Levetiracetam for preventing seizures
Levetiracetam for preventing seizures
This leaflet is about the use of levetiracetam to prevent epileptic seizures. (Seizures may also be called convulsions or fits.)
This leaflet has been written specifically for parents and carers about the use of this medicine in children. The information may differ from that provided by the manufacturer. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.
Do not stop giving levetiracetam suddenly, as your child may have more seizures.
Name of drug
Brand names: Keppra ®, Keppra® XR
Why is it important for my child to take this medicine?
It is important that your child takes levetiracetam regularly so that they have fewer seizures.
What is levetiracetam available as?
- Tablets: 250 mg, 500 mg, 750 mg, 1000 mg
- Modified release tablets (Keppra XR): 500 mg, 750 mg
- Liquid medicine: 500 mg in 5 mL
When should I give levetiracetam?
Levetiracetam is usually given twice each day, once in the morning and once in the evening. Ideally, these times are 10–12 hours apart, for example sometime between 7 and 8 am and between 7 and 8 pm.
Your doctor may prescribe modified release tablets (Keppra XR). These are usually given once each day. This can be in the morning OR evening.
Give the medicine at about the same time(s) each day so that this becomes part of your child’s daily routine, which will help you to remember.
How much should I give?
Your doctor will work out the amount of levetiracetam (the dose) that is right for your child. The dose will be shown on the medicine label.
Your doctor will start your child on a low dose and then gradually increase it over a few days or weeks to help your child get used to the medicine. If you are not sure how much to give, check with your doctor or pharmacist.
It is important that you follow your doctor’s instructions about how much to give.
How should I give it?
Tablets should be swallowed whole with a glass of water, milk or juice. Your child should not chew the tablet.
You can crush the tablet and mix it with about 2 tablespoons of fruit juice or soft food such as yogurt, honey or jam. Make sure your child swallows it straight away, without chewing.
Liquid medicine: Measure out the right amount using an oral syringe or medicine spoon. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.
To hide the taste of the liquid medicine, you can add the dose into a glass of water, milk or fruit juice (preferably at room temperature. Your child should drink all the mixture straight away.
When should the medicine start working?
It may take a few weeks for levetiracetam to work properly, so your child may still have seizures during this time. This is because the amount of medicine has to be increased slowly. Continue to give the medicine in the way you have been told to by your doctor or epilepsy nurse.
Levetiracetam may not stop your child’s seizures completely. If you are worried about whether it is helping, contact your doctor but continue to give the medicine.
What if my child is sick (vomits)?
- If your child is sick less than 30 minutes after having a dose of levetiracetam, give them the same dose again.
- If your child is sick more than 30 minutes after having a dose of levetiracetam, you do not need to give them another dose. Wait until the next normal dose.
What if I forget to give it?
If you usually give it twice a day: If you remember up to 4 hours after you should have given a dose, give your child the missed dose. For example, if you usually give a dose at about 7 am, you can give the missed dose at any time up to 11 am. If you remember after that time, do not give the missed dose. Just give the next dose as usual.
Modified release tablets
If you usually give it once a day in the morning: Give the missed dose when you remember during the day, as long as this is at least 12 hours before the next dose is due.
If you usually give it once a day in the evening: If you remember before bedtime, give the missed dose. You do not need to wake up a sleeping child to give a missed dose. You can give the missed dose in the morning, as long as this is at least 12 hours before the evening dose is due.
Never give a double dose of levetiracetam.
What if I give too much?
You are unlikely to do harm if you give an extra dose of levetiracetam by mistake.
If you think you may have given your child too much levetiracetam, contact your doctor or NHS Direct (0845 4647 in England and Wales; 08454 24 24 24 in Scotland) or take your child to hospital.
Take the medicine container or packaging with you, even if it is empty. This will be useful to the doctor. Have the packaging with you if you telephone for advice.
Are there any possible side-effects?
We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).
Levetiracetam usually causes only mild side-effects or none at all. These should get better as your child’s body gets used to the medicine. If they are still a problem after 2 weeks or you are worried, contact your doctor, but continue to give levetiracetam.
- Your child’s behaviour may change – they may be drowsy (sleepy), seem less alert than normal and may say they cannot think clearly or remember things. They may develop a tremor (shakiness), or their coordination may be affected (they may seem clumsy). They may also have changes in mood and may be aggressive or hyperactive (more active than usual and finding it hard to relax).
- Your child may have a decreased appetite, feel sick (nausea) or be sick (vomit) or have stomach ache or diarrhoea (runny poo).
- Your child may have a headache or feel dizzy.
- They may develop a rash.
There may, sometimes, be other side-effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor.
Can other medicines be given at the same time as levetiracetam?
- You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
- Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.
Epilepsy and pregnancy
- Pregnancy presents a risk to both the mother with epilepsy and her unborn baby. If your daughter has sex, it is essential that she uses adequate contraception to prevent an unplanned pregnancy.
- If your daughter thinks that she may be pregnant, it is important that she sees your family doctor as early as possible. Your daughter should keep taking her medication until she sees her doctor.
Levetiracetam and pregnancy
- Doctors don’t yet know whether levetiracetam can harm an unborn baby.
- The oral contraceptive pill can be used safely in women or girls who are taking levetiracetam.
General advice about medicines for seizures
Do not suddenly stop giving any of these medicines to your child, as they may have a seizure. If you are worried, contact your doctor but carry on giving the medicine to your child as usual.
If your child seems to have more seizures than usual, contact your doctor or epilepsy nurse.
- If your doctor decides to stop a particular medicine, they will discuss this with you. You will usually reduce the dose bit by bit.
Do not change the dose of any drug without talking to your doctor first.
- It is best that your child always has the same brand of each medicine, as there may be differences between brands. Keep a record of which medicines your child has.
- Try to give medicines at about the same times every day, to help you remember.
- Only give the medicine(s) to your child. Never give them to anyone else, even if their condition appears to be the same, as this could do harm.
- If you think someone else may have taken the medicine by accident, contact your doctor straight away.
- Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
- Make sure that the medicines you have at home have not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.
Where I should keep this medicine?
- Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
- Make sure that children cannot see or reach the medicine.
- Keep the medicine in the container it came in.
Who to contact for more information
Your doctor, pharmacist or nurse will be able to give you more information about levetiracetam and other medicines used to treat epilepsy.
- NHS Direct (England)
- NHS 24 (Scotland)
08454 24 24 24
- NHS Direct Wales / Galw lechyd Cymru
- NI Direct (Northern Ireland)
- Young Epilepsy Helpline
- Epilepsy Society Helpline
01494 601 400
- Epilepsy Action Helpline
0808 800 5050
Version 2, October 2012. © NPPG, RCPCH and WellChild 2011, all rights reserved. Reviewd by: October 2015
The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk
We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.