ADVERTISEMENT
ADVERTISEMENT

Keppra (KEP-ruh) is the brand name used in the United States, Canada, the UK, Australia, and some other countries for the seizure medicine levetiracetam (lev-eh-teer-ASS-eh-tam).

Keppra (KEP-ruh) is the brand name used in the United States, Canada, the UK, Australia, and some other countries for the seizure medicine levetiracetam (lev-eh-teer-ASS-eh-tam).Keppra recently became available in generic (non-brand name) form as generic levetiracetam.

Keppra
Tablet
Keppra 250mg

250-mg (blue, oblong, scored)
Tablets marked with “ucb” and “250” on one side.

Keppra 500mg

500-mg (yellow, oblong, scored)
Tablets marked with “ucb” and “500” on one side.

Keppra 750mg

750-mg (orange, oblong, scored)
Tablets marked with “ucb” and “750” on one side.

Keppra 1000mg

1000-mg (white, oblong, scored)
Tablets marked with “ucb” and “1000” on one side

Liquid Solution
Keppra Solution

100 mg/mL (clear, colorless, grape-flavored)
The liquid Keppra solution was approved by the FDA in 2003.

Liquid Injection
Keppra Injection Vial

100 mg per 1 mL (milliliters).

Approved by the FDA in 2006, this is an alternative for patients when oral administration is temporarily not feasible; it must be diluted prior to use as per the package insert and administered as a 15-minute intravenous infusion.

Used to Treat

  • Juvenile Myoclonic Epilepsy
  • Temporal Lobe Epilepsy
  • Complex Partial Seizures
  • Myoclonic Seizures
  • Refractory Seizures
  • Secondarily Generalized Seizures
  • Simple Partial Seizures
  • Tonic-clonic Seizures

Forms

Keppra is sold in the United States by UCB Pharma, Inc. The name or appearance may be different in various countries, but the dose (measured in milligrams, abbreviated "mg") usually will be the same. These descriptions apply to the U.S. versions:

How to Take and Store

Please see package insert.

How to take and store Levetiracetam?

Follow your doctor's directions. Call if you have any questions. Usually, your doctor will tell you to start by taking one tablet—either 250 or 500 milligrams— two times each day. After a while, the doctor may gradually increase the dosage up to as much as 3000 milligrams per day to get better control of your seizures. To take that amount, you probably would take two 750-mg tablets, two times a day.

Most people swallow the tablets whole to avoid their bitter taste. But people who cannot swallow whole tablets can crush the tablet and mix it with food, or use the liquid form.

When measuring Keppra liquid, be sure to use a standard-size medicine spoon or dropper (not a regular teaspoon) to get the right amount every time.

It's OK to take Keppra either with food or without food, but it's a good idea to take it the same way every time. Taking Keppra with food does not change how much Keppra your body absorbs, but it does slow down the absorption a bit.

Be careful if the doctor writes a new prescription using a different kind of pill. For example, if you've been using 500-mg tablets and the new prescription is for 750-mg tablets, be sure you use the correct number. Don't automatically continue to use the same number of pills as before.

Don't take more than the doctor prescribes. If you think you've used one or two extra tablets or one extra spoonful of liquid, call your doctor for advice. For a larger overdose, call your local poison control center or emergency room right away, unless you have special instructions from the doctor.

Don't stop taking Keppra or change the amount you use without talking to the doctor first. Stopping any seizure medicine all at once can cause serious problems.

All forms of Keppra should be stored at room temperature, away from light and humidity. (Don't keep the pills in the bathroom if it's damp there.) Of course, keep all Keppra out of the reach of children.

What if I forget?

If you forget a dose of Keppra, take it as soon as you remember. If it is almost time for the next dose, delay that dose for a few hours, instead of taking two doses very close together. Then go back to the regular schedule. If you're not sure about what to do, call the doctor's office for more advice.

Do your best to follow the doctor's directions. If you forget doses often, it may be a good idea to get a special pillbox or watch with an alarm to remind you.

Taking the right amount of seizure medicine on time every single day is the most important step in preventing seizures!

How does Levetiracetam effect the brain?

Brain cells need to work (fire) at a certain rate to function normally. During a seizure, brain cells are forced to work much more rapidly than normal. How Keppra helps prevent brain cells from working as fast as a seizure requires is still being investigated. It appears to work differently from other seizure medicines.

How does the body digest Levetiracetam?

