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{{
{{Use dmy dates|date=
{{Infobox drug
| Verifiedfields = changed
| Watchedfields = changed
| verifiedrevid = 419931567
| imageL = Levetiracetam.svg
| widthL = 125
| altL =
| imageR = Levetiracetam ball-and-stick model.png
| widthR = 120
| altR =
<!--Clinical data-->
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| Drugs.com = {{drugs.com|monograph|levetiracetam}}
| MedlinePlus = a699059
| DailyMedID = Levetiracetam
| pregnancy_AU = B3
| pregnancy_AU_comment = <ref name="Drugs.com pregnancy">{{cite web |title=Levetiracetam Use During Pregnancy |url=https://www.drugs.com/pregnancy/levetiracetam.html |website=Drugs.com |access-date=5 March 2019 |archive-date=6 March 2019 |archive-url=https://web.archive.org/web/20190306044746/https://www.drugs.com/pregnancy/levetiracetam.html |url-status=live }}</ref>
| pregnancy_category =
| routes_of_administration = [[Oral administration|By mouth]], [[intravenous]]
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| legal_AU = S4
| legal_BR = C1
| legal_BR_comment = <ref>{{Cite web |author=Anvisa |author-link=Brazilian Health Regulatory Agency |date=31 March 2023 |title=RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial |trans-title=Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control|url=https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-784-de-31-de-marco-de-2023-474904992 |url-status=live |archive-url=https://web.archive.org/web/20230803143925/https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-784-de-31-de-marco-de-2023-474904992 |archive-date=3 August 2023 |access-date=16 August 2023 |publisher=[[Diário Oficial da União]] |language=pt-BR |publication-date=4 April 2023}}</ref>
| legal_CA = Rx-only
| legal_UK = POM
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| metabolism = Enzymatic hydrolysis of acetamide group
| elimination_half-life = 6–8 hrs
| excretion =
<!--Identifiers-->
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<!-- Side effects and mechanism -->
Common side effects of levetiracetam include sleepiness, dizziness, feeling tired, and aggression.<ref name=AHFS2019>{{cite web |title=Levetiracetam Monograph for Professionals |url=https://www.drugs.com/monograph/levetiracetam.html |website=Drugs.com |publisher=AHFS |access-date=14 January 2019
Levetiracetam was approved for medical use in the United States in 1999<ref name=AHFS2019/> and is available as a [[generic medication]].<ref name=BNF76>{{cite book|title=British national formulary: BNF 76|date=2018|publisher=Pharmaceutical Press|isbn=9780857113382|pages=319|edition=76}}</ref> In
▲Levetiracetam was approved for medical use in the United States in 1999<ref name=AHFS2019/> and is available as a [[generic medication]].<ref name=BNF76>{{cite book|title=British national formulary: BNF 76|date=2018|publisher=Pharmaceutical Press|isbn=9780857113382|pages=319|edition=76}}</ref> In 2020, it was the 92nd most commonly prescribed medication in the United States, with more than 7{{nbsp}}million prescriptions.<ref>{{cite web | title = The Top 300 of 2020 | url = https://clincalc.com/DrugStats/Top300Drugs.aspx | website = ClinCalc | access-date = 7 October 2022 | archive-date = 12 February 2021 | archive-url = https://web.archive.org/web/20210212142534/https://clincalc.com/DrugStats/Top300Drugs.aspx | url-status = live }}</ref><ref>{{cite web | title = Levetiracetam - Drug Usage Statistics | website = ClinCalc | url = https://clincalc.com/DrugStats/Drugs/Levetiracetam | access-date = 7 October 2022 | archive-date = 28 February 2020 | archive-url = https://web.archive.org/web/20200228055039/https://clincalc.com/DrugStats/Drugs/Levetiracetam | url-status = live }}</ref>
==Medical uses==
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Levetiracetam is effective for treatment of generalized tonic-clonic epilepsy.<ref name ="Cochrane_2022" /> It has been approved in the United States as add-on treatment for [[Seizure types#Generalized seizures|myoclonic]], and [[Seizure types#Generalized seizures|tonic-clonic]] seizures.<ref name="Keppra tablet FDA label" /> Levetiracetam has been approved in the European Union as a [[monotherapy]] treatment for epilepsy in the case of partial seizures or as an [[Combination therapy|adjunctive therapy]] for partial, myoclonic, and tonic-clonic seizures.<ref>{{cite book |title=BNF 59 |year=2010 |publisher=BMA & RPSGB}}</ref>
