Levetiracetam

Parent or patient Information Leaflet

Dr. C. P. Ravi Kumar

Consultant Paediatric Neurologist MRCPCH, CCT in Paediatrics (U.K.) Fellow in Paediatric Epilepsy & Neurology (London)

Brand names:
Tablet: Levipil, Levecetam
Syrup: Epitra, Levipil, Levera Levetiracetam that is pronounced as “lev-ee-tear-a- see-tam”, is a medicine used to treat the patients of Epilepsy.

Why is Levetiracetam important for my child’s treatment? It is important that your child takes Levetiracetam regularly so that your child doesn’t suffer from Seizures or have fewer seizures.
Do not stop giving Levetiracetam all of a sudden, as it may result in your child having more seizures.

What is Levetiracetam available as?
Liquid medicine, Tablets.
“Generic Vs Branded Drugs”

When should Levetiracetam be given?

Twice a day; morning and evening. Ideally, 10-12 hours apart.
For example, anytime between 7 to 8 am and right after 12 hours between 7 to 8 pm. You can adjust the time slot according to your schedule.
However, there are some exceptions when your doctor may advise to give it thrice a day. Please follow your doctor’s instructions in such case.
It should ideally be given at the same time every day to establish a routine as it minimizes the chances of missing a dose.

What if I miss a dose?
The child can be given the missed dose, if you remember to give it within a lapse of 6 hours. If you fail to give the missed dose within 6 hours, then might as well leave it. It is advisable to wait until the time of next routine dose.
Never give a double dose of Levetiracetam.
If your child vomits out the content within 30 minutes of taking the medicine dosage then you can give the dose again; but if your child vomits after 30 minutes of taking the dose, then just leave it be and do not give it again.

How much of the drug should be given?
Your doctor will work out the accurate amount of Levetiracetam (the dose) for your child and write the dosage in your prescription.
When you first start giving Levetiracetam to your child,you are supposed to give them a small amount and then increase the dose little by little over a course of few days or weeks. This helps your child’s body to get use to the medicine. Your doctor will clarify what steps to take.
It is mandatory to follow the instructions given by your doctor about the dosage of medication.
Ultimately, when your child is free of seizures or convulsions (fits) and has no obvious side effects, you will know that the dosage is just correct.

How should I give the medicine ? “Giving Medicines”
Tablets: A whole tablet must be swallowed with a glass of water, juice or milk. You may give it by crushing and mixing it in water/ juice or small serving of yogurt / Curd.
Liquid or syrup: Use an oral syringe or a medicine spoon to measure the adequate amount. You can easily get these from any pharmacy nearby.
Do not use a kitchen teaspoon as it will not give the accurate amount of the drug.

Could this medication have any side effects on my child? Side effects
Although medicines are given to make children feel better, sometimes, they may cause some unwanted side effects. It should get better as your child’s body gets use to the medicine. If there is still a problem after 2 weeks or you notice then getting them worse, contact your doctor, but continue to give levetiracetam.
Your child’s behaviour may change – they may feel drowsy (sleepy), seem less alert than normal and may not be able to think clearly or remember things.
Slight tremor of hands, clumsiness and lack in coordination may rarely be seen in children when given a high dosage. However, they disappear following a reduction in dosage.
They may experience sudden changes in mood and may be aggressive or hyperactive (more active than usual and finding it hard to relax).
Your child may lose his/her appetite and feel like vomiting (nausea) or actually vomit.
Your child may complain of having a headache or feel dizzy.
Levetiracetam can cause depression or low mood. Risk is worse in people who already have above concerns, generally these are less common in children.
If your child has Kidney disease or failure; please inform doctor, the use of this medication and dose must be re-considered.
If your child starts developing skin Rash, Stop Medications right there and SEEK IMMEDIATE MEDICAL ADVICE from your DOCTOR
Sometimes your child may experience other side-effects that are not listed above. If you notice any abnormalities with your child’s body or behavior, do not hesitate and immediately contact your doctor.

Is it Okay to give other medicines at the same time as Levetiracetam?
Medications like ibuprofen, paracetamol, antibiotics or any of the other over the counter medicines can be given when necessary, except the ones your doctor has prohibited you from.
Consult with your doctor before giving any other medicines to your child. This includes herbal or complementary medicines.
Some other medicines used to treat epilepsy may affect how well Levetiracetam works or may cause side effects.If your child is experiencing more fits or seizures, or any other side effects after using other medications, talk to your doctor immediately.

Where should I keep the medication? Keep the medicine in a cupboard, secured away from heat and direct sunlight. It is not a must to keep the medicine in the refrigerator though.
Make sure the medicine is out of your child’s reach.
Store the medication in the same box it was packed in.
For more information please refer the manufacturer’s information leaflet.

References :

1. IAP Drug Formulary Web Update 2020(3) Edition 58, https://www.iapdrugformulary.com/Home
2. Consumer Medicines Information (CMI), https://www.tga.gov.au/consumer-medicines-information-cmi
3. British National Formulary for Children (BNFC) 4. Food and Drug Administration, USA https://www.fda.gov