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Antiepileptic

Levetiracetam

Brand names: Keppra, Desitrend

Used in: Head Injury Seizures & Epilepsy

Levetiracetam is a widely used antiepileptic for focal and generalised seizures, valued for few drug interactions and straightforward initiation.

Dosing — being independently re-sourced

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.

US labelling (FDA)

Reference — US labelling, may differ from UK

Use the oral solution for pediatric patients with body weight ≤ 20 kg ( 2.1 ) For pediatric patients, use weight-based dosing for the oral solution with a calibrated measuring device (not a household teaspoon or tablespoon) ( 2.1 ) Partial-Onset Seizures (monotherapy or adjunctive therapy) 1 Month to < 6 Months: 7 mg/kg twice daily; increase by 7 mg/kg twice daily every 2 weeks to recommended dose of 21 mg/kg twice daily ( 2.2 ) 6 Months to < 4 Years: 10 mg/kg twice daily; increase by 10 mg/kg twice daily every 2 weeks to recommended dose of 25 mg/kg twice daily ( 2.2 ) 4 Years to < 16 Years: 10 mg/kg twice daily; increase by 10 mg/kg twice daily every 2 weeks to recommended dose of 30 …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-11-21. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It binds synaptic vesicle protein SV2A, modulating neurotransmitter release — a mechanism distinct from older antiepileptics.

Prescribing in practice

  • Behavioural and mood effects are the main issue — irritability, agitation, depression and (rarely) suicidal thoughts.
  • Reduce the dose in renal impairment.
  • It has minimal enzyme interactions (useful in polypharmacy and in liver disease); do not stop it abruptly.

Monitoring

Review seizure control, mood/behaviour and renal function.

Counselling the patient

  • Report low mood, marked irritability or any thoughts of self-harm.
  • Do not stop it suddenly.

Evidence & guidelines

A first-line option for several seizure types (NICE NG217), favoured for its interaction profile.

Reference: NICE CG137; 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.

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