Levetiracetam (Intravenous)

Levetiracetam injections are given to help reduce the frequency of certain types of seizure.

Overview

You will only be given this medication in a hospital or clinic by trained medical personnel, usually twice per day for several weeks.

When you start taking levetiracetam, your dosage will be increased gradually over a period of several weeks. When the time comes for you to stop taking this medication, the dose will be lowered gradually, and it may take several weeks or months before you are taken off the medication completely. If you stop taking the drug abruptly you will be at risk of side-effects, including a greater risk of seizures.

Levetiracetam is known to produce side-effects in some people. Mental issues including depression and emotional disturbances, potentially serious skin problems, and high blood pressure can occur in some individuals. Report any unusual side-effects to your doctor.

You should avoid alcohol while you are taking Levetiracetam as this can cause drowsiness.

This medication is commonly sold under the brand name 'œKeppra.'

Conditions Treated

  • Partial onset seizures
  • Myoclonic seizures
  • Primary generalized tonic-clonic seizures

Type Of Medicine

  • Anti-epileptic
  • Anticonvulsant

Side Effects

As well as its intended beneficial effects, levetiracetam can also cause negative side-effects in some people. Contact the doctor or nurse on duty immediately if you experience any of the following side-effects:

  • Agitation or restlessness
  • Black or tarry stools
  • Bleeding, especially around the gums
  • Bloatedness
  • Changes to your heartbeat, such as a fast or irregular heartbeat
  • Constipation
  • Coughing or hoarseness
  • Diarrhea
  • Difficulty urinating, pain during urination, or darkened urine
  • Irritation in the eyes
  • Light-colored stools
  • Loss of appetite
  • Muscle pain, especially in the lower back or sides
  • Nausea or sickness
  • Pale skin
  • Red dots on the skin
  • Sore throat
  • Ulcers or white spots in the mouth or on the lips
  • Weakness, fatigue, or tiredness
  • Yellow skin or eyes

Other side effects are less severe, but may be unpleasant to experience. In such cases, you may be given another medication to help manage the side-effects, or you may be monitored more closely. Consult the medical professional if you notice any of the following:

  • Changes to your voice
  • Crying
  • Difficulty concentrating
  • Difficulty swallowing
  • Dizziness
  • Emotional changes
  • Euphoria
  • Feeling discouraged or uninterested
  • Feeling like you or the environment is moving or spinning
  • Feeling 'œoff-balance' or uncoordinated
  • Hair loss or thinning
  • Lightheadedness
  • Headaches
  • Memory problems
  • Nasal congestion
  • Prickling or 'œpins and needles'
  • Runny nose
  • Sadness
  • Swollen or sensitive glands
  • Weakness
  • Weight loss

Levetiracetam can cause changes to mood or behavior. People with existing mental health conditions may be particularly susceptible to this. Contact your doctor straight away if you notice any of the following symptoms in yourself or your child:

  • Anger
  • Anxiousness or nervousness
  • Depression, low mood, feeling sad or upset, or emotional instability
  • Thoughts of self-harm or suicide
  • Unusual weakness, fatigue, or tiredness

Levetiracetam can cause skin reactions that can be serious if they are not treated quickly, because they are prone to become infected. Consult your doctor straight away if you notice any of the following:

  • Blisters or sores
  • Chills
  • Fever
  • Loose or peeling skin
  • Red skin lesions
  • Rashes, spots or acne
  • Ulcers on the skin

Levetiracetam can cause high blood pressure in children aged 4 and under. Your doctor may want to see your child for frequent check-ups. If your child's blood pressure does change, contact your doctor immediately.

This is not an exhaustive list and levetiracetam might cause other side effects that are not listed here. If you notice anything unusual, consult the doctor or nurse immediately. In many cases, side-effects are not harmful, and will pass with time. However, in other cases you may need medical attention.

Overdose

Seek medical assistance immediately if you notice any symptoms of overdose when you have taken levetiracetam. These include:

  • Anxiety, especially if severe
  • Difficulty breathing, shortness of breath, or hyperventilation
  • Irregular heartbeat
  • Feinting or loss of consciousness
  • Paleness or blue coloration to the lips, skin, or fingernails
  • Shaking, tremors, or agitation
  • Trouble sleeping
  • Unusual drowsiness or sleepiness

Allergic reaction

Allergic reactions to this medication are very rare, but they can occur in some people. Seek emergency medical assistance immediately if you notice any of the following.

  • Breathing problems
  • Itching, especially when severe
  • Redness, rashes or hives on the skin
  • Severe disorientation, dizziness, or loss of consciousness
  • Swelling, especially in the face, tongue, throat, or hands

Dosage

The dosage of levetiracetam that you are given will be unique to you, based on your condition, the type, and severity of your symptoms, your age, any other medical conditions you suffer from, and other factors. However, as a guideline, some typical doses given for different conditions are listed below:

For partial onset seizures

  • Adults:

1000 mg separated into two 500 mg doses per day. Increase by 1000 mg every two weeks until the dose reaches 3000 mg.

  • Children:

Your doctor will determine an appropriate dose.

For myoclonic seizures in people with juvenile myoclonic epilepsy

  • Adults:

1000 mg separated into two 500 mg doses per day. Increase by 1000 mg every two weeks until the dose reaches 3000 mg.

  • Children aged 12+ years:

Same as the adult dose.

For primary generalized tonic-clonic seizures

  • Adults:

1000 mg separated into two 500 mg doses per day. Increase by 1000 mg every two weeks until the dose reaches 3000 mg.

  • Children aged 16+ years:

Same as the adult dose.

Children aged 6 to 16: 10 mg per kg of body weight twice per day. Increase by 10 mg per kg every 2 weeks, up to a maximum of 30 mg per kg.

If your symptoms improve before you reach the maximum recommended dose, your doctor may keep you at that dosage level rather than increase further.

The injection will be given to you by a doctor, nurse or other medical professional, usually in a hospital or other clinic. You will usually be given this medication several times by injection to see how it affects your seizures. The drug needs to be administered into your body slowly, so you will be attached to an IV tube, usually through a vein in your arm, for approximately 15 minutes.

You should keep all of your appointments to receive your levetiracetam injections. When the time comes to stop taking the drug, you will usually be advised to reduce the dose gradually over a period of time, as opposed to stopping abruptly, which might cause some undesired side-effects, including a greater risk of experiencing seizures. When tapering off, your doctor will usually reduce the dose by 500 mg per dose every 2 to 4 weeks. In children, the dose will usually be reduced by no more than 10 mg per kg of body weight every 2 weeks.

If your condition improves as a result of the levetiracetam injections, and if you are not experiencing any harmful side-effects, you will usually then be moved on to an oral version of the drug that you can take home with you.

Interactions

Levetiracetam can interact with some other medications in ways that can cause undesired or harmful side-effects. Before you take levetiracetam, it is important that you tell your doctor about any other medications that you are taking, as well as any vitamins or herbal supplements. The following medications are especially likely to cause an interaction:

  • Acetaminophen
  • Buprenorphine
  • Calcifediol
  • Carbamazepine
  • Ginkgo
  • Methotrexate
  • Naloxone
  • Orlistat
  • Propoxyphene
  • Sodium oxybate

In some cases, your doctor may advise that you do not take levetiracetam. In other cases, you may still be prescribed it, but your dose of one or both medications may be altered, and you will probably be asked to see your doctor more frequently so that they can ensure that the medications are not interacting.

The above is not a conclusive list of interactions. Always tell your doctor about all medications you are currently taking before you are given levetiracetam.

You should also avoid consuming alcohol during the course of your treatment with levetiracetam. Alcohol may make certain side-effects more likely, including drowsiness, dizziness, and difficulty concentrating.

Warnings

Levetiracetam does not cure the condition that is causing your seizures, and can only reduce the frequency of your seizure, or make them less intense to experience. When you stop taking the medication, your condition will return to how it was before you were taking levetiracetam.

This medication can cause drowsiness. Do not drive or operate machinery after you have been given the levetiracetam, unless you are sure that you can do so safely. If you feel dizzy, disoriented, or drowsy while you are being given the drug, or afterwards, tell the doctor or nurse immediately.

If you see another doctor for any other condition, or if you go to your dentist for dental care, let them know that you are taking levetiracetam. This is because the medication can affect the results of some medical tests.

Do not stop taking the medication unless your doctor has told you that it is safe to do so. You may experience side-effects if you stop taking the drug abruptly. Your doctor may want to reduce your dose gradually over a period of time before you stop taking the drug completely.

You will probably be asked to see your doctor at regular intervals while you are taking this medication. Your doctor will want to make sure that the medication is working properly, and that Ensure that you keep these appointments.

Levetiracetam may not be safe to use by people with certain medical conditions. You should discuss any present or past medical conditions with your doctor before you take this medication. The following conditions are of particular concern:

  • Any mental illness, but particularly depression and other mood or emotion disorders. Levetiracetam may make the symptoms of these disorders worse.
  • Kidney problems. This may cause the drug to be eliminated from your system more slowly than usual, which increases the effect of the drug.

If you have any of these conditions, you may still be able to take levetiracetam. However, you may be given a smaller dose than usual, or your doctor may want to see you more frequently to better monitor how the drug is affecting you.

Pregnancy and breastfeeding

Studies have not yet conclusively determined whether this drug is safe to be taken by pregnant or breastfeeding women. There is some evidence from animal studies that the drug may harm the fetus, but evidence in human studies is not conclusive. Controlling seizures during pregnancy is very important, as this can also potentially lead to the unborn baby being harmed. Your doctor discuss this with you and help you determine whether the benefits of reduced seizures outweigh the potential risks of taking the medication.

Children

This medication can sometimes be given to children, depending on the particular type of seizure that they experience. It can be given to infants older than 1 month of age for partial onset seizures, to children aged 12 years or older for juvenile myoclonic epilepsy, and to children aged 6 years and older for idiopathic generalized epilepsy. It is not normally recommended that children use this medication for these conditions outside of these age groups.

Older people

Studies have not show this medication to be less effective when used by older individuals, however, since older people are more likely to be suffering from kidney problems, if you are over the age of 65 your doctor may want to adjust your dose slightly, or they may want to see you more frequently for checkups.

Storage

You will only be administered levetiracetam by medical staff in a hospital or other medical clinic. You will not be given the injectable form of the drug to take and store at home, although after a period of several weeks you may be moved onto an oral version of the drug, which you will be able to take home with you.

Summary

Levetiracetam injections are given to help treat seizures, including partial onset seizures,

Myoclonic seizures, and primary generalized tonic-clonic seizures. The injections are given twice per day, usually in a hospital or other medical facility.

This medication can cause some side-effects in some people, notably changes to your mental state. You should tell your doctor if you experience depression or thoughts of suicide. Skin conditions and high blood pressure can also occur, as well as other side-effects.

When you stop taking this drug, your dosage will be tapered off gradually over a period of time. This is to minimize the risk of side-effects, including a greater frequency of seizures.