, also called an anticonvulsant.

Keppra is used to treat partial onset seizures in adults and children who are at least 1 month old.

Keppra is also used to treat tonic-clonic seizures in adults and children who are at least 6 years old, and myoclonic seizures in adults and children who are at least 12 years old.

Important information

Do not stop using Keppra without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using Keppra suddenly. You may need to use less and less before you stop the medication completely.

You may have thoughts about suicide while taking Keppra. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, irritable, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Wear a medical alert tag or carry an ID card stating that you take Keppra. Any medical care provider who treats you should know that you take seizure medication.

Keppra may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Do not start or stop taking Keppra during pregnancy without your doctor"s advice. Having a seizure during pregnancy could harm both the mother and the baby. Seizure control is very important during pregnancy and the benefits of preventing seizures may outweigh any risks posed by using Keppra.

Before taking this medicine

You should not use Keppra if you are allergic to levetiracetam.

To make sure Keppra is safe for you, tell your doctor if you have:

• kidney disease;

• depression or other mood problems;

• a history of mental illness or psychosis; or

• a history of suicidal thoughts or actions.

You may have thoughts about suicide while taking this medicine. Tell your doctor if you have symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Do not start or stop taking Keppra during pregnancy without your doctor"s advice. Having a seizure during pregnancy could harm both mother and baby. Tell your doctor right away if you become pregnant while taking Keppra for seizures.

Seizure control is very important during pregnancy. The benefit of preventing seizures may outweigh any risks posed by taking Keppra. There may be other seizure medications that can be more safely used during pregnancy. Follow your doctor"s instructions about taking this medicine while you are pregnant.

Levetiracetam can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using Keppra.

Do not give this medicine to a child without the advice of a doctor. Your child"s dose needs are based on age and weight. The child should remain under the care of a doctor while using Keppra.

How should I take Keppra?

Take Keppra exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Keppra is usually taken twice per day. Take the medicine at the same time each day. You may take Keppra with or without food.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

If a child is using this medicine, tell your doctor if the child has any changes in weight. Levetiracetam doses are based on weight in children, and any changes may affect your child"s dose.

Use Keppra regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Do not stop using Keppra suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor"s instructions about tapering your dose.

Seizures are often treated with a combination of drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor"s advice.

Wear a medical alert tag or carry an ID card stating that you take Keppra. Any medical care provider who treats you should know that you take seizure medication.

While using Keppra, your kidney function may need to be tested often.

Store at room temperature away from moisture, heat, and light.

Keppra dosing information

Usual Adult Dose of Keppra for Seizures:

16 years of age and older:

Initial Dose: 1000 mg daily by either immediate release oral or intravenous administration, given as 500 mg twice daily. Additional dosing increments may be given (1000 mg/day additional every 2 weeks) to a maximum recommended daily dose of 3000 mg. There is no evidence that doses greater than 3000 mg/day confer additional benefit.

Extended release:
Initial dose: 1000 mg orally once daily
This dose may be increased every 2 weeks by 1000 mg/day to a maximum of 3000 mg once daily.

Usual Pediatric Dose of Keppra for Seizures:

Myoclonic seizures:
Oral:
Children 12 years and older: Immediate release: Initial: 500 mg twice daily; may increase every 2 weeks by 500 mg/dose to the recommended dose of 1500 mg twice daily. Efficacy of doses greater than 3000 mg/day has not been established.

Partial onset seizures:
Oral:
Children 1 month to less than 6 months old: Immediate release: 7 mg/kg/dose given twice daily (14 mg/kg/day); may increase every 2 weeks by increments of 14 mg/kg to the recommended daily dose of 42 mg/kg.
Children 6 months to less than 4 years old: Immediate release: 10 mg/kg given twice daily (20 mg/kg/day); may increase in 2 weeks by an increment of 20 mg/kg to the recommended daily dose of 50 mg/kg (25 mg/kg twice daily). The daily dose of 50 mg/kg may be reduced in patients who cannot tolerate this dose.
Children 4 to less than 16 years: Immediate release: 10 mg/kg/dose given twice daily; may increase every 2 weeks by 10 mg/kg/dose to the recommended dose of 30 mg/kg/dose twice daily (60 mg/kg/daily). The daily dose of 60 mg/kg may be reduced in patients who cannot tolerate this dose.
Children 16 years and older: Refer to adult dosing.
Maximum dose: 3000 mg/day

Tonic-clonic seizures:
Oral:
Children 6 to less than 16 years: Immediate release: Initial: 10 mg/kg dose given twice daily; may increase every 2 weeks by 10 mg/kg/dose to the recommended dose of 30 mg/kg twice daily. Efficacy of doses greater than 60 mg/kg/day has not been established.
Children 16 years and older: Refer to adult dosing.
Maximum dose: 3000 mg/day

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include extreme drowsiness, agitation, aggression, shallow breathing, weakness, or fainting.

What should I avoid while taking Keppra?

Avoid drinking alcohol. It can increase some of the side effects of Keppra and may also increase the risk of seizures.

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Keppra side effects

Get emergency medical help if you have signs of an allergic reaction to Keppra: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, panic attacks, trouble sleeping, or if you feel agitated, hostile, irritable, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

• unusual changes in mood or behavior (unusual risk-taking behavior, being irritable or talkative);

• confusion, hallucinations, loss of balance or coordination;

• extreme drowsiness, feeling very weak or tired;

• bruising, severe tingling, numbness, pain, muscle weakness;

• problems with walking or movement;

• the first sign of any skin rash, no matter how mild;

• severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling; or

• signs of infection - fever, swollen gums, painful mouth sores, pain when swallowing, skin sores, cold or flu symptoms, cough, trouble breathing.

Common Keppra side effects may include:

• dizziness, drowsiness;

• weakness; or

• infection.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Keppra?

Other drugs may interact with levetiracetam, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.