Levetiracetam (IV)
Brand names: Keppra (IV), Desitrend
Levetiracetam is an antiepileptic used for focal and generalised seizures, including acutely (e.g. status epilepticus) and as maintenance therapy.
ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.
Clinical monograph
How it works
It binds the synaptic vesicle protein SV2A, modulating neurotransmitter release; the precise anticonvulsant mechanism is not fully defined.
Prescribing in practice
- It has few significant drug interactions, which is useful acutely and in polypharmacy.
- Behavioural and mood effects (irritability, agitation, low mood) are recognised — ask about them.
- Reduce the dose in renal impairment, as it is renally cleared.
Monitoring
No routine level monitoring; review seizure control, mood/behaviour and renal function.
Counselling the patient
- Take it regularly and do not stop suddenly.
- Report irritability, low mood or behaviour changes.
- Tell your clinician about thoughts of self-harm.
Evidence & guidelines
Widely used for focal and generalised epilepsy and as an option in status epilepticus, valued for its few interactions.
Reference: NICE NG217 (Epilepsy); EsCCAPE Trial; ConSEPT Trial; ESETT Trial; APLS Guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).
Related
Curated clinical cross-links plus same-class fallbacks.
- ASA Physical Status Classification · Pre-operative Risk
- ASA Physical Status Classification · Perioperative Risk
- Duke Activity Status Index (DASI) · Functional Assessment
- ECOG / WHO Performance Status · Performance Status
- Karnofsky Performance Status Scale · Performance Status
- Duval/CIBMTR Score for AML in Second Complete Remission · Leukaemia
- Paracetamol overdose · TOXBASE/NPIS; MHRA DSU 2012/2024; SNAP regimen (Lancet 2014)
- TCA overdose · TOXBASE/NPIS; AACT/EAPCCT position statements; Resuscitation Council UK ALS
- Opioid overdose · TOXBASE/NPIS; Resuscitation Council UK
- Anticholinergic toxidrome · TOXBASE/NPIS; AACT/EAPCCT
- Benzodiazepine overdose · TOXBASE/NPIS; AACT/EAPCCT
- β-blocker overdose · TOXBASE/NPIS; AACT/EAPCCT; ESC
Featured in these MRCEM clinical pathways
Levetiracetam (IV) is a core drug in the following exam-focused workups on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.