Leviceta
Generic Name
Levetiracetam
Manufacturer
Acme Pharmaceuticals (Hypothetical)
Country
Bangladesh (Hypothetical)
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| leviceta 500 mg tablet | ৳ 30.00 | ৳ 300.00 |
Description
Overview of the medicine
Levetiracetam is an antiepileptic drug used to treat various types of seizures, including partial onset seizures, myoclonic seizures, and primary generalized tonic-clonic seizures.
Uses & Indications
Dosage
Adults
Initial dose: 500 mg twice daily. Can be increased by 500 mg twice daily increments every 2-4 weeks up to a maximum of 1500 mg twice daily. The dose is dependent on the type of seizure and patient response.
Elderly
Similar to adults, but dosage adjustment may be necessary in patients with impaired renal function.
Renal_impairment
Dosage should be adjusted based on creatinine clearance (CrCl). For CrCl 50-79 mL/min, 500-1000 mg twice daily; CrCl 30-49 mL/min, 250-750 mg twice daily; CrCl <30 mL/min, 250-500 mg twice daily. For ESRD patients on dialysis, a loading dose of 750 mg, then 500-1000 mg once daily with a 250-500 mg supplementary dose after dialysis.
How to Take
Leviceta 500 mg tablet should be taken orally with or without food, swallowed whole with a sufficient amount of liquid. Do not crush or chew.
Mechanism of Action
The exact mechanism is unknown, but it involves binding to the synaptic vesicle protein 2A (SV2A) in the brain, leading to modulation of neurotransmitter release and thus reducing neuronal excitability.
Pharmacokinetics
Onset
Clinical effects may be observed within an hour of oral administration.
Excretion
Primarily renal excretion (approximately 66% unchanged drug, 24% as inactive metabolite). Less than 1% excreted in feces.
Half life
Approximately 6-8 hours in adults, shorter in children (around 5-6 hours).
Absorption
Rapid and almost complete absorption after oral administration; peak plasma concentrations achieved in about 1 hour.
Metabolism
Not extensively metabolized in the liver; primary metabolic pathway is enzymatic hydrolysis of the acetamide group, producing an inactive carboxylic acid metabolite.
Side Effects
Contraindications
- Hypersensitivity to levetiracetam or any other pyrrolidone derivatives or to any of the excipients.
- Patients with severe renal impairment without dose adjustment.
Drug Interactions
Macrogol
Case reports of decreased levetiracetam efficacy when co-administered with macrogol-containing laxatives in patients with chronic constipation.
Methotrexate
Possible reduction in methotrexate clearance, leading to increased methotrexate levels and potential toxicity. Co-administration should be carefully monitored.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include somnolence, agitation, aggression, depressed consciousness, respiratory depression, and coma. Management is primarily supportive; hemodialysis may be effective in removing the drug.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Levetiracetam is excreted in breast milk; therefore, 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.
Side Effects
Contraindications
- Hypersensitivity to levetiracetam or any other pyrrolidone derivatives or to any of the excipients.
- Patients with severe renal impairment without dose adjustment.
Drug Interactions
Macrogol
Case reports of decreased levetiracetam efficacy when co-administered with macrogol-containing laxatives in patients with chronic constipation.
Methotrexate
Possible reduction in methotrexate clearance, leading to increased methotrexate levels and potential toxicity. Co-administration should be carefully monitored.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include somnolence, agitation, aggression, depressed consciousness, respiratory depression, and coma. Management is primarily supportive; hemodialysis may be effective in removing the drug.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Levetiracetam is excreted in breast milk; therefore, 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.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 24 to 36 months from the date of manufacture, specific to manufacturer.
Availability
Available in pharmacies and hospitals
Approval Status
Approved (Generic)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated Levetiracetam's efficacy as monotherapy and adjunctive therapy for various seizure types, supporting its use across different age groups and epilepsy syndromes.
Lab Monitoring
- Routine laboratory monitoring is generally not required for levetiracetam. However, renal function should be assessed, especially in elderly patients or those with known renal impairment, to guide dose adjustments.
- Liver function tests may be considered in patients with pre-existing liver conditions or if symptoms suggest hepatic dysfunction.
Doctor Notes
- Emphasize patient adherence to the prescribed regimen to optimize seizure control and minimize withdrawal risks.
- Educate patients on potential neuropsychiatric side effects, including mood changes and suicidal ideation, and instruct them to report these promptly.
- Monitor renal function, especially in elderly or renally impaired patients, and adjust dose accordingly.
Patient Guidelines
- Take this medicine exactly as prescribed by your doctor. Do not change the dose or stop taking it without consulting your doctor.
- Swallow the tablet whole with water. Do not crush, chew, or break it.
- Do not stop taking this medicine suddenly, as it can lead to increased seizures. Gradual withdrawal is necessary under medical supervision.
- Be aware of potential side effects like drowsiness, dizziness, and behavioral changes. Report any concerning symptoms to your doctor immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double dose to make up for a missed one.
Driving Precautions
Leviceta 500 mg tablet may cause drowsiness, dizziness, or blurred vision, especially at the beginning of treatment or after dose increases. Patients should be advised to exercise caution when driving or operating machinery until they know how the medicine affects them.
Lifestyle Advice
- Maintain a regular sleep schedule and avoid sleep deprivation, as it can trigger seizures.
- Avoid excessive alcohol consumption while on this medication.
- Manage stress effectively, as stress can sometimes contribute to seizure activity.
- Maintain good hydration and a balanced diet.
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