المحتويات
Last updated: xxx 2023
Prescription under medical supervision
Therapeutic action
- Anticonvulsant
Indications
- Epilepsy: generalised tonic-clonic seizures, partial (focal) seizures and absence seizures
Forms and strengths
- 250 mg, 500 mg, 750 mg and 1 g tablets
- 500 mg/5 ml oral solution
Dosage
- Child 1 to 5 months: 7 mg/kg once daily, then increase the dose to 7 mg/kg 2 times daily after 2 weeks if necessary, then in increments of 7 mg/kg 2 times daily every 2 weeks, up to 21 mg/kg 2 times daily max.
- Child 6 months to 17 years (under 50 kg): 10 mg/kg once daily, then increase the dose to 10 mg/kg 2 times daily after 2 weeks if necessary, then in increments of 10 mg/kg 2 times daily every 2 weeks, up to 30 mg/kg 2 times daily max.
- Child 50 kg and over and adult: 250 mg 2 times daily, then increase the dose to 500 mg 2 times daily after 2 to 4 weeks if necessary, then in increments of 500 mg 2 times daily every 2 to 4 weeks, up to 1500 mg 2 times daily max.
Duration
- As long as required. Do not stop treatment abruptly, even if changing treatment to another antiepileptic.
Contra-indications, adverse effects, precautions
- Administer with caution to older patients and patients with hepatic or renal impairment (reduce dosage) or heart disorders.
- May cause:
- hypersensitivity reactions sometimes severe;
- central nervous system depression, drowsiness (caution when driving/operating machinery), headache, asthenia, dizziness, behavioural disturbances;
- haematological disorders, gastrointestinal disturbances, cough, nasopharyngitis;
- rarely, QT prolongation.
- Administer with caution and monitor combination in patients taking:
- drugs containing alcohol, benzodiazepines, opioid analgesics, antipsychotics, first-generation antihistamines (hydroxyzine, promethazine), antidepressants, other anticonvulsants, etc. (increased sedation);
- drugs that prolong the QT interval (antimalarials, antipsychotics, fluconazole, fluoroquinolones, hydroxyzine, macrolides, ondansetron, etc.).
- Avoid alcohol during treatment (increased sedation).
- Pregnancy: use only if the benefits outweigh the risks (limited data). Use the lowest effective dose.
- Start folic acid (5 mg daily) as soon as possible (including in the preconception period in case of planned pregnancy) and continue treatment for at least the first trimester.
- Plasma concentrations may decrease during pregnancy (monitor clinical response; increase dose if needed then resume the usual dose after delivery).
- Breast-feeding: administer with caution (excreted in milk); reduce the dose if increased during pregnancy and monitor the child (risk of drowsiness and poor feeding).
Remarks
- Levetiracetam can be used with contraceptive implants and oral contraceptives.
Storage