Levetiracetam

A modern antiepileptic drug with broad-spectrum seizure control and good safety profile.

What is Levetiracetam?

Levetiracetam is a second-generation antiepileptic (anticonvulsant) used to treat various types of seizure disorders.

It is well known for minimal drug interactions and good tolerability.

History & Background

Levetiracetam was developed in the 1990s and quickly became a first-line antiepileptic drug due to its safety, effectiveness, and ease of use.

Chemical Structure & Properties

• IUPAC name: (S)-2-(2-oxopyrrolidin-1-yl)butanamide
• Molecular formula: C₈H₁₄N₂O₂
• Molar mass: 170.21 g/mol
• Functional groups: Amide, lactam ring

Mechanism of Action

Unlike older antiepileptics, levetiracetam works by:

• Binding to synaptic vesicle protein SV2A
• Modulating neurotransmitter release
• Reducing neuronal hyperexcitability

Pharmacokinetics

• Absorption: Rapid and complete oral absorption
• Peak plasma time: ~1 hour
• Half-life: 6–8 hours
• Metabolism: Minimal hepatic metabolism
• Excretion: Urine (mostly unchanged)

Medical Uses

• Partial-onset seizures
• Generalized tonic–clonic seizures
• Myoclonic seizures
• Adjunctive or monotherapy in epilepsy

Dosage Guidelines

Adults: 500–3000 mg/day in two divided doses

Starting dose: 500 mg twice daily

⚠️ Dose adjustment required in renal impairment.

Side Effects

• Drowsiness
• Dizziness
• Irritability
• Fatigue

Warnings & Precautions

• Monitor mood and behavior
• Adjust dose in kidney disease
• Do not stop abruptly

Drug Interactions

• Minimal drug interactions
• Alcohol (may increase sedation)

Frequently Asked Questions

Is levetiracetam safe? – Yes.

Does it require blood monitoring? – No.

Is it first-line? – Yes.

Is it sedating? – Mildly.

⚠️ Educational content only. Not a substitute for professional medical advice.