Levetiracetam (intravenous route)


    Brand Name

    US Brand Name

    Keppra


    Description

    Levetiracetam injection is used alone or together with other medicines to help control certain types of seizures (eg, partial-onset seizures, myoclonic seizures, or tonic-clonic seizures) in the treatment of epilepsy. This medicine cannot cure epilepsy and will only work to control seizures for as long as you continue to use it.

    This medicine is to be given only by or under the direct supervision of a doctor.

    This product is available in the following dosage forms:

    • Solution

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies have not been performed on the relationship of age to the effects of levetiracetam injection in children younger than 1 month of age. Safety and efficacy have not been established.

    Geriatric

    Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of levetiracetam injection in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution or an adjustment in the dose for patients receiving levetiracetam injection.

    Breastfeeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Apixaban
    • Calcifediol
    • Dabigatran Etexilate Mesylate
    • Edoxaban
    • Levoketoconazole
    • Methotrexate
    • Orlistat
    • Rivaroxaban

    Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Carbamazepine
    • Ginkgo

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Depression, history of or
    • Hypertension (high blood pressure) or
    • Mental illness, history of—Use with caution. May make these conditions worse.
    • Kidney problems—Use with caution. The effects may be increased because of slower removal from the body.

    Proper Use

    A nurse or other trained health professional will give you or your child this medicine in a hospital. Levetiracetam is given through an IV catheter that is placed in one of your veins. The medicine must be injected slowly, so your IV will need to stay in place for 15 minutes.

    Your doctor will give you or your child a few doses of this medicine until your condition improves, and then switch you to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.


    Precautions

    It is very important that your doctor check your or your child's progress closely, especially for the first few months of using this medicine. This is to see if the medicine is working properly and to allow for a change in the dose. Blood tests may be needed to check for any unwanted effects.

    It is important to tell your doctor if you become pregnant while using this medicine. Your doctor may want you to join a pregnancy registry for patients taking a seizure medicine.

    Levetiracetam may cause changes in mood or behavior, problems with coordination, or unusual tiredness or weakness. Tell your doctor right away if you or your child starts to feel depressed, anxious, or angry, getting upset easily, restless, or if you have thoughts about hurting yourself. Report any unusual thoughts or behavior that trouble you or your child, especially if they are new or getting worse quickly.

    This medicine may cause some people to become dizzy, drowsy, tired, or less alert than they are normally. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

    This medicine may cause serious allergic reactions, including anaphylaxis or angioedema, which can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, itching, large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs, trouble breathing or swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

    Serious skin reactions (eg, Stevens-Johnson syndrome, toxic epidermal necrolysis) can occur with this medicine. Check with your doctor right away if you or your child have blistering, peeling, or loosening of the skin, chills, cough, diarrhea, itching, joint or muscle pain, red irritated eyes, red skin lesions, sore throat, sores, ulcers, or white spots in the mouth or on the lips, or unusual tiredness or weakness while you are using this medicine.

    Check with your doctor right away if you have black, tarry stools, chest pain, chills, cough, fever, painful or difficult urination, sore throat, sores, ulcers, or white spots in the mouth or on the lips, swollen glands, unusual bleeding or bruising, or unusual tiredness or weakness. These may be symptoms of serious skin reaction called drug reaction with eosinophilia and systemic symptoms (DRESS).

    Do not interrupt or stop receiving this medicine without checking first with your doctor. Your doctor may want you or your child to gradually reduce the amount you are using before stopping it completely.

    This medicine lowers the number of some types of blood cells in your body. Because of this, you may bleed or get infections more easily. To help with these problems, avoid being near people who are sick or have infections. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor or nurse immediately if any of the following side effects occur:

    More common

    • Cough or hoarseness
    • fever or chills
    • lower back or side pain
    • painful or difficult urination

    Incidence not known

    • Black, tarry stools
    • bleeding gums
    • blistering, peeling, or loosening of the skin
    • bloating
    • blood in the urine or stools
    • changes in behavior
    • chest pain
    • darkened urine
    • diarrhea
    • difficulty having a bowel movement
    • fast heartbeat
    • general tiredness and weakness
    • indigestion
    • itching
    • joint or muscle pain
    • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
    • light-colored stools
    • loss of appetite
    • nausea and vomiting
    • pains in the stomach, side, or abdomen, possibly radiating to the back
    • pale skin
    • pinpoint red spots on the skin
    • red skin lesions, often with a purple center
    • red, irritated eyes
    • restlessness or agitation
    • sore throat
    • sores, ulcers, or white spots in the mouth or on the lips
    • swollen glands
    • thoughts or attempts at killing oneself
    • twitching, twisting, or uncontrolled repetitive movements of the tongue, lips, face, arms, or legs
    • uncontrolled jerking or twisting movements of the hands, arms, or legs
    • uncontrolled movements of the lips, tongue, or cheeks
    • unusual bleeding or bruising
    • unusual tiredness or weakness
    • upper right abdominal or stomach pain
    • yellow eyes or skin

    Get emergency help immediately if any of the following symptoms of overdose occur:

    Symptoms of overdose

    • Anxiety
    • attack, assault, or force
    • decrease, loss, or change in consciousness
    • difficult or troubled breathing
    • dry mouth
    • hyperventilation
    • irregular, fast or slow, or shallow breathing
    • irregular heartbeats
    • irritability
    • pale or blue lips, fingernails, or skin
    • restlessness
    • shaking
    • sleepiness or unusual drowsiness
    • trouble sleeping

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    More common

    • Body aches or pain
    • dizziness
    • headache
    • lack or loss of strength
    • pain
    • stuffy or runny nose
    • tender, swollen glands in the neck
    • trouble swallowing
    • voice changes

    Less common

    • Aggressive or angry
    • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
    • crying
    • depersonalization
    • discouragement
    • double vision or seeing double
    • dysphoria
    • euphoria
    • feeling of constant movement of self or surroundings
    • feeling sad or empty
    • lightheadedness
    • loss of interest or pleasure
    • loss of memory
    • loss or lack of appetite
    • pain or tenderness around the eyes and cheekbones
    • paranoia
    • problems with memory
    • quick to react or overreact emotionally
    • rapidly changing moods
    • rash
    • sensation of spinning
    • shakiness and unsteady walk
    • sneezing
    • stuffy nose
    • tiredness
    • trouble concentrating
    • unsteadiness, trembling, or other problems with muscle control or coordination
    • weight loss

    Incidence not known

    • Hair loss or thinning of the hair

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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