After medicine is swallowed, it must be absorbed into the blood so it can move throughout the body. The process of absorbing, digesting, and excreting a medicine or food is called metabolism. The way the body metabolizes a particular medicine affects how often it must be taken. It also determines whether it will interact with other medicines or be affected by liver disease or kidney disease.

Keppra is not metabolized by the liver. It also does not affect the way the liver metabolizes other medicines.

Instead, the body eliminates Keppra through the kidneys. People with poor kidney function usually need to take less Keppra and they may take it less often, because it stays in their body longer.

The tablets and the liquid form of Keppra take the same amount of time to be absorbed by the body. This time is a little longer if they are taken with food instead of on an empty stomach, but all the medicine is absorbed either way.

How well does the Levetiracetam work?

Doctors have studied large numbers of patients to find out how well Keppra controls seizures. In most of the studies, the Keppra was given to people who were taking another seizure medicine but still having seizures. With Keppra, between 20% and 40% of these people had the number of seizures cut at least in half. They also didn't have much trouble with side effects.

Keppra is not a perfect add-on seizure medicine for everyone, however. Sometimes people must try a series of combinations before finding what is best for them. But because Keppra doesn't interact with other medicines, it can be used as an add-on without the need for complicated changes in dosage.

At least one study has found that Keppra also may be effective when used alone to treat partial seizures.

What are the most common side effects of Levetiracetam?

Keppra has now been used by at least 100,000 people, and it appears to be very safe. In the earliest tests, people who took it as an add-on to another seizure medicine were only slightly more likely to quit because of side effects than people who took a placebo (a pill with no active medicine) instead.

Some side effects that have been reported include:

  • sleepiness
  • loss of strength and energy
  • dizziness
  • anxiety
  • nervousness
  • irritability
  • depression
  • other mood changes

Some of these are more likely during the first month of treatment.

If you notice any of these problems, call the doctor's office. Sometimes the doctor can help by changing the amount of Keppra you take or how you take it. Don't stop taking Keppra or change the amount you take without the doctor's guidance.

Some people have reported helpful effects from Keppra. They say they can think and concentrate better and feel more alert. It's hard to be sure whether these benefits are from the Keppra or from having fewer and less severe seizures.

If you have just started taking Keppra (or have just started taking a larger amount), be careful doing anything that might be dangerous until you know whether you are feeling sleepy, dizzy, or uncoordinated.

Allergic reactions
There are no known allergic reactions to Keppra.

Long-term side effects
The long-term side effects of Keppra are not yet known.

What are the most serious side effects of Levetiracetam?

Very few people have serious reactions to Keppra. If you take it, you should be aware of them, however, so you and your family can recognize them.

If you notice any of these symptoms, call your doctor right away:

  • decreased ability to cope with daily life events
  • depression
  • thoughts of suicide
  • severe anxiety, agitation, or confused thought
  • It is important to remember that only a tiny number of people who take Keppra have any serious problems.

On July 10, 2008, an advisory panel was convened by the Food and Drug Administration (FDA) to review data that the FDA had previously collected from drug studies showing an association between many of the antiepileptic drugs (AEDs) and suicidal ideation and behavior, which together are called suicidality. According to the FDA’s Alert, among the patients with epilepsy in these drug studies, 1 out of 1000 people taking the placebo (inactive substance) showed suicidality compared to approximately 3.5 out of 1000 people who took an AED. The FDA advisory panel voted to accept the FDA's data at its meeting on July 10. The FDA has provided the following information for patients, family members, and caregivers at http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm100192.htm.

  • Taking antiepileptic medicines may increase the risk of having suicidal thoughts or actions;
  • Do not make any changes to the medication regimen without first talking with the responsible healthcare professional;
  • Pay close attention to any day-to-day changes in mood, behavior and actions. These changes can happen very quickly so it is important to be mindful of any sudden differences.
  • Be aware of common warning signs that might be a signal for risk of suicide. Some of these are:
    • Talking or thinking about wanting to hurt yourself or end your life
    • Withdrawing from friends and family
    • Becoming depressed or having your depression get worse
    • Becoming preoccupied with death and dying
    • Giving away prized possessions

We again urge patients and families to contact their doctor before stopping an epilepsy medication because this may possibly lead to seizures and worsening of mood.

What else is Levetiracetam used for?

Often doctors find that medicines are useful for more than one purpose. It is legal to prescribe medicines for "off-label uses" even though the FDA has not formally approved such use. In the case of Keppra, some doctors have found that it is effective against myoclonic seizures.

Who should not take Levetiracetam?

The only people who definitely should not take Keppra are those who are allergic to it or any of its inactive ingredients.

