Keppra

Before using this medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease (including dialysis treatment), mental/mood disorders (such as depression).This drug may make you dizzy or drowsy, especially during the first month of treatment. Do not drive, use machinery, ride a bicycle, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Children may be more sensitive to the side effects of the drug, especially mental/mood changes (such as irritability, aggression, agitation, anger, anxiety, depression, thoughts of suicide).Older adults may be more sensitive to the side effects of this drug, especially drowsiness, dizziness or loss of coordination. These side effects can increase the risk of falling.During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. However, since untreated seizures are a serious condition that can harm both a pregnant woman and her unborn baby, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately talk to your doctor about the benefits and risks of using this medication during pregnancy.This medication passes into breast milk. Consult your doctor before breast-feeding.

Keppra (Levetiracetam) and Other Drug Interactions

You should always tell your healthcare professional about all prescription, non-prescription, over the counter (OTC), illegal and recreational drugs, herbal remedies, and nutritional and dietary supplements. Certain medications may cause Keppra to be less effective or produce side effects.

Let your doctor know if you are taking anything that could cause you to become drowsy, including:

• Antihistamines like cetirizine (Zyrtec or Alleroff)
• Diphenhydramine (Benadryl, Sominex, Diphenhist, Wal-Dryl, Hydramine, Banophen, Dicopanol, or Silphen)
• Sleeping or anxiety medication such as alprazolam (Niravam or Xanax)
• Diazepam (Valium)
• Zolpidem (Edluar, Zolpimist, Ambien, or Intermezzo)
• Muscle relaxants
• Narcotic pain relievers, such as codeine

Be sure to check the labels on all your medications, especially allergy and cold products since they might have ingredients that make you drowsy. If you are unsure, ask your pharmacist.

Keppra (Levetiracetam) and Other Interactions

Since Keppra may make you feel sleepy or dizzy, you should not plan to drive, operate machinery, or attempt to perform any potentially dangerous activities until you know how this drug affects you. Drinking alcohol can worsen these effects.

Keppra is a prescription medicine taken by mouth that is used with other medicines to treat:

• partial onset seizures
• myoclonic seizures in people with juvenile myoclonic epilepsy
• primary generalized tonic-clonic seizures with certain types of generalized epilepsy

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

• UCB, Inc.

Keppra is part of the drug class:

• Other antiepileptics

The most common side effects seen in people who take Keppra include:

• sleepiness
• weakness
• dizziness
• infection

The most common side effects seen in children who take Keppra include, in addition to those listed above:

• accidental injury
• irritability
• hostility

These side effects can happen at any time but happen more often within the first 4 weeks of treatment except for infection.

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

Before taking Keppra, tell your doctor about all of your medical conditions, including if you:

• have or have had depression, mood problems or suicidal thoughts or behavior
• have kidney problems
• are pregnant or planning to become pregnant. It is not known if Keppra will harm your unborn baby. 
• are breastfeeding. Keppra can pass into your milk and may harm your baby. 

Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. Do not start a new medicine without first talking with your doctor.

Know the medicines you take. Keep a list of them to show your doctor and pharmacist each time you get a new medicine.

 

• Seizure (Epilepsy)
• Seizures Symptoms and Types

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Not a substrate or inhibitor of CYP isoenzymes.1 2

Drugs Affecting or Metabolized by Hepatic Microsomal Enzymes

Pharmacokinetic interactions unlikely.1 2 12

Protein-bound Drugs

Pharmacokinetic interaction unlikely.1 2 12

Specific Drugs

Drug	Interaction	Comments
Anticonvulsants (e.g., carbamazepine, gabapentin, lamotrigine, phenobarbital, phenytoin, primidone, valproic acid)	Clinically important pharmacokinetic interactions unlikely1 2 12 14 In pediatric patients, approximately 22% increase in levetiracetam clearance observed when administered with hepatic enzyme-inducing anticonvulsants1	When coadministered with hepatic enzyme-inducing anticonvulsants, dosage adjustment not necessary1
Digoxin	Pharmacokinetic interaction unlikely1 2 12
Oral contraceptives	Pharmacokinetic interaction unlikely1 2 12
Probenecid	No effect on levetiracetam pharmacokinetics, but steady-state plasma concentrations of principal inactive metabolite of levetiracetam approximately doubled because of 60% reduction in renal clearance1 2 12	Clinically unimportant5
Warfarin	Pharmacokinetic interaction unlikely1 2 12

• Structurally unrelated to other currently available anticonvulsants.1 2 3 5 12

• Mechanism of anticonvulsant action is not known.1 2 4 12

• Protection observed against secondarily generalized activity from focal seizures induced by 2 chemoconvulsants known to induce seizures that mimic some features of human complex partial seizures with secondary generalization.1 2 12

• Demonstrated inhibitory properties in the kindling model in rats, another model of human complex partial seizures.1 2 4 12

• Provide copy of manufacturer’s patient information.1

• Risk of adverse neuropsychiatric effects (e.g., somnolence, fatigue, dizziness, coordination difficulties, behavioral changes), especially during the initial weeks of therapy.1 2

• Risk of drowsiness; avoid driving, operating machinery, or performing hazardous tasks until effects on individual are known.1 2 5

• Risk of suicidality (anticonvulsants may increase risk of suicidal thoughts or actions in about 1 in 500 people).10 21 22 Importance of patients, family members, and caregivers being alert to day-to-day changes in mood, behavior, and actions and immediately informing clinician of any new or worrisome behaviors (e.g., talking or thinking about wanting to hurt oneself or end one's life, withdrawing from friends and family, becoming depressed or experiencing worsening of existing depression, becoming preoccupied with death and dying, giving away prized possessions).10 22

• Risk of serious dermatologic reactions.1 Importance of patients immediately notifying their clinician if a rash develops.1

• Risk of anaphylaxis and angioedema.1 Importance of patients discontinuing therapy and seeking medical care if any signs and symptoms of these reactions occur.1

• Importance of adhering to prescribed directions for use.1

• Importance of not abruptly discontinuing therapy.1 2

• Use in combination with other anticonvulsants, not as monotherapy.1 2

• Importance of informing patients who are taking levetiracetam oral solution not to use a household teaspoon or tablespoon to measure the dose; a calibrated measuring device (such as a medicine dropper, spoon, cup, or syringe) should be obtained and used when administering the oral solution.1 22

• Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.1 2 Importance of clinicians informing women about existence of and encouraging enrollment in pregnancy registries.1 12 22 (See Pregnancy under Cautions.)

• Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, dietary supplements, and/or herbal products, as well as any concomitant illness (e.g., renal disease).1

• Importance of informing patients of other important precautionary information.1 (See Cautions.)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of levetiracetam oral solution, tablets, or tablets for suspension in children younger than 1 month of age (Keppra®) or in children younger than 4 years of age and weighing less than 20 kilograms (Spritam®, Spritam® tablets for oral suspension), and levetiracetam extended-release tablets in children younger than 16 years of age (Keppra XR®). Safety and efficacy have not been established in these age groups.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of levetiracetam in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require an adjustment in the dose for patients receiving levetiracetam.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Calcifediol
• Methotrexate
• Orlistat

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Carbamazepine
• Ginkgo

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Depression, history of or
• Hypertension (high blood pressure) or
• Mental illness, history of—Use with caution. May make these conditions worse.

• Kidney problems—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Partial Onset Seizures

Effectiveness in Partial Onset Seizures in Adults with Epilepsy

The effectiveness of Keppra as adjunctive therapy (added to other antiepileptic drugs) in adults was established in three multicenter, randomized, double-blind, placebo-controlled clinical studies in patients who had refractory partial onset seizures with or without secondary generalization. The tablet formulation was used in all these studies. In these studies, 904 patients were randomized to placebo, 1000 mg, 2000 mg, or 3000 mg/day. Patients enrolled in Study 1 or Study 2 had refractory partial onset seizures for at least two years and had taken two or more classical AEDs. Patients enrolled in Study 3 had refractory partial onset seizures for at least 1 year and had taken one classical AED. At the time of the study, patients were taking a stable dose regimen of at least one and could take a maximum of two AEDs. During the baseline period, patients had to have experienced at least two partial onset seizures during each 4-week period.

Study 1

Study 1 was a double-blind, placebo-controlled, parallel-group study conducted at 41 sites in the United States comparing Keppra 1000 mg/day (N=97), Keppra 3000 mg/day (N=101), and placebo (N=95) given in equally divided doses twice daily. After a prospective baseline period of 12 weeks, patients were randomized to one of the three treatment groups described above. The 18-week treatment period consisted of a 6-week titration period, followed by a 12-week fixed dose evaluation period, during which concomitant AED regimens were held constant. The primary measure of effectiveness was a between group comparison of the percent reduction in weekly partial seizure frequency relative to placebo over the entire randomized treatment period (titration + evaluation period). Secondary outcome variables included the responder rate (incidence of patients with ≥50% reduction from baseline in partial onset seizure frequency). The results of the analysis of Study 1 are displayed in Table 10.

Table 10: Reduction in Mean Over Placebo in Weekly Frequency of Partial Onset Seizures in Study 1

	Placebo (N=95)	Keppra 1000 mg/day (N=97)	Keppra 3000 mg/day (N=101)
* statistically significant versus placebo
Percent reduction in partial seizure frequency over placebo	–	26.1%*	30.1%*

The percentage of patients (y-axis) who achieved ≥50% reduction in weekly seizure rates from baseline in partial onset seizure frequency over the entire randomized treatment period (titration + evaluation period) within the three treatment groups (x-axis) is presented in Figure 1.

Figure 1: Responder Rate (≥50% Reduction from Baseline) in Study 1

*statistically significant versus placebo

Study 2

Study 2 was a double-blind, placebo-controlled, crossover study conducted at 62 centers in Europe comparing Keppra 1000 mg/day (N=106), Keppra 2000 mg/day (N=105), and placebo (N=111) given in equally divided doses twice daily.

The first period of the study (Period A) was designed to be analyzed as a parallel-group study. After a prospective baseline period of up to 12 weeks, patients were randomized to one of the three treatment groups described above. The 16-week treatment period consisted of the 4-week titration period followed by a 12-week fixed dose evaluation period, during which concomitant AED regimens were held constant. The primary measure of effectiveness was a between group comparison of the percent reduction in weekly partial seizure frequency relative to placebo over the entire randomized treatment period (titration + evaluation period). Secondary outcome variables included the responder rate (incidence of patients with ≥50% reduction from baseline in partial onset seizure frequency). The results of the analysis of Period A are displayed in Table 11.

Table 11: Reduction in Mean Over Placebo in Weekly Frequency of Partial Onset Seizures in Study 2: Period A

	Placebo (N=111)	Keppra 1000 mg/day (N=106)	Keppra 2000 mg/day (N=105)
* statistically significant versus placebo
Percent reduction in partial seizure frequency over placebo	–	17.1%*	21.4%*

The percentage of patients (y-axis) who achieved ≥50% reduction in weekly seizure rates from baseline in partial onset seizure frequency over the entire randomized treatment period (titration + evaluation period) within the three treatment groups (x-axis) is presented in Figure 2.

Figure 2: Responder Rate (≥50% Reduction from Baseline) in Study 2: Period A

*statistically significant versus placebo

The comparison of Keppra 2000 mg/day to Keppra 1000 mg/day for responder rate was statistically significant (P=0.02). Analysis of the trial as a cross-over yielded similar results.

Study 3

Study 3 was a double-blind, placebo-controlled, parallel-group study conducted at 47 centers in Europe comparing Keppra 3000 mg/day (N=180) and placebo (N=104) in patients with refractory partial onset seizures, with or without secondary generalization, receiving only one concomitant AED. Study drug was given in two divided doses. After a prospective baseline period of 12 weeks, patients were randomized to one of two treatment groups described above. The 16-week treatment period consisted of a 4-week titration period, followed by a 12-week fixed dose evaluation period, during which concomitant AED doses were held constant. The primary measure of effectiveness was a between group comparison of the percent reduction in weekly seizure frequency relative to placebo over the entire randomized treatment period (titration + evaluation period). Secondary outcome variables included the responder rate (incidence of patients with ≥50% reduction from baseline in partial onset seizure frequency). Table 12 displays the results of the analysis of Study 3.

Table 12: Reduction in Mean Over Placebo in Weekly Frequency of Partial Onset Seizures in Study 3

	Placebo (N=104)	Keppra 3000 mg/day (N=180)
* statistically significant versus placebo
Percent reduction in partial seizure frequency over placebo	–	23.0%*

The percentage of patients (y-axis) who achieved ≥50% reduction in weekly seizure rates from baseline in partial onset seizure frequency over the entire randomized treatment period (titration + evaluation period) within the two treatment groups (x-axis) is presented in Figure 3.

Figure 3: Responder Rate (≥50% Reduction from Baseline) in Study 3

*statistically significant versus placebo

Effectiveness in Partial Onset Seizures in Pediatric Patients 4 Years to 16 Years with Epilepsy

The effectiveness of Keppra as adjunctive therapy (added to other antiepileptic drugs) in pediatric patients was established in one multicenter, randomized double-blind, placebo-controlled study (Study 4), conducted at 60 sites in North America, in pediatric patients 4 to 16 years of age with partial seizures uncontrolled by standard antiepileptic drugs (AEDs). Eligible patients on a stable dose of 1-2 AEDs, who still experienced at least 4 partial onset seizures during the 4 weeks prior to screening, as well as at least 4 partial onset seizures in each of the two 4-week baseline periods, were randomized to receive either Keppra or placebo. The enrolled population included 198 patients (Keppra N=101, placebo N=97) with refractory partial onset seizures, whether or not secondarily generalized. The study consisted of an 8-week baseline period and 4-week titration period followed by a 10-week evaluation period. Dosing was initiated at a dose of 20 mg/kg/day in two divided doses. During the treatment period, Keppra doses were adjusted in 20 mg/kg/day increments, at 2-week intervals to the target dose of 60 mg/kg/day. The primary measure of effectiveness was a between group comparison of the percent reduction in weekly partial seizure frequency relative to placebo over the entire 14-week randomized treatment period (titration + evaluation period). Secondary outcome variables included the responder rate (incidence of patients with ≥ 50% reduction from baseline in partial onset seizure frequency per week). Table 13 displays the results of this study.

Table 13: Reduction in Mean Over Placebo in Weekly Frequency of Partial Onset Seizures in Study 4

	Placebo (N=97)	Keppra (N=101)
* statistically significant versus placebo
Percent reduction in partial seizure frequency over placebo	-	26.8%*

The percentage of patients (y-axis) who achieved ≥ 50% reduction in weekly seizure rates from baseline in partial onset seizure frequency over the entire randomized treatment period (titration + evaluation period) within the two treatment groups (x-axis) is presented in Figure 4.

Figure 4: Responder Rate (≥ 50% Reduction from Baseline) in Study 4

*statistically significant versus placebo

Effectiveness in Partial Onset Seizures in Pediatric Patients 1 Month to <4 Years with Epilepsy

The effectiveness of Keppra as adjunctive therapy in pediatric patients was established in one multicenter, randomized double-blind, placebo-controlled study (Study 5), conducted at 62 sites in North America, South America, and Europe in pediatric patients 1 month to less than 4 years of age with partial seizures, uncontrolled by standard epileptic drugs (AEDs). Eligible patients on a stable dose of 1-2 AEDs, who experienced at least 2 partial onset seizures during the 48-hour baseline video EEG were randomized to receive either Keppra or placebo. The enrolled population included 116 patients (Keppra N=60, placebo N=56) with refractory partial onset seizures, whether or not secondarily generalized. Randomization was stratified by age range as follows: 1 month to less than 6 months of age (N=4 treated with Keppra), 6 months to less than 1 year of age (N=8 treated with Keppra), 1 year to less than 2 years of age (N=20 treated with Keppra), and 2 years to less than 4 years of age (N=28 treated with Keppra). The study consisted of a 5-day evaluation period which included a 1-day titration period followed by a 4-day maintenance period. Keppra dosing was determined by age and weight as follows: children 1 month to less than 6 months old were randomized to a target dose of 40 mg/kg/day, and children 6 months to less than 4 years old were randomized to a target dose of 50 mg/kg/day. The primary measure of effectiveness was the responder rate (percent of patients with ≥ 50% reduction from baseline in average daily partial onset seizure frequency) assessed by a blinded central reader using a 48-hour video EEG performed during the last two days of the 4-day maintenance period. A total of 109 patients were included in the efficacy analysis. A statistically significant difference between Keppra and placebo was observed (see Figure 5). The treatment effect associated with Keppra was consistent across age groups.

Figure 5: Responder Rate for All Patients Ages 1 Month to < 4 Years (≥ 50% Reduction from Baseline) in Study 5

*statistically significant versus placebo

Myoclonic Seizures In Patients With Juvenile Myoclonic Epilepsy

Effectiveness of Myoclonic Seizures in Patients ≥12 Years of Age with Juvenile Myoclonic Epilepsy (JME)

The effectiveness of Keppra as adjunctive therapy (added to other antiepileptic drugs) in patients 12 years of age and older with juvenile myoclonic epilepsy (JME) experiencing myoclonic seizures was established in one multicenter, randomized, double-blind, placebo-controlled study (Study 6), conducted at 37 sites in 14 countries. Of the 120 patients enrolled, 113 had a diagnosis of confirmed or suspected JME. Eligible patients on a stable dose of 1 antiepileptic drug (AED) experiencing one or more myoclonic seizures per day for at least 8 days during the prospective 8-week baseline period were randomized to either Keppra or placebo (Keppra N=60, placebo N=60). Patients were titrated over 4 weeks to a target dose of 3000 mg/day and treated at a stable dose of 3000 mg/day over 12 weeks (evaluation period). Study drug was given in 2 divided doses.