Levetiracetam is sometimes used off label to treat [[status epilepticus]].<ref>{{cite journal | vauthors = Brophy GM, Bell R, Claassen J, Alldredge B, Bleck TP, Glauser T, Laroche SM, Riviello JJ, Shutter L, Sperling MR, Treiman DM, Vespa PM | display-authors = 6 | title = Guidelines for the evaluation and management of status epilepticus | journal = Neurocritical Care | volume = 17 | issue = 1 | pages = 3–23 | date = August 2012 | pmid = 22528274 | doi = 10.1007/s12028-012-9695-z | s2cid = 4675838 | collaboration = Neurocritical Care Society Status Epilepticus Guideline Writing Committee }}</ref><ref>{{cite journal | vauthors = Meierkord H, Boon P, Engelsen B, Göcke K, Shorvon S, Tinuper P, Holtkamp M | title = EFNS guideline on the management of status epilepticus in adults | journal = European Journal of Neurology | volume = 17 | issue = 3 | pages = 348–355 | date = March 2010 | pmid = 20050893 | doi = 10.1111/j.1468-1331.2009.02917.x | s2cid = 1032139 | doi-access =
===Prevention of seizures===
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===Other===
Levetiracetam has not been found to be useful for treatment of [[neuropathic pain]],<ref>{{cite journal | vauthors = Crawford-Faucher A, Huijon RM | title = The Role of Levetiracetam in Treating Chronic Neuropathic Pain Symptoms | journal = American Family Physician | volume = 92 | issue = 1 | pages = 23–24 | date = July 2015 | pmid = 26132123 | url = http://www.aafp.org/link_out?pmid=26132123 | access-date = 1 September 2017 | archive-date = 29 August 2021 | archive-url = https://web.archive.org/web/20210829200854/https://www.aafp.org/afp/2015/0701/p23.html | url-status = live }}</ref> nor for treatment of [[essential tremor]]s.<ref>{{cite journal | vauthors = Zesiewicz TA, Elble RJ, Louis ED, Gronseth GS, Ondo WG, Dewey RB, Okun MS, Sullivan KL, Weiner WJ | display-authors = 6 | title = Evidence-based guideline update: treatment of essential tremor: report of the Quality Standards subcommittee of the American Academy of Neurology | journal = Neurology | volume = 77 | issue = 19 | pages = 1752–1755 | date = November 2011 | pmid = 22013182 | pmc = 3208950 | doi = 10.1212/WNL.0b013e318236f0fd }}</ref> Levetiracetam has not been found to be useful for treating all developmental disorders within the [[autism spectrum
=== Special groups ===
Studies in female pregnant rats have shown minor fetal skeletal abnormalities when given maximum recommended human doses of levetiracetam orally throughout pregnancy and lactation.{{
Studies were conducted to look for increased adverse effects in the elderly population as compared to younger patients. One such study published in Epilepsy Research showed no significant increase in incidence of adverse symptoms experienced by young or elderly patients with central nervous system (CNS) disorders.{{
== Adverse effects ==
The most common adverse effects of levetiracetam treatment include CNS effects such as somnolence, decreased energy, headache, dizziness, mood swings and coordination difficulties. These adverse effects are most pronounced in the first month of therapy. About 4% of patients dropped out of pre-approval clinical trials due to these side effects.<ref name="Keppra tablet FDA label" />
About 13% of people taking levetiracetam experience adverse neuropsychiatric symptoms, which are usually mild. These include agitation, hostility, apathy, anxiety, emotional lability, and depression. Serious psychiatric adverse side effects that are reversed by drug discontinuation occur in about 1%. These include hallucinations, suicidal thoughts, or psychosis. These occurred mostly within the first month of therapy, but they could develop at any time during treatment.<ref name="pmid18728811">{{cite journal | vauthors = Gambardella A, Labate A, Colosimo E, Ambrosio R, Quattrone A | title = Monotherapy for partial epilepsy: focus on levetiracetam | journal = Neuropsychiatric Disease and Treatment | volume = 4 | issue = 1 | pages = 33–38 | date = February 2008 | pmid = 18728811 | pmc = 2515905 | doi = 10.2147/NDT.S1655 | doi-access = free }}</ref>
