Letol
Generic Name
Levetiracetam
Manufacturer
Reputable pharmaceutical company (e.g., Square Pharmaceuticals Ltd.)
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| letol 1 mg syrup | ৳ 40.00 | N/A |
Description
Overview of the medicine
Letol 1 mg/mL syrup contains Levetiracetam, an antiepileptic drug used to treat various types of seizures in adults and children. It is believed to work by binding to synaptic vesicle protein 2A (SV2A) in the brain.
Uses & Indications
Dosage
Adults
Initial dose typically 500 mg twice daily, increasing up to 1500 mg twice daily based on response and tolerability. For a 1 mg/mL syrup, this would imply administering 500 mL to 1500 mL twice daily, which is impractical. Please note that a 1 mg/mL concentration is unusually low for adult Levetiracetam dosing, where 100 mg/mL oral solutions are common. Dosages must be carefully calculated and adjusted based on body weight for children and renal function for adults.
Elderly
Similar to adults, but dosage adjustment may be necessary in elderly patients with compromised renal function.
Renal_impairment
Dosage reduction is recommended for patients with impaired renal function, based on creatinine clearance. For CrCl 50-79 mL/min, 500-1000 mg twice daily; for CrCl 30-49 mL/min, 250-750 mg twice daily; for CrCl <30 mL/min, 250-500 mg twice daily. Patients on dialysis require supplementary dose after dialysis.
How to Take
Letol syrup can be taken with or without food. Use a calibrated measuring device (e.g., oral syringe or measuring spoon) to ensure accurate dosing, especially for children. Do not dilute the syrup unless directed by a healthcare professional.
Mechanism of Action
The precise mechanism by which Levetiracetam exerts its antiepileptic effects is unknown, but it is thought to involve modulation of synaptic vesicle protein 2A (SV2A) and inhibition of N-type calcium currents. It does not act through conventional mechanisms of existing antiepileptic drugs.
Pharmacokinetics
Onset
Within hours of administration, reaching steady-state within 2-3 days with twice-daily dosing.
Excretion
Mainly excreted by the kidneys (approximately 66% as unchanged drug, 24% as metabolite) within 48 hours.
Half life
Approximately 6-8 hours in adults, shorter in children (around 5-7 hours).
Absorption
Rapid and almost complete absorption after oral administration; peak plasma concentrations reached within 1 hour. Absolute bioavailability is approximately 100%.
Metabolism
Not extensively metabolized in the liver. Primarily hydrolyzed via enzymatic hydrolysis, not by cytochrome P450 enzymes. One major inactive metabolite.
Side Effects
Contraindications
- Hypersensitivity to Levetiracetam or any component of the formulation.
- Severe renal impairment without appropriate dose adjustment.
Drug Interactions
Methotrexate
May decrease clearance of Methotrexate, leading to increased Methotrexate levels and potential toxicity. Co-administration should be carefully monitored.
Other antiepileptic drugs
Levetiracetam does not significantly interact with most other antiepileptic drugs (e.g., carbamazepine, phenytoin, valproate, phenobarbital) at typical doses.
Central nervous system depressants (e.g., alcohol, opioids, benzodiazepines)
May enhance CNS depressant effects, leading to increased drowsiness, dizziness, or sedation. Concurrent use should be approached with caution.
Storage
Store at room temperature (20°C to 25°C or 68°F to 77°F), away from moisture, heat, and direct light. Do not freeze. Keep out of reach of children.
Overdose
Symptoms of overdose include somnolence, agitation, aggression, depressed level of consciousness, respiratory depression, and coma. Treatment is symptomatic and supportive, including gastric lavage (if recent ingestion) and general supportive measures. Hemodialysis can remove Levetiracetam effectively.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Levetiracetam is excreted in human breast milk; a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother and the potential effects on the infant.
Side Effects
Contraindications
- Hypersensitivity to Levetiracetam or any component of the formulation.
- Severe renal impairment without appropriate dose adjustment.
Drug Interactions
Methotrexate
May decrease clearance of Methotrexate, leading to increased Methotrexate levels and potential toxicity. Co-administration should be carefully monitored.
Other antiepileptic drugs
Levetiracetam does not significantly interact with most other antiepileptic drugs (e.g., carbamazepine, phenytoin, valproate, phenobarbital) at typical doses.
Central nervous system depressants (e.g., alcohol, opioids, benzodiazepines)
May enhance CNS depressant effects, leading to increased drowsiness, dizziness, or sedation. Concurrent use should be approached with caution.
Storage
Store at room temperature (20°C to 25°C or 68°F to 77°F), away from moisture, heat, and direct light. Do not freeze. Keep out of reach of children.
Overdose
Symptoms of overdose include somnolence, agitation, aggression, depressed level of consciousness, respiratory depression, and coma. Treatment is symptomatic and supportive, including gastric lavage (if recent ingestion) and general supportive measures. Hemodialysis can remove Levetiracetam effectively.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Levetiracetam is excreted in human breast milk; a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother and the potential effects on the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years unopened. Refer to the manufacturer's specific packaging for the exact expiry date.
Availability
Pharmacies, hospitals, and clinics
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Generic versions available (original patent expired)
WHO Essential Medicine
YesClinical Trials
Levetiracetam has undergone numerous pivotal clinical trials demonstrating its efficacy and safety in various seizure types and age groups. Ongoing research explores its potential use in other neurological and psychiatric conditions.
Lab Monitoring
- No routine laboratory monitoring is required for Levetiracetam levels. Renal function should be assessed before and periodically during treatment, especially in patients with pre-existing renal impairment, as dose adjustments may be needed.
- Complete blood counts (CBC) may be considered if signs of hematological abnormalities develop.
Doctor Notes
- Emphasize the importance of patient education regarding adherence to dosing schedules and the potential for behavioral/psychiatric side effects.
- Advise slow titration of the dose, especially when initiating therapy, to minimize CNS side effects and improve tolerability.
- Carefully consider renal function before and during treatment, especially in elderly and renally impaired patients, to adjust dosage appropriately.
- Patients should be advised against abrupt discontinuation to avoid exacerbation of seizures.
Patient Guidelines
- Take this medicine exactly as prescribed by your doctor. Do not change the dose or stop taking it without consulting your doctor.
- Do not stop taking this medicine suddenly, as this may increase your seizure frequency or worsen your condition.
- Always use the provided calibrated measuring device for accurate dosing, especially when administering to children.
- Inform your doctor immediately about any new or worsening side effects, particularly mood changes, depression, agitation, or suicidal thoughts or behavior.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Levetiracetam may cause drowsiness, dizziness, and problems with coordination or concentration, especially at the beginning of treatment or after a dose increase. Patients should be advised not to drive or operate machinery until they are certain that the drug does not adversely affect their ability to perform such tasks.
Lifestyle Advice
- Avoid alcohol consumption, as it may increase CNS depressant effects. Maintain a regular sleep schedule and avoid sleep deprivation, which can sometimes trigger seizures. Avoid activities that could be dangerous if a seizure occurs, such as operating heavy machinery or swimming alone, until you know how the medication affects you.
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