How levetiracetam works
Levetiracetam is a drug from the class of antiepileptic drugs (drugs against epilepsy, also called anticonvulsants). It mediates its effect mainly by reducing the amount of certain messenger substances of the nervous system (neurotransmitters).
The human nervous system is activated or inhibited by neurotransmitters. Normally, these neurotransmitters are released according to external circumstances and ensure an appropriate response of the body to various situations such as injury, stress or rest.
In diseases of the nervous system, this controlled balance is disturbed. Thus, due to a genetic predisposition or brain injury, excitation may be increased or inhibition decreased. As a result, the brain is overexcitable, which can lead to epileptic seizures.
Absorption, degradation and excretion
Levetiracetam is rapidly and almost completely absorbed from the intestine into the blood after ingestion by mouth (peroral). It is then distributed throughout the body.
After about seven hours, half of the active substance has been broken down (half-life). The breakdown products are excreted mainly through the kidneys in the urine.
When is levetiracetam used?
The indications for the use of Levetiracetam include various forms of seizure disorders, namely:
- focal seizures (confined to one region of the brain) with or without secondary generalization (= spread to both hemispheres of the brain) – levetiracetam is used here either alone (as monotherapy) or as an add-on therapy to other drugs
- myoclonic seizures (seizures with sudden onset of muscle twitching) – the active substance is used here as an add-on therapy
How levetiracetam is used
Medicines containing levetiracetam are usually used in the form of tablets or drinking solutions. In acute cases, the drug may also be injected directly into the bloodstream.
The dosage is usually between 500 and 1500 milligrams of levetiracetam, but is determined individually by the doctor. For example, the dose must be reduced in patients with renal dysfunction and in children and adolescents.
Levetiracetam tablets and drinkable solutions are usually taken twice daily, independently of meals, and always at approximately the same time.
If the active substance is to be discontinued, this should be done “gradually” (not abruptly). This means that the dose is reduced gradually.
What are the side effects of levetiracetam?
Very often, i.e. in more than ten percent of those treated, levetiracetam causes side effects such as headache, dizziness and drowsiness.
Abrupt discontinuation of levetiracetam may result in increased seizures due to the sudden absence of the active substance. Therefore, the dose should always be gradually reduced when discontinuing use.
What should be considered when taking Levetiracetam?
Contraindications
Levetiracetam must not be used in cases of known hypersensitivity to the active substance.
Drug interactions
If patients are also using methotrexate (e.g., for a rheumatic disease), the two drug levels in the blood may affect each other.
Trafficability and operation of machines
The decision to actively participate in road traffic or operate heavy machinery also depends on the frequency and severity of epileptic seizures and their control with levetiracetam.
Age restrictions
Medications containing levetiracetam may be used for single-agent treatment (monotherapy for focal seizures) in adolescents 16 years of age and older.
In the form of combination therapy (add-on therapy), levetiracetam may be used for certain forms of epilepsy as early as 12 years of age (tonic-clonic and myoclonic seizures) or as early as the first month of life (focal seizures).
In infants and young children, the dosage is reduced in adaptation to body weight and renal function.
Pregnancy and lactation
Levetiracetam can also be used during breastfeeding. However, since it passes into breast milk, breastfeeding during use is not recommended. Occasionally, adjustment disorders in the newborn have been recorded.
The risk of taking medication during pregnancy and breastfeeding is always weighed against the risk of untreated epilepsy.
How to receive medication with levetiracetam
Therapy with levetiracetam requires regular medical monitoring. To ensure this, medicines containing this active ingredient are only available from pharmacies in Germany, Austria and Switzerland with a doctor’s prescription.
How long has levetiracetam been known?
Levetiracetam was developed from the older active ingredient piracetam by making minor changes to its chemical structure. This is actually used to treat dementia (progressive loss of memory).