Can you overdose on levetiracetam

It comes as tablets, a liquid and granules. These can be swallowed directly from the packet or mixed with water to make a drink. Take our survey. To make sure levetiracetam is safe for you, tell your doctor if you:. Levetiracetam is a prescription medicine. It's important to take it as advised by your doctor. If you take it twice a day, try to space your doses evenly through the day — for example, first thing in the morning and in the evening.

Tablets — swallow whole with a drink of water, milk or juice. Do not chew them. Liquid — can be swallowed whole or mixed into a glass of water, milk or juice. This comes with a syringe to help you measure it. If you do not have a syringe, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not give you the right amount.

Granules — can be swallowed straight from the packet or mixed with food or water. Drink some water after you have swallowed them. To prevent side effects, your doctor will prescribe a low dose to start with and then increase it over a few weeks. Do not take 2 doses at the same time. Never take an extra dose to make up for a forgotten one. It's important to take this medicine regularly. Missing doses may trigger a seizure. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

Get someone else to drive you or call for an ambulance. Take the levetiracetam packet or the leaflet inside it, plus any remaining medicine, with you. Like all medicines, levetiracetam can cause side effects, although not everyone gets them. These common side effects may happen in more than 1 in people.

They're usually mild and go away by themselves. Keep taking the medicine, but talk to your pharmacist or doctor if these side effects bother you or do not go away:. In rare cases, it's possible to have a serious allergic reaction anaphylaxis to levetiracetam. These are not all the side effects of levetiracetam. For a full list, see the leaflet inside your medicines packet.

There's no firm evidence that levetiracetam is harmful to an unborn baby. But for safety, your doctor will only advise you to take it in pregnancy if the benefits of the medicine outweigh the risks.

It's very important that your epilepsy is treated during pregnancy as seizures can harm you and your unborn baby. If you become pregnant while taking levetiracetam, tell your doctor or nurse straight away.

If you're pregnant, or trying to get pregnant, and taking levetiracetam, you're recommended to take a higher dose of folic acid, a vitamin that helps your baby grow normally. Your doctor might prescribe a high dose of 5mg a day for you to take when you're trying to get pregnant, and during the first 12 weeks of pregnancy. If your doctor or health visitor says your baby is healthy, levetiracetam can be taken while you're breastfeeding.

There have been some reports of side effects in breastfed babies, including not feeding well. But in most cases babies do not get any side effects. If your baby's not feeding as well as usual, seems unusually sleepy, or you have any other concerns about them, talk to your pharmacist, health visitor or doctor as soon as possible.

For more information about how levetiracetam can affect you and your baby during pregnancy, read this leaflet on the Best Use of Medicines in Pregnancy BUMPs website. Some medicines and levetiracetam interfere with each other and increase your side effects. Your doctor may need to change your dose of levetiracetam if you're taking any of these medicines. There might be a problem taking some herbal remedies and supplements alongside levetiracetam, especially ones that cause sleepiness or dizziness.

Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements. Brain cells normally "talk" to each other using electrical signals and chemicals. Conclusion: In overdose, levetiracetam is sedating and causes respiratory depression, however, recovery is rapid with supportive care. This is the first reported case of levetiracetam overdose; serial serum concentrations suggest first-order elimination even at concentrations fold higher than therapeutic.

Abstract Background: Levetiracetam Keppra is a new anticonvulsant used to treat partial complex seizures that is also being investigated for its mood-stabilizing properties. Publication types Case Reports. Kornegay, Ruth E. Since , the North Carolina Office of the Chief Medical Examiner Toxicology Laboratory has collected quantitative levetiracetam data in samples for 56 postmortem cases. The data presented herein will provide the forensic community with concentrations to assist in the interpretation of levetiracetam in postmortem blood.

Decedents were divided into two groups according to manner of death as determined by the medical examiner for the purposes of studying levetiracetam concentrations. These data were subsequently divided into subgroups for further study to explore the therapeutic range of levetiracetam and how it relates to postmortem data. The cases not certified as natural were investigated to study levetiracetam concentrations in cases where it was determined to contribute to the cause of death attributed and those where it was not unattributed.

Until now, the literature has only reported levetiracetam overdoses in which the individuals have recovered with respiratory support.

Also included in the complete data set are postmortem concentrations for five patients under the age of 10 with levetiracetam ranging from 1.

This paper will also address the adverse effects of the drug and explore its potential risk for suicide. Along with drugs such as topiramate, lamotrigine, and oxcarbazepine, the newer antiepileptic drugs AEDs have been reported to have a more tolerable side-effect profile, better efficacy and more predictable pharmacokinetics 1 , 2.

Levetiracetam is a pyrrolidine derivative structurally unrelated to other antiepileptic drugs Figure 1 3. It is now also used as adjunctive therapy for primary generalized tonic-clonic seizures and myoclonic seizures of juvenile myoclonic epilepsy 3. Levetiracetam is available in —1, mg tablets with a daily adult prescribed amount between 1,—3, mg, given in two doses.

Therapeutically, levetiracetam's side-effect profile includes somnolence and adverse behavioral changes. A majority of the metabolism is accomplished through hydrolysis of the acetamide group, yielding pharmacologically inactive metabolites. Metabolism does not involve the enzymes of the cytochrome P system 3 , 5. The elimination half-life is 6—8 h; however, renal insufficiency will cause a patient to clear the drug much more slowly.

When taken in excess, this anticonvulsant drug is sedating, causing respiratory depression and potential vomiting 4 , 8. Only a few cases of suicidal drug overdoses involving levetiracetam have been reported in the literature and the individuals all recovered with supportive care 6 , 8.

While there are less overall negative side effects for levetiracetam in comparison to classical anticonvulsants, there have been some recognized psychiatric effects. Additionally, individuals with prior psychiatric difficulties may be at increased risk This means that not every case involving the use of levetiracetam will be detected based on our protocol.

The current procedure at our laboratory quantifies 14 acidic and neutral compounds with p -methylphenobarbital Sigma—Aldrich Co. Louis, MO as internal standard utilizing a solid-supported liquid extraction procedure followed by analysis via gas chromatography with flame ionization detection. Briefly: 1. Drugs are eluted from the column with two consecutive washes of 6 mL of methylene chloride. Confirmation of peak identity is accomplished by library spectra and retention time matching by means of gas chromatography mass spectrometry in full scan mode.

The method linearity, limit of quantification and limit of detection are: 1. Other method validation particulars are listed in Table I. Due to the discontinuation by Sigma—Aldrich as a supplier of p -methylphenobarbital, the laboratory switched internal standards to mephobarbital Grace-Davidson Discovery Sciences; Columbia, MD in late None of the data in this study were collected using the new internal standard. The exact laboratory extraction method and instrument parameters used to detect and quantify acid and neutral compounds, including levetiracetam, have been previously described 11 , Since , there have been 56 cases at the NC-OCME in which quantitative blood data have been collected for levetiracetam.

Detailed findings, including other drugs found and history, as well as scene information are displayed in Table II.

In the table, cases are listed in ascending amount of levetiracetam divided into two groups; natural deaths Cases 1—28 and non-natural deaths Cases 29— The year-by-year breakdown of levetiracetam cases are presented in Figure 2 and demographic information are presented in Figure 3.

There were 18 levetiracetam cases in which decedents were 30 years of age and under mean Included in this set were five decedents under the age of 10 with concentrations ranging from 1. This information adds to the knowledge of postmortem concentrations in children. Levetiracetam was quantified in 35 cases between the ages of 31 and 60 mean Only three cases in which levetiracetam was detected in decedents over the age of 61 were found in our study. This might be related to reduced clearance sometimes displayed in elderly patients because of age-related decline in renal function 3 , However, one patient who overdosed on levetiracetam became obtunded and developed significant respiratory distress that required intubation and ventilatory support.

Therefore, clinical vigilance is still required in the cases of levetiracetam overdose.