Keppra

Overview

Keppra, generically known as levetiracetam, is an anticonvulsant medication used to manage seizures in epilepsy. It stabilizes brain electrical activity, reducing seizure frequency and severity. Indicated for partial-onset, myoclonic, and primary generalized tonic-clonic seizures, Keppra is available in tablets, oral solutions, and injectable forms, offering flexible administration for diverse patient needs.

History of Development and Approval

Developed in the early 1990s by UCB Pharma, Keppra received FDA approval in 1999 for partial-onset seizures, with later approvals for myoclonic and tonic-clonic seizures. Its broad efficacy and favorable safety profile have made it a cornerstone in epilepsy treatment.

Key Benefits

• Seizure Reduction: Effectively lowers frequency and severity of seizures.
• Broad Application: Treats multiple seizure types, including partial, myoclonic, and tonic-clonic.
• Safe Profile: Well-tolerated with minimal severe side effects.
• Flexible Forms: Tablets, solutions, and injectables suit varied patient needs.

Unique Properties

Keppra’s minimal drug interactions, due to limited liver metabolism, make it ideal for patients on multiple medications. Its broad-spectrum efficacy and rapid onset provide reliable seizure control across epilepsy types.

Comparison with Similar Medications

Compared to other anticonvulsants, Keppra offers:

• Low Interaction Risk: Minimal impact on other drugs’ metabolism.
• Fast Stabilization: Quickly reduces seizure activity.
• Better Tolerability: Lower risk of severe side effects than some alternatives.

Safety and Tolerability

Keppra is generally well-tolerated, with common side effects like drowsiness, dizziness, and fatigue. Rare serious effects include severe allergic reactions or psychiatric symptoms (e.g., mood changes, depression). Regular medical monitoring ensures safe and effective use.

Indications for Use

Keppra is prescribed for:

• Partial-Onset Seizures: In adults and children (4+ years).
• Myoclonic Seizures: In adults and adolescents (12+ years) with juvenile myoclonic epilepsy.
• Primary Generalized Tonic-Clonic Seizures: In adults and children (6+ years).

Dosage and Administration

Adults: Start 500 mg twice daily, may increase to 1000–3000 mg/day.
Children: Weight-based (20–60 mg/kg/day), divided twice daily.
Elderly: Adjust for renal function, start lower.
Timing: Consistent twice daily, with/without food.
Notes: Gradual dose increases; renal impairment requires adjustment.

Mechanism of Action

Levetiracetam modulates synaptic vesicle protein SV2A, reducing abnormal neuronal firing and stabilizing brain electrical activity to prevent seizures.

Composition

Active Ingredient: Levetiracetam, drives anticonvulsant effects.
Inactive Ingredients: Tablets: cellulose, starch; solution: maltitol; injectable: sodium acetate for stability.

Side Effects

Common: Drowsiness, dizziness, fatigue, irritability.
Rare: Mood changes, coordination issues.
Serious: Severe allergic reactions, suicidal thoughts, psychosis require urgent care.

Prevention of Side Effects

Start with low doses, increase gradually, monitor mood/behavior. Use reminders (alarms, apps) for adherence; report issues promptly.

Contraindications

Avoid in hypersensitivity to levetiracetam; caution in renal impairment.

Warnings and Precautions

Monitor for psychiatric symptoms, renal function, or withdrawal seizures. Caution in depression history or renal issues.

Drug Interactions

Minimal interactions; some anticonvulsants (e.g., carbamazepine) may alter levels. Disclose all medications to provider.

Overdose

Symptoms: drowsiness, agitation, respiratory depression. Seek emergency care immediately.

Pharmacokinetics

Absorption: Rapid, peak 1 hour.
Distribution: Wide, minimal protein binding.
Metabolism: Minimal liver metabolism.
Elimination: Kidneys (66% unchanged); half-life 6–8 hours.

Dosage Forms

Tablets (250–1000 mg), oral solution (100 mg/mL), injectable (100 mg/mL) for flexible use.

Pregnancy and Breastfeeding

Use if benefits outweigh risks (Category C); excreted in milk, consult provider.

Storage

Store at 20°C–25°C (68°F–77°F), dry, light-protected, away from children. Dispose expired properly.

Clinical Evidence

Trials confirm Keppra reduces seizure frequency across partial, myoclonic, and tonic-clonic types versus placebo, with minimal interactions and good tolerability.

Conclusion

Keppra is a highly effective, well-tolerated anticonvulsant for epilepsy, offering broad-spectrum seizure control and minimal drug interactions. Adhere to dosing, monitor effects, and consult providers for optimal outcomes.