Levetiracetam

A to Z Drug Facts

 Action Mechanism unknown; may selectively prevent hypersynchronization of epileptiform burst firing and propagation of seizure activity.

 Indications Adjunctive therapy in partial onset seizures in adults with epilepsy.

 Contraindications Standard considerations.

 Route/Dosage

ADULTS: PO Initiate therapy with 500 mg bid; dose may be increased by 1000 mg daily every 2 weeks to a maximum daily dose of 3000 mg.

 Interactions None well documented.

 Lab Test Interferences None well documented.

 Adverse Reactions

RESP: Cough; pharyngitis; rhinitis; sinusitis. CNS: Somnolence; dizziness; headache; amnesia; anxiety; ataxia; depression; emotional lability; hostility; nervousness; paresthesia; vertigo. EENT: Diplopia. GI: Anorexia. OTHER: Asthenia; infection; pain.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established in patients < 16 year of age. Impaired renal function: Should use reduced doses. Withdrawal seizures: Do not discontinue abruptly because of possible increased seizure frequency. Dialysis patients: Administer supplemental doses because drug is removed during the treatment.

 Administration/Storage

• Store at room temperature. Excursions permitted to 15° to 30°C (59° to 86°F).
• Administer orally as adjunct therapy with or without food.
• Do not administer to pregnant women unless it is determined that the benefit to the mother justifies the potential risk to the fetus.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Monitor patient for potential hypersensitivity.
• Monitor for signs and symptoms of asthenia, somnolence, and dizziness that might occur, especially in the first weeks of treatment.
• Monitor patient's CBC and for signs and symptoms of infection.
• Monitor renal function.
• Exercise caution to assure that patients are withdrawn gradually from levetiracetam or any other antiseizure drug to avoid the potential of increased seizures.

 Patient/Family Education

• Inform patient that levetiracetam does not cure the cause of seizure activity but will control symptoms.
• Caution patient to take the dose exactly as prescribed and not to stop taking the medication even if feeling better. Instruct patient not to increase or decrease the dosage.
• Teach family that seizure control requires rigid adherence to the prescribed regimen, as noncompliance is a major cause of therapeutic failure.
• Caution patient to stop taking levetiracetam or any other antiseizure medication abruptly; there is potential for increased seizure activity.
• Teach patient/family to maintain a seizure frequency chart indicating the date, time, and nature of all seizure events as prescriber can use this record to evaluate treatment, make dosage adjustments, and alter drug selections.
• Warn patient against using alcohol, antihistamines, and or other CNS depressants as these will intensify the depressant effects of antiseizure medications.
• Advise patient that levetiracetam may cause dizziness and somnolence.
• Instruct patient/family that if seizures occur, the patient should be protected from injury.
• Caution patient/family that patient should neither drive a car, operate complex machinery, or engage in any other hazardous activity until knowing the reaction to the drug.
• Advise patient to notify physician immediately if pregnant, planning to become pregnant, or planning to breastfeed.

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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts