Levetiracetam โ€” NZ Medication Guide

What is Levetiracetam?

Levetiracetam is a broad-spectrum anticonvulsant used for focal and generalised epilepsy. This medication is funded by Pharmac for epilepsy.

What is Levetiracetam Used For?

Used as adjunct or monotherapy for focal onset seizures, myoclonic seizures in juvenile myoclonic epilepsy, and generalised tonic-clonic seizures.

How Does Levetiracetam Work?

Binds to the synaptic vesicle protein SV2A, modulating neurotransmitter release and inhibiting synchronised neuronal burst firing across a broad range of seizure types.

How to Take Levetiracetam

Taken twice daily with or without food. Start 250โ€“500 mg twice daily, titrate to max 1500 mg twice daily. Dose reduction required in renal impairment.

Common Side Effects of Levetiracetam

  • Behavioural changes โ€” irritability, agitation, aggression, depression (important โ€” report promptly)
  • Drowsiness and fatigue
  • Headache
  • Dizziness
  • Nasopharyngitis

Serious Side Effects โ€” Seek Medical Attention

Contact your doctor or call 111 immediately if you experience any of the following:

  • Serious psychiatric and behavioural effects (suicidal ideation, psychosis โ€” rare)
  • Serious skin reactions (rare)
  • Haematological effects โ€” anaemia, neutropenia (rare)

Drug Interactions

Levetiracetam may interact with other medicines. Always inform your doctor and pharmacist of all medications you are taking. Key interactions include:

  • Very few clinically significant interactions โ€” a major advantage over other anticonvulsants
  • May enhance sedative effects of CNS depressants

New Zealand Prescribing Information

Levetiracetam (500 mg, 1000 mg tablets; 100 mg/mL oral solution โ€” Keppraยฎ and generics) is funded by Pharmac. Increasingly used as first-line due to broad-spectrum activity, lack of enzyme induction, and minimal interactions. Behavioural/psychiatric side effects must be monitored.

Frequently Asked Questions

Can levetiracetam affect my mood?

Yes โ€” irritability, mood swings, and rarely aggression or psychosis can occur at any dose. Report significant mood or behaviour changes to your neurologist promptly, as dose reduction or a medicine change may be needed.

Does levetiracetam interact with other medicines?

Unlike most anticonvulsants, levetiracetam has very few drug interactions and does not affect liver enzyme activity, making it very convenient for patients on multiple medications.

Reviewed by a Registered Pharmacist NZ

References & Further Information

The following New Zealand and international resources were used to inform this page:

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