How does it work?
Keppra tablets, oral solution and injection all contain the active ingredient levetiracetam, which is a medicine used to treat epilepsy. It works by stabilising electrical activity in the brain.
The brain and nerves are made up of many nerve cells that communicate with each other through electrical signals. These signals must be carefully regulated for the brain and nerves to function properly. When abnormally rapid and repetitive electrical signals are released in the brain, it becomes over-stimulated and normal function is disturbed. This results in fits or seizures.
It is not fully understood how levetiracetam works to control seizures, but its mechanism appears to be different from other antiepileptic medicines.
Levetiracetam may be used on its own, or as an additional treatment, if other antiepileptic medicines have failed to fully control the epileptic seizures.
The medicine can be given as a drip into a vein (intravenous infusion) when administration by mouth is not possible.
What is it used for?
- Partial seizures, with or without secondary generalised seizures in adults and children from one month of age with epilepsy. (Keppra can be used on its own to treat people aged 16 years and over with newly diagnosed epilepsy. In children aged one month and over it should be used as an additional medicine when other antiepileptic medicines have failed to fully control the seizures.)
- Primary generalised tonic-clonic seizures in adults and adolescents from 12 years of age with generalised epilepsy with no known cause (in combination with other treatments).
- Myoclonic seizures in adults and adolescents from 12 years of age with juvenile myoclonic epilepsy (in combination with other treatments).
- This medicine may reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.
- There may be a small increased risk of depression, suicidal thoughts and behaviour in people taking antiepileptic medicines such as levetiracetam for any condition. For this reason, it is very important to seek medical advice if you, or someone else taking this medicine, experience any changes in mood, distressing thoughts, or feelings about suicide or self-harm at any point while taking this medicine. For more information speak to your doctor or pharmacist.
- If you have epilepsy it is important to take your medication regularly, as directed by your doctor, because missing doses can trigger seizures in some people. If you have trouble remembering to take your medicine you should ask your pharmacist for advice. You may find a pill reminder box helpful.
- You should not stop taking this medicine suddenly unless your doctor tells you otherwise, as this may result in your seizures returning or getting worse. If it is decided that you should stop taking this medicine, it should be withdrawn gradually, according to the instructions given by your doctor.
Use with caution in
- Children and adolescents (although available data in children do not suggest an impact of this medicine on growth and puberty, long term effects on learning, intelligence, growth, hormone function, puberty and childbearing potential in children remain unknown).
- Decreased kidney function.
- Severely decreased liver function.
- Keppra injection contains sodium, which should be taken into consideration in people on a low sodium diet.
Not to be used in
- This medicine is not recommended for children under one month of age, as there is insufficient information about its safety and effectiveness in this age group. Keppra tablets are not suitable for children under six months of age. Keppra intravenous infusion is not recommended for children under four years of age.
- Keppra oral solution contains maltitol and is not suitable for patients with rare hereditary problems of fructose intolerance.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- The safety of this medicine for use during pregnancy has not been established. The manufacturer states that it is not recommended for use in pregnancy unless considered essential by your doctor. It is very important for women with epilepsy to talk to the doctor responsible for their epilepsy treatment before becoming pregnant. Stopping antiepileptic treatment during pregnancy runs the risk of the mother having seizures, which can harm both the mother and the foetus. This risk may be higher than that from continuing the medication. It is important that all the risks and benefits of treatment are weighed up. Seek medical advice from your doctor.
- This medicine passes into breast milk. Breastfeeding is not recommended while taking this medicine. Mothers who need to take this medicine should seek medical advice from their doctor.
- Do not stop taking this medication except on your doctor's advice.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.
Very common (affect more than 1 in 10 people)
- Feeling weak or fatigued.
Common (affect between 1 in 10 and 1 in 100 people)
- Dizziness or loss of balance.
- Shaky movements and unsteady walk (ataxia).
- Problems with attention or memory.
- Shaking, usually of the hands (tremor).
- Unstable moods (emotional lability).
- Difficulty sleeping (insomnia).
- Nervousness, agitation.
- Hostility, irritability, aggression.
- Personality disorders.
- Gut disturbances such as abdominal pain, diarrhoea, nausea, vomiting, indigestion.
- Loss of appetite.
- Double or blurred vision.
- Rash or itching.
- Disturbances in the normal numbers of blood cells in the blood.
- Inflammation of the liver or pancreas.
- Hair loss.
- Pins and needles sensations.
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
No significant interactions have so far been reported with this medicine. However, you should tell your doctor what other medicines you are taking before starting treatment with this medicine, and likewise, check with your doctor or pharmacist before taking any new medicines once you have started treatment. This includes medicines bought without a prescription and herbal medicines.
This medicine does not affect the contraceptive pill.
It is recommended that people who are taking any antiepileptic medicines should avoid taking the herbal remedy St John's wort (Hypericum perforatum). This is because St John's wort may affect the level of antiepileptic medicines in the blood and could increase the risk of seizures.
Other medicines containing the same active ingredient
There are currently no other medicines available in the UK that contain levetiracetam as the active ingredient.