Levetam XR 500 mg Tablet

Antiepileptic for:

• Partial-onset (focal) seizures, with or without secondary generalisation — alone or as add-on
• Myoclonic seizures in juvenile myoclonic epilepsy (add-on)
• Primary generalised tonic-clonic seizures (add-on)
• Injection: when oral treatment is temporarily not possible; status epilepticus (hospital)

Adults and adolescents (50 kg and over): start 250–500 mg twice daily; increase by 500 mg twice daily every 2 weeks as needed; usual 500–1,500 mg twice daily (maximum 3,000 mg/day).

Children 6 months and over (under 50 kg): start 10 mg/kg twice daily; increase to maximum 30 mg/kg twice daily.

Infants 1–6 months: 7 mg/kg twice daily, up to 21 mg/kg twice daily.

Kidney impairment: dose reduced according to creatinine clearance.

• Take at the same times daily, with or without food.
• Do not stop suddenly — risk of seizures; withdraw gradually.

• Allergy to levetiracetam or other pyrrolidone derivatives

Very common: drowsiness, tiredness, nasopharyngitis, headache.

Common: dizziness, irritability, aggression, mood changes, depression, anxiety, insomnia, loss of appetite, nausea, cough.

Rare but serious: behavioural changes and suicidal thoughts, psychosis, severe skin reactions, low blood counts, pancreatitis, liver failure, rhabdomyolysis.

• Watch for mood changes, aggression or suicidal thoughts and report them promptly.
• Avoid driving until you know how it affects you; follow local driving rules for epilepsy.
• Kidney impairment: adjust dose.

One of the preferred antiepileptics in pregnancy (lower birth-defect risk than valproate); plan with a specialist and take folic acid. Passes into breast milk — breastfeeding usually possible with monitoring of the baby for drowsiness.

Few interactions.

• Alcohol and other sedatives (more drowsiness)
• Methotrexate (levels may rise)
• Macrogol laxatives (take 1 hour apart)

Drowsiness, agitation, aggression, reduced consciousness, breathing depression, coma. Emergency care; haemodialysis removes it.

Store below 30°C.