Keppra (Levetiracetam) is an anti-epileptic drug, also called an anticonvulsant. Levetiracetam (Keppra) is used to treat partial onset seizures in adults and children who are at least 1 month old.
This description of the drug "Keppra (Levetiracetam)" is a simplified and augmented version of the official annotation.
Before purchasing or using the drug, you should consult your doctor and read the manufacturer's approved instructions for use. Information about the medicine is provided solely for informational purposes and should not be used as a guide to self-medication. The appearance of the packaging of the drug "Keppra (Levetiracetam)" may differ from the photo on the site.
Before applying the drug "Keppra" always consult with your doctor.
People suffering from epilepsy usually try not to advertise their diagnosis. They can be understood - after all, no one would like to see sideways and tension in a friendly company in his direction: What if a seizure starts right now?
Do not be scared - better help!
Epileptic seizures are unpredictable. It is impossible to predict the strength of another seizure, nor the time of its development. Usually there are no precursors indicating its approach, the attack develops unexpectedly - for the patient himself, and especially for those around him. But you should not be afraid of unwitting witnesses of such a spectacle, you just need to know something about this disease.
If the seizure has already developed, it is impossible to stop it. To transfer the patient epilepsy during a fit is not necessary anywhere. You just need to take care that during the spasms, he does not hurt himself. Therefore, under his head he needs to put something soft (at least a jacket or bag), and between his teeth lay a folded napkin or handkerchief, since a person in this state can inadvertently bite his tongue.
After the end of the attack, the patient usually does not remember anything, so do not be surprised.
Anticonvulsant drug Keppra is a fairly new drug. Given that Keppra has a wide range of activities, this drug is advised to be used in the treatment of virtually all types of epilepsy.
Since the seizures themselves can not be cured, the medications prescribed for such patients are designed to reduce the frequency of seizures and make their course easier.
The active substance of the drug is levetiracetam. The mechanism of its action, as well as the structure, are significantly different from those of other antiepileptic drugs. When it is used, the stabilization of nerve cell membranes is achieved. In the region of synapses (junctions of neurons) of the brain, he is associated with a special protein (glycoprotein), inhibits the release of calcium, prevents the decrease in the concentration of gamma-aminobutyric acid - that is, inhibits the processes that usually lead to the development of convulsive seizures.
An anticonvulsant drug Keppra can be bought in the form of tablets. To do this simply - just order a medicine on our specialized website on the Internet without a prescription, which is very convenient for our customers. Keppra, as follows from the reviews of patients and doctors, is easily tolerated by patients, so the drug has found application in pediatrics - it is prescribed for children suffering from epilepsy, starting at four and sometimes two years. Usually it is a case of severe cases of the disease, when taking other medications did not lead to the expected improvement.
Physicians note that Keppra is highly bioavailable. This drug is excreted mainly by the kidneys. Keppra can be combined with other antiepileptic medicines, but it shows good efficacy and as a monotherapy. In patients taking this drug, there was a significant reduction in the frequency of seizure intensity.
Keppra is an anticonvulsant medication that the chemical composition is different from other similar tools for action. The active substance medications - levetiracetam, the effect of which is not known until the end, but found that synaptic transmission (propagation of nerve impulses), it does not break.
The efficacy of Keppra drug in focal epilepsy, as well as its more serious stages, such as paroxysmal reaction epileptiform manifestations. Judging by the reviews of Keppra, the patient's condition has stabilized after two days if you take the drug twice a day.
→ 250 mg. ←
→ 500 mg. ←
→ 1000 mg. ←
Keppra - coated tablets are packaged in foil blisters in a cardboard box.
○ Violations of a general nature:
- Asthenia, fatigue.
○ From the side of the central nervous system:
- Drowsiness, headache, amnesia, ataxia, convulