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Anticonvulsant (SV2A Ligand)

Levetiracetam (Paediatric)

Brand names: Keppra

Levetiracetam (paediatric) is an antiepileptic drug used in children for focal seizures and, as adjunctive therapy, for myoclonic and primary generalised tonic-clonic seizures. This page covers its use in the paediatric population.

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.

Clinical monograph

How it works

It binds the synaptic vesicle protein SV2A, modulating neurotransmitter release and reducing the synchronised neuronal firing that drives seizures.

Prescribing in practice

  • The most important paediatric concern is the risk of behavioural and psychiatric adverse effects (irritability, aggression, agitation, mood change and rarely suicidal ideation), which are common in children and should be discussed with families and monitored.
  • Dose adjustment is required in renal impairment because the drug is largely cleared unchanged by the kidneys; dosing is weight-based and should be checked against a children's formulary.
  • It should be withdrawn gradually rather than stopped abruptly to reduce the risk of rebound seizures.

Monitoring

Monitor for behavioural and mood changes, seizure control and renal function; routine plasma-level monitoring is not usually needed.

Counselling the patient

  • Report any new irritability, aggression, low mood or unusual behaviour to the clinical team.
  • Give the medicine regularly and do not stop it suddenly.
  • An oral solution is available for younger children who cannot swallow tablets.

Evidence & guidelines

Paediatric use is supported by NICE epilepsy guidance, with behavioural effects being a well-recognised class consideration.

Reference: ECLIPSE Trial (Lyttle et al, Lancet 2019); NICE NG217; 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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