Definition
Keppra® is the trade name of the drug Levetiracetam. This is a drug from the group of antiepileptic drugs. It is used for the treatment, especially the prevention of epileptic seizures.
Approval
Keppra® contains an active ingredient and is therefore used as a monotherapy for the treatment of focal seizures from the age of 16 years. As an additional medication, this active ingredient may also be administered from the age of one month. It is also used in the treatment of myoclonic seizures in patients with juvenile myoclonic epilepsy. Generalized tonic-clonic seizures in patients over 12 years of age can also be treated with the drug.
Active ingredient
The active ingredient Levetiracetam binds to a specific vesicle protein at the synapses. Various neurotransmitters are stored in the vesicles, which are located in the presynaptic termination. Now that the drug has bound to the vesicle protein, many more vesicles fuse with the membrane of the synapse and release the neurotransmitter GABA into the synaptic cleft.
GABA finally binds to specific GABA receptors on the postsynaptic membrane. GABA causes a chloride ion channel to open, through which chloride ions then flow into the postsynaptic membrane. The chloride ions exert an inhibitory effect so that the transmission of excitation is stopped. The speed of nerve conduction is reduced, which also prevents the triggering of epileptic seizures.
Dose
Keppra® are mostly taken as film tablets. They can be taken independently of food. For prophylaxis and prevention of seizures, patients are recommended to take a daily dose, which is divided into two equal doses per day.
This medication should always be taken exactly as directed by the treating physician. Since this is a drug and long-term therapy, it should be taken as long as it is agreed with the doctor. Accordingly, the patient should not stop taking the medication of his own accord.
In the best case, the medication should be reduced again step by step (gradually), otherwise the epileptic seizures can occur again in greater numbers. A dose of 250 mg twice a day is recommended for adults and adolescents aged 16 years and older when taking Keppra® monotherapy. After two weeks, the dose is increased to 500 mg twice daily.
Depending on how well the patient responds to the drug, the dose can still be adjusted and increased. The maximum daily dose is 1500 mg twice daily. When treating epilepsy in children, the doctor should adjust the dose according to body weight.
For infants and toddlers between 6 and 23 months of age, the therapeutic dose is 10 mg twice daily per kilogram of body weight. For children with a body weight over 50 kilograms, the daily doses apply as for adults. For patients with limited kidney function, such as those with renal insufficiency, the daily dose must also always be adjusted.
The dose is then based on the current performance of the kidneys. This can be calculated with the creatinine clearance of the patient. This value indicates how much blood the kidney can cleanse of a certain substance and thus also corresponds to the function of the kidney.