The primary measure of effectiveness was the proportion of patients with at least 50% reduction in the number of days per week with one or more myoclonic seizures during the treatment period (titration + evaluation periods) as compared to baseline. Table 14 displays the results for the 113 patients with JME in this study.

Table 14: Responder Rate (≥50% Reduction from Baseline) in Myoclonic Seizure Days per Week for Patients with JME in Study 6

	Placebo (N=59)	Keppra (N=54)
* statistically significant versus placebo
Percentage of responders	23.7%	60.4%*

Primary Generalized Tonic-Clonic Seizures

Effectiveness in Primary Generalized Tonic-Clonic Seizures in Patients ≥6 Years of Age

The effectiveness of Keppra as adjunctive therapy (added to other antiepileptic drugs) in patients 6 years of age and older with idiopathic generalized epilepsy experiencing primary generalized tonic-clonic (PGTC) seizures was established in one multicenter, randomized, double-blind, placebo-controlled study (Study 7), conducted at 50 sites in 8 countries. Eligible patients on a stable dose of 1 or 2 antiepileptic drugs (AEDs) experiencing at least 3 PGTC seizures during the 8-week combined baseline period (at least one PGTC seizure during the 4 weeks prior to the prospective baseline period and at least one PGTC seizure during the 4-week prospective baseline period) were randomized to either Keppra or placebo. The 8-week combined baseline period is referred to as "baseline" in the remainder of this section. Patients were titrated over 4 weeks to a target dose of 3000 mg/day for adults or a pediatric target dose of 60 mg/kg/day and treated at a stable dose of 3000 mg/day (or 60 mg/kg/day for children) over 20 weeks (evaluation period). Study drug was given in 2 equally divided doses per day. The primary measure of effectiveness was the percent reduction from baseline in weekly PGTC seizure frequency for Keppra and placebo treatment groups over the treatment period (titration + evaluation periods). The population included 164 patients (Keppra N=80, placebo N=84) with idiopathic generalized epilepsy (predominately juvenile myoclonic epilepsy, juvenile absence epilepsy, childhood absence epilepsy, or epilepsy with Grand Mal seizures on awakening) experiencing primary generalized tonic-clonic seizures. Each of these syndromes of idiopathic generalized epilepsy was well represented in this patient population.

There was a statistically significant decrease from baseline in PGTC frequency in the Keppra-treated patients compared to the placebo-treated patients.

Table 15: Median Percent Reduction from Baseline in PGTC Seizure Frequency per Week in Study 7

	Placebo (N=84)	Keppra (N=78)
* statistically significant versus placebo
Percent reduction in PGTC seizure frequency	44.6%	77.6%*

The percentage of patients (y-axis) who achieved ≥50% reduction in weekly seizure rates from baseline in PGTC seizure frequency over the entire randomized treatment period (titration + evaluation period) within the two treatment groups (x-axis) is presented in Figure 6.

Figure 6: Responder Rate (≥50% Reduction from Baseline) in PGTC Seizure Frequency per Week in Study 7

*statistically significant versus placebo

NDC 50474-597-66
60 tablets

Keppra®
(levetiracetam)

1000 mg tablets

Dispense accompanying
Medication Guide to
each patient.

Rx only

You should not use Keppra if you are allergic to levetiracetam.

To make sure this medicine is safe for you, tell your doctor if you have:

• kidney disease (or if you are on dialysis);

• depression or other mood problems;

• a history of mental illness or psychosis; or

• a history of suicidal thoughts or actions.

You may have thoughts about suicide while taking Keppra. Tell your doctor if you have symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Do not start or stop taking Keppra during pregnancy without your doctor's advice. Having a seizure during pregnancy could harm both mother and baby. Tell your doctor right away if you become pregnant while taking levetiracetam for seizures.

Seizure control is very important during pregnancy. The benefit of preventing seizures may outweigh any risks posed by taking this medicine. There may be other seizure medications that can be more safely used during pregnancy. Follow your doctor's instructions about taking this medicine while you are pregnant.

Levetiracetam can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using Keppra.

Do not give this medicine to a child without the advice of a doctor. Your child's dose needs are based on age and weight. The child should remain under the care of a doctor while using Keppra.

• Keppra is a brand (trade) name for levetiracetam.
• Levetiracetam is an anticonvulsant used for the treatment of certain types of epilepsy. Experts aren't sure exactly how it works but research suggests it dampens down excessive nerve firing and reduces seizure propagation, possibly through an impact on pathways involving calcium, glycine, and GABA.