Levetiracetam for preventing seizures

Name of medicine

Levetiracetam

Brand names: Keppra, Desitrend

Why is it important for my child to take Levetiracetam?

It is important that your child takes Levetiracetam regularly so that they have fewer seizures. Seizures may also be called convulsions or fits.

What is Levetiracetam available as?

• Tablets: 250 mg, 500 mg, 750 mg, 1 g
• Liquid medicine: 100 mg in 1 mL
• Granules: 250 mg, 500 mg, 1000 mg

When should I give Levetiracetam

The Levetiracetam is usually given twice each day. Give one dose in the morning and one in the evening. Ideally these times are 10–12 hours apart. For example, this could be between 7am and 8am and between 7pm and 8pm.

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 may suggest that your child starts with a low dose. They may then increase the dose as your child gets used to the medicine and depending on how they respond to it. Your doctor will explain what to do. If you are not sure how much to give, check with your doctor, nurse or pharmacist.

How should I give Levetiracetam?

Tablets

• Tablets should be swallowed with a glass of water, squash or juice. Your child should not chew the tablets.
• You can crush the tablet and mix it with a small amount of soft food such as yogurt, honey, or mashed potato. Make sure your child swallows it straight away, without chewing.

Liquid medicine

• Shake the medicine well. Measure out the right amount using an oral syringe or a 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 small glass of juice or squash (preferably at room temperature).
• Your child should drink all the mixture straight away.

Granules

• Granules should be poured from the sachet onto your child’s tongue and swallowed with a glass of water or squash. Your child should not chew the granules. You can also mix the granules with a small amount of soft food such as yogurt or jam. Make sure your child swallows it all straight away, without chewing

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 that 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, do not give them another dose. Wait until the next normal dose.

If your child is sick again, seek advice from your family doctor, nurse, pharmacist, or hospital. They will decide what to do based on your child’s condition and the specific medicine involved.

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 7am, you can give the missed dose at any time up to 11am. If you remember after that time, do not give the missed dose. Give the next dose as usual.

What if I give too much?

You are unlikely to cause harm if you give an extra dose of Levetiracetam by mistake. If you are concerned that you may have given too much, contact your doctor or local NHS services (details at end of leaflet). Have the medicine or packaging with you if you telephone for advice.

Are there any possible side effects?

We use medicines to help our children, but sometimes they have effects that we don’t want (side-effects).

Levetiracetam usually causes only mild side-effects which 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. You can report any suspected side effects to a UK safety scheme at mhra.gov.uk/yellowcard

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.

• Levetiracetam should not be taken with some medicines. Tell your doctor or pharmacist about any other medicines your child is taking before giving Levetiracetam.

Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and 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 she may be pregnant, it is important that she sees her doctor as soon as possible. Your daughter should keep taking her medication until she sees her doctor. 

Levetiracetam and pregnancy

• Doctors do not yet know whether Levetiracetam can harm an unborn baby.
• The oral contraceptive pill can be used safely in women and girls who are taking Levetiracetam.

General advice about medicines

Advice about medicines for seizures

• If your doctor decides to stop a particular medicine, they will discuss this with you. They will usually reduce the dose bit by bit.
• 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 each day, to help you remember.

• Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.

• 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 should I 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 child’s doctor, pharmacist or nurse will be able to give you more information about Levetiracetam and about other medicines used to treat epilepsy.

Copyright disclaimer

Version [3]. © NPPG, RCPCH and WellChild, all rights reserved. Review by March 2023.

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.