Although rare, [[Stevens–Johnson syndrome]] (SJS) and [[toxic epidermal necrolysis]] (TEN), which appears as a painful spreading rash with redness and blistering and/or peeling skin, have been reported in patients treated with levetiracetam.<ref>{{cite journal | vauthors = Zou LP, Ding CH, Song ZJ, Li XF | title = Stevens-Johnson syndrome induced by levetiracetam | journal = Seizure | volume = 21 | issue = 10 | pages = 823–825 | date = December 2012 | pmid = 23036769 | doi = 10.1016/j.seizure.2012.09.005 | doi-access = free }}</ref> The incidence of SJS following exposure to anti-epileptics such as levetiracetam is about 1 in 3,000.<ref>{{cite journal | vauthors = Griebel ML | title = Acute management of hypersensitivity reactions and seizures | journal = Epilepsia | volume = 39 | issue = Suppl 7 | pages = S17–S21 | year = 1998 | pmid = 9798757 | doi = 10.1111/j.1528-1157.1998.tb01680.x | s2cid = 10305861 | doi-access = free }}</ref>
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=== Excretion ===
In persons with normal kidney function, levetiracetam is eliminated from the body primarily by the kidneys with about 66 percent of the original drug passed unchanged into urine. The plasma half-life of levetiracetam in adults is about 6 to 8 hours
=== Analogues ===
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Levetiracetam is available as regular and extended release oral formulations and as intravenous formulations.<ref>{{Cite web|url=http://www.sagentpharma.com/wp-content/uploads/2015/05/Levetiracetam-Injection_PI.pdf|title=Levetiracetam Injection Prescribing Information|access-date=4 November 2015|archive-date=1 November 2018|archive-url=https://web.archive.org/web/20181101112508/http://www.sagentpharma.com/wp-content/uploads/2015/05/Levetiracetam-Injection_PI.pdf|url-status=live}}</ref>
The immediate release tablet has been available as a [[Generic drug|generic]] in the United States since 2008, and in the UK since 2011.<ref>{{cite web |title=Patent Terms Extended Under 35 USC §156 |url=http://www.uspto.gov/patent/laws-and-regulations/patent-term-extension/patent-terms-extended-under-35-usc-156 |website=www.uspto.gov |access-date=5 November 2015
The branded version Keppra is manufactured by [[UCB (company)|UCB Pharmaceuticals
In 2015, Aprecia's
=== Legal status ===
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==Research==
Levetiracetam
Levetiracetam is being tested as a drug to reduce hyperactivity in the hippocampus in [[Alzheimer's disease]].<ref>{{cite journal | vauthors = Haberman RP, Branch A, Gallagher M | title = Targeting Neural Hyperactivity as a Treatment to Stem Progression of Late-Onset Alzheimer's Disease | journal = Neurotherapeutics | volume = 14 | issue = 3 | pages = 662–676 | date = July 2017 | pmid = 28560709 | pmc = 5509635 | doi = 10.1007/s13311-017-0541-z | doi-access = free }}</ref>
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Additionally, Levetiracetam has been experimentally shown to reduce [[Levodopa-induced dyskinesia]],<ref>{{cite journal | vauthors = Du H, Nie S, Chen G, Ma K, Xu Y, Zhang Z, Papa SM, Cao X | display-authors = 6 | title = Levetiracetam Ameliorates L-DOPA-Induced Dyskinesia in Hemiparkinsonian Rats Inducing Critical Molecular Changes in the Striatum | journal = Parkinson's Disease | volume = 2015 | issue = 1 | pages = 253878 | date = 27 January 2015 | pmid = 25692070 | pmc = 4322303 | doi = 10.1155/2015/253878 | publisher = [[Hindawi Publishing Corporation]] | publication-place = London, England, United Kingdom | veditors = Reichmann H, Alves da Costa C | lccn = 2010247839 | doi-access = free }}</ref> a type of movement disorder, or [[dyskinesia]] associated with the use of [[Levodopa]], a medication used to treat [[Parkinson's disease]].
Of the
== References ==
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[[Category:Racetams]]
[[Category:Wikipedia medicine articles ready to translate]]
[[Category:World Health Organization essential medicines]]
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