lPREGNANCY
MonitoringThe dose should be monitored carefully during
pregnancy and after birth, and adjustments made on a
clinical basis. It is recommended that the fetal growth
should be monitored.
lBREAST FEEDINGPresent in milk—manufacturer advises
avoid.
lHEPATIC IMPAIRMENT
Dose adjustmentsHalve dose in severe hepatic impairment
if estimated glomerularfiltration rate less than
60 mL/minute/ 1. 73 m^2.
lRENAL IMPAIRMENT
Dose adjustmentsReduce dose if estimated glomerular
filtration rate less than 80 mL/minute/ 1. 73 m^2 (consult
product literature).
lDIRECTIONS FOR ADMINISTRATION
▶With intravenous useForintravenous infusion(Keppra®),
dilute requisite dose with at least 100 mL Glucose 5 %or
Sodium Chloride 0. 9 %; give over 15 minutes.
▶With oral useFor administration oforal solution, requisite
dose may be diluted in a glass of water.
lPRESCRIBING AND DISPENSING INFORMATIONIf switching
between oral therapy and intravenous therapy (for those
temporarily unable to take oral medication), the
intravenous dose should be the same as the established
oral dose.
lPATIENT AND CARER ADVICE
Medicines for Children leaflet: Levetiracetam for preventing
seizureswww.medicinesforchildren.org.uk/levetiracetam-for-
preventing-seizureslMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral suspension, oral solution
Granules
CAUTIONARY AND ADVISORY LABELS 8
▶Desitrend(Desitin Pharma Ltd)
Levetiracetam 250 mgDesitrend 250 mg granules sachets sugar-free
| 60 sachetP£ 22. 41 DT = £ 22. 41
Levetiracetam 500 mgDesitrend 500 mg granules sachets sugar-
free| 60 sachetP£ 39. 46 DT = £ 39. 46
Levetiracetam 1 gramDesitrend 1000 mg granules sachets sugar-
free| 60 sachetP£ 76. 27 DT = £ 76. 27
Tablet
CAUTIONARY AND ADVISORY LABELS 8
▶Levetiracetam (Non-proprietary)
Levetiracetam 250 mgLevetiracetam 250 mg tablets|
60 tabletP£ 26. 86 DT = £ 19. 31
Levetiracetam 500 mgLevetiracetam 500 mg tablets|
60 tabletP£ 47. 31 DT = £ 30. 73
Levetiracetam 750 mgLevetiracetam 750 mg tablets|
60 tabletP£ 84. 02 DT = £ 43. 15
Levetiracetam 1 gramLevetiracetam 1 g tablets| 60 tabletP
£ 93. 09 DT = £ 54. 76
▶Keppra(UCB Pharma Ltd)
Levetiracetam 250 mgKeppra 250 mg tablets| 60 tabletP
£ 28. 01 DT = £ 19. 31
Levetiracetam 500 mgKeppra 500 mg tablets| 60 tabletP
£ 49. 32 DT = £ 30. 73
Levetiracetam 750 mgKeppra 750 mg tablets| 60 tabletP
£ 84. 02 DT = £ 43. 15
Levetiracetam 1 gramKeppra 1 g tablets| 60 tabletP£ 95. 34
DT = £ 54. 76
Solution for infusion
ELECTROLYTES:May contain Sodium
▶Levetiracetam (Non-proprietary)
Levetiracetam 100 mg per 1 mlLevetiracetam 500 mg/ 5 ml
concentrate for solution for infusion vials| 10 vialP£ 125. 00 –
£ 127. 31 | 10 vialP£ 114. 57 (Hospital only)
▶Desitrend(Desitin Pharma Ltd)
Levetiracetam 100 mg per 1 mlDesitrend 500 mg/ 5 ml concentrate
for solution for infusion ampoules| 10 ampouleP£ 127. 31 DT =
£ 127. 31▶Keppra(UCB Pharma Ltd)
Levetiracetam 100 mg per 1 mlKeppra 500 mg/ 5 ml concentrate for
solution for infusion vials| 10 vialP£ 127. 31
Oral solution
CAUTIONARY AND ADVISORY LABELS 8
▶Levetiracetam (Non-proprietary)
Levetiracetam 100 mg per 1 mlLevetiracetam 100 mg/ml oral
solution sugar free sugar-free| 150 mlP£ 27. 00 sugar-free|
300 mlP£ 63. 60 DT = £ 6. 76
▶Desitrend(Desitin Pharma Ltd)
Levetiracetam 100 mg per 1 mlDesitrend 100 mg/ml oral solution
sugar-free| 300 mlP£ 15. 90 DT = £ 6. 76
▶Keppra(UCB Pharma Ltd)
Levetiracetam 100 mg per 1 mlKeppra 100 mg/ml oral solution
sugar-free| 150 mlP£ 33. 48 sugar-free| 300 mlP£ 66. 95
DT = £ 6. 76Oxcarbazepine
lINDICATIONS AND DOSE
Monotherapy for the treatment of focal seizures with or
without secondary generalised tonic-clonic seizures
▶BY MOUTH
▶Child 6–17 years:Initially 4 – 5 mg/kg twice daily (max.
per dose 300 mg), then increased in steps of up to
5 mg/kg twice daily, adjusted according to response,
dose to be adjusted at weekly intervals; maximum
46 mg/kg per day
Adjunctive therapy for the treatment of focal seizures
with or without secondary generalised tonic-clonic
seizures
▶BY MOUTH
▶Child 6–17 years:Initially 4 – 5 mg/kg twice daily (max.
per dose 300 mg), then increased in steps of up to
5 mg/kg twice daily, adjusted according to response,
dose to be adjusted at weekly intervals; maintenance
15 mg/kg twice daily; maximum 46 mg/kg per day
DOSE ADJUSTMENTS DUE TO INTERACTIONS
▶In adjunctive therapy, the dose of concomitant
antiepileptics may need to be reduced when using high
doses of oxcarbazepine.lCAUTIONSAvoid in Acute porphyrias p. 603 .cardiac
conduction disorders.heart failure.hyponatraemia
lINTERACTIONS→Appendix 1 : antiepileptics
lSIDE-EFFECTS
▶Common or very commonAbdominal pain.agitation.
alopecia.asthenia.ataxia.concentration impaired.
constipation.depression.diarrhoea.dizziness.
drowsiness.emotional lability.headache.hyponatraemia
.nausea.nystagmus.skin reactions.vertigo.vision
disorders.vomiting
▶UncommonLeucopenia
▶Rare or very rareAngioedema.arrhythmia.
atrioventricular block.hepatitis.hypothyroidism.
pancreatitis.severe cutaneous adverse reactions (SCARs).
systemic lupus erythematosus (SLE).thrombocytopenia
▶Frequency not knownAgranulocytosis.bone disorders.
bone marrow disorders.hypertension.inappropriate
antidiuretic hormone secretion like-syndrome.
neutropenia.speech impairment
lALLERGY AND CROSS-SENSITIVITYCaution in patients with
hypersensitivity to carbamazepine. Antiepileptic
hypersensitivity syndrome associated with oxcarbazepine.
See under Epilepsy p. 191 for more information.
lPREGNANCY
MonitoringThe dose should be monitored carefully during
pregnancy and after birth, and adjustments made on a
clinical basis.
lBREAST FEEDINGAmount probably too small to be
harmful but manufacturer advises avoid.204 Epilepsy and other seizure disorders BNFC 2018 – 2019
Nervous system4