Experiences with

Levetiracetam

Levetiracetam is a medicine used to treat epilepsy.

Seizures are bursts of electrical activity in the brain that temporarily affect how it works. Levetiracetam slows these electrical signals down to stop seizures.

Levetiracetam is available on prescription. It comes as tablets, a liquid and granules.

Who can take levetiracetam

Most adults and children aged 1 month and over can take levetiracetam.

Who may not be able to take levetiracetam

Levetiracetam is not suitable for some people. To make sure it's safe for you, tell your doctor if you:

• have ever had an allergic reaction to levetiracetam or any other medicine
• have kidney problems
• have had low mood (depression) or thoughts of harming or killing yourself
• are pregnant, or planning to get pregnant

Dosage

The usual dose of levetiracetam to treat epilepsy in:

• adults and older children (aged 12 years and over) is 250mg to 3,000mg a day, taken as 1 or 2 doses, but the exact dose may depend on your weight
• children (aged 1 month to 11 years) varies depending on their weight

Changes to your dose

To prevent side effects, your doctor will prescribe a low dose to start with and then increase it over a few weeks. Once you find a dose that suits you, it'll usually stay the same.

How to take it

You can take levetiracetam with or without food.

If you take it twice a day, try to space your doses evenly through the day – for example, first thing in the morning and in the evening.

How to take tablets

Swallow your tablets whole with a drink of water, milk or juice. Do not chew them.

How to take liquid

You can take your liquid dose of levetiracetam by itself or mixed into a glass of water, milk or juice.

Liquid levetiracetam comes with a syringe to help you measure it. If you do not have a syringe, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.

How to take granules

You can swallow levetiracetam granules straight from the packet or mix them with food or water. Do not chew the granules because they can sometimes taste bitter. Drink some water after you have taken your dose.

How long to take it for

If you have epilepsy, it's likely that once your illness is under control you will still need to take levetiracetam for many years.

If you're taking levetiracetam for epilepsy, stopping it suddenly can cause seizures. Coming off levetiracetam should be done very slowly and may take a few months.

However, if you do get a serious side effect, such as a severe skin condition, your doctor may tell you to stop taking levetiracetam straight away, even if you have epilepsy.

Do not stop taking levetiracetam without talking to your doctor first.

If you take levetiracetam once a day and miss your dose, take the missed dose as soon as you remember, unless it's less than 12 hours before the next dose is due. In this case, leave out the missed dose and take your next dose at the usual time.

If you take it twice a day, take the missed dose as soon as you remember, unless it's less than 8 hours before the next dose is due. In this case, skip the missed dose and take your next dose at the usual time.

Do not take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

It's important to take your medicine regularly. Missing doses may trigger a seizure.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

Taking more than your prescribed dose of levetiracetam can cause serious side effects.

you take more than your prescribed dose of levetiracetam and:

• feel sleepy or less alert
• feel agitated or aggressive

Get help from 111 online or call 111. Call 111 if you need advice for a child under 5 years old

• you have problems breathing
• you lose consciousness (pass out)

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the levetiracetam packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Common side effects

These common side effects of levetiracetam may happen in more than 1 in 10 people. There are things you can do to help cope with them:

Tell a doctor or call 111 straight away if you have a serious side effect, including:

• fits or seizures getting worse
• passing very little pee, feeling tired or confused, or having swollen legs, ankles or feet – these could be signs of kidney problems
• signs of serious mental changes, or someone around you notices signs of confusion, sleepiness, loss of memory, forgetfulness, abnormal behaviour or uncontrolled movements

Very few people taking levetiracetam have serious side effects.

• you have thoughts of harming or killing yourself

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to levetiracetam.

These are not all the side effects of levetiracetam. For a full list, see the leaflet inside your medicine packet.

Levetiracetam and pregnancy

You can take levetiracetam during pregnancy if it's needed to keep you well. It is important that epilepsy is well treated during pregnancy, as seizures can harm you and your baby.

Do not stop taking levetiracetam if you become pregnant. Talk to your doctor, as they may want to review your epilepsy medicine and may need to change the dose.

If you're trying to get pregnant or have become pregnant while taking levetiracetam, it's recommended you take a high dose of folic acid (5mg a day). You can get this from your doctor or midwife.

Ideally it's best to take high dose folic acid for 3 months before you start trying to get pregnant and for the first 12 weeks of pregnancy. Do not worry if you have not taken it before you get pregnant, but start taking it as soon as possible once you know that you are pregnant. It helps your baby to grow normally.

Your baby may need extra monitoring for a few days after they're born. This is because they can sometimes have withdrawal symptoms from levetiracetam.

Levetiracetam and breastfeeding

If your doctor or health visitor says your baby is healthy, you can take levetiracetam while you're breastfeeding.

If you were taking levetiracetam during pregnancy, your dose may need to be reduced once you have given birth.

Levetiracetam can pass into breast milk in different amounts (it is usually small but occasionally it may pass into breast milk in larger amounts). However, there is information to show that the amount your baby gets is very small.

There have been some reports of side effects in breastfed babies, including feeling drowsy, vomiting and not feeding well. This usually happens when you have taken other epilepsy medicines at the same time. But in most cases, babies do not get any side effects.

It's important to keep taking levetiracetam to keep you well. Breastfeeding will also benefit both you and your baby.

If your baby's not feeding as well as usual, or seems unusually sleepy or irritable, or you have any other concerns about your baby, talk to your pharmacist, health visitor, midwife or doctor as soon as possible.

Levetiracetam and fertility

There's no evidence to suggest that taking levetiracetam causes fertility problems in either men or women.

Speak to a pharmacist or your doctor if you're trying to get pregnant. They may want to review your treatment.

Cautions with other medicines

Some medicines can affect the way that levetiracetam works, and increase your chance of side effects.

Your doctor may need to change your dose of levetiracetam if you're taking any of these:

• macrogol, a laxative
• other epilepsy medicines, such as carbamazepine, lamotrigine, oxcarbazepine, phenobarbital or phenytoin
• methotrexate, a medicine that can be used to treat arthritis and other conditions

Mixing levetiracetam with herbal remedies and supplements

There might be a problem taking some herbal remedies and supplements alongside levetiracetam, especially ones that make you feel sleepy or dizzy. Ask your pharmacist for advice.

Some people take vitamin B6 (also known as pyridoxine) alongside levetiracetam to reduce the chances of mood changes. A few studies have reported that it might be helpful, but we do not have enough information to be sure.

If you want to take any vitamins alongside your prescribed medicines, it's important to speak to your pharmacist or doctor, who can advise what you can take.

There's not enough information to say that other complementary medicines and herbal remedies are safe to take with levetiracetam. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Related links

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