Levetiracetam

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Information about Levetiracetam

Levetiracetam is a relatively unique anticonvulsant that is typically used in combination with other antiepileptic medications for partial onset seizures. 

Liver safety of Levetiracetam

Levetiracetam has been linked to rare instances of serum aminotransferase and alkaline phosphatase elevations during treatment and to rare cases of clinically apparent drug induced liver disease.

Mechanism of action of Levetiracetam

Levetiracetam (lee" ve tre ra' se tam) is a pyrrolidine derivative unrelated in structure to other anticonvulsant medications.  Its mechanism of action is not known, but it is believed to act by preventing secondary spread of focal seizure activity and to decrease simultaneous neuronal firing. 

FDA approval information for Levetiracetam

Levetiracetam was approved for use in epilepsy in 1999 and current indications are as adjunctive therapy for partial onset seizures, generalized tonic-clonic seizures and myoclonic seizures in both children and adults. 

Dosage and administration for Levetiracetam

Levetiracetam is available as tablets of 250, 500, 750 and 1000 mg generically and under the brand name Keppra.  Liquid oral and injectable forms are also available.  The recommended initial dose in adults is 500 mg twice daily with dose escalation based upon tolerance and effect to a maximum of 1500 mg twice daily.  Dosing in children is based upon body weight.  Common side effects include dizziness, somnolence and fatigue.

Anticonvulsants

Generic Name / Brand Name Liver Toxicity Score Approval Year Major Indications
Brivaracetam / Briviact E 2016 Partial seizures
Carbamazepine / Tegretol A 1968 Partial, mixed and generalized seizures, trigeminal neuralgia
Clobazam / Onfi E 2011 Seizures assocated with Lennox-Gastaut syndrome
Clonazepam / Klonopin D 1975 Absence and myoclonic seizures, anxiety and panic disorders
Clorazepate / Tranxene E 1972 Partial seizures, anxiety disorders, and alcohol withdrawal
Diazepam / Valium E 1963 Convulsions, anxiety disorders, muscle spasms
Eslicarbazepine / Aptiom D 2013 Partial seizures
Ethosuximide / Zarontin E 1960 Absence seizures
Ezogabine / Potiga E 2011 Partial seizures
Felbamate / Febatol B 1993 Refractory or severe epilepsy
Fosphenytoin / Cerebyx A 1996 Tonic-clonic seizures, status epilepticus
Gabapentin / Neurontin C 1993 Partial seizures, post-herpetic neuralgia
Lacosamide / Vimpat D 2008 Partial seizures
Lamotrigine / Lamictal B 1994 Partial and generalized tonic-clonic seizures, bipolar disorder
Levetiracetam / Keppra C 1999 Partial, generalized tonic-clonic, and myoclonic seizures
Methsuximide / Celontin E 1957 Absence seizures
Oxcarbazepine / Trileptal D 2000 Partial seziures
Perampanel / Fycompa E 2012 Partial and generalized tonic-clonic seizures
Phenobarbital / Luminal A 1916 Partial and generalized seizures, anxiety, and irritable bowel syndrome
Phenytoin / Dilantin A 1938 Generalized tonic-clonic and partial onset seizures, status epilepticus
Pregabalin / Lyrica C 2004 Partial seizures, fibromyalgia, and neuropathic pain
Primidone / Mysoline E 1954 Partial and generalized tonic-clonic seizures
Rufinamide / Banzel E 2008 Seizures associated with Lennox-Gastaut syndrome
Tiagabine / Gabitril E 1997 Partial seizures
Topiramate / Topamax C 1996 Partial and generalized tonic-clonic seizures, migraine headaches
Valproate / Depakene A 1978 Absence and complex partial seizures
Vigabatrin / Sabril D 2009 Refractory, complex partial seizures, and infantile spasms
Zonisamide / Zonegran D 2000 Partial seizures

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