People with kidney disorders need to be extra careful, however. Keppra may build up to a level that's too high unless they take very low doses.

Can Levetiracetam be taken with other medicines?

Sometimes one kind of medicine changes the way another kind of medicine works in the body. Taking Keppra does not seem to cause this kind of problem. it does not affect the level of other medicines in the body, and other medicines do not affect the level of Keppra.

What are the effects of Levetiracetam on Children?

In children, Keppra has been used primarily to treat partial seizures, ones that begin in a limited area of the brain.

Doctors figure out how much medicine to give to young children based mostly on their weight. To keep side effects at a minimum, the doctor probably will prescribe a low dose to start with and increase it slowly. Children usually start with a dose of 10 milligrams (mg) for each kilogram (kg, about 2.2 pounds) of their body weight per day. This would be 250 mg per day for a 55-pound child, for instance. Half this amount is usually given two times a day.

After a gradual increase, most children do best taking about 20 to 40 mg per kg per day, Adjusted for weight, this is a little higher than the adult dose because children's bodies eliminate Keppra more quickly.

If a woman takes Levetiracetam during pregnancy will it hurt the baby?

In the United States, the Food and Drug Administration (FDA) assigns each medication to a Pregnancy Category according to whether it has been proven to be harmful in pregnancy. Keppra is listed in Pregnancy Category C. This indicates that caution is advised, but the benefits of the medicine may outweigh the potential risks. Studies in animals have shown some harm to the baby, but there haven't been any good studies of results in women.

Talk to your doctor or another health professional if you are pregnant or plan to become pregnant. We don't yet have enough information to be able to estimate the risk of various types of birth defects that might occur if Keppra is taken during pregnancy. We also don't know enough to compare the risk with Keppra to the risk with other seizure medicines.

All women who are capable of becoming pregnant should take at least 0.4 mg (400 mcg) of the vitamin called folic acid every day because it helps to prevent one type of birth defect. (The most well-known of these is spina bifida, in which the spinal cord is not completely enclosed.) Women at high risk, such as those with a history of this kind of defect in a previous pregnancy, should take 4000 mcg (4 mg) daily, beginning before they become pregnant.

How much Keppra is passed through breast milk is not known for certain, but the way the body uses it suggests that probably a large portion does enter the milk. If you want to breast-feed your baby, check with your doctor about what seizure medicine would be best for you.

What are the effects of Levetiracetam on Seniors

Keppra is commonly prescribed for people over 65, but it's important for the doctor to be careful about how much Keppra these people take. When people are older than 65 or 70, their kidneys usually don't work as well as before. The kidneys are responsible for removing Keppra from the body, so it stays in the body longer.

Seniors need to start with a very low dose of Keppra at the beginning and then increase the amount more slowly than a younger person would. The doctor may even suggest that the senior take Keppra only once day, instead of twice.

Seniors also may be more sensitive to the side effects of Keppra. Some of the common side effects, like sleepiness, dizziness, or loss of strength, may worsen problems they had before taking Keppra. Seniors also are at greater risk of injury from falls or other accidents resulting from these problems.

The lack of interactions between Keppra and other medicines is an advantage over most other seizure medicines commonly used by seniors.

What are the dose ranges for Levetiracetam?

The best amount is the amount that completely controls seizures without causing troublesome side effects. It depends on many factors, which are different for every individual. Follow the doctor's directions. Call if you have any questions.

No one should stop taking Keppra or change the amount they take without talking to the doctor first. Stopping any seizure medicine all at once can cause a problem that may be life-threatening.

Don’t use more than the doctor prescribes. If a little extra (such as an extra tablet or two) is taken by accident, call the doctor for advice. For a larger overdose, call a poison control center or emergency room right away unless you have other specific directions from your doctor.

To avoid unwanted side effects, the doctor will prescribe a low dose to start and increase it gradually. Young adults usually start by taking 500 milligrams (mg) twice a day. The doctor gradually prescribes more until their seizures are controlled, if side effects are not troublesome. Some people need to take as much as 4,000 mg per day, in two doses.

People who are over 65 and those with kidney disorders need to take much less Keppra.

Read the package insert of Levetiracetam

In the United States, companies that manufacture medicines are required to publish certain kinds of information about each product. This document is commonly known as a “package insert” because it is usually included with each package of the medicine.

You can also read these documents (also called "prescribing information") online. The U.S. package insert for Keppra (levetiracetam) is found at:

Some of the information may differ in other countries.

The summary of package characteristics can be obtained in any European language from:

To learn how to read and understand a package insert, see How to read a package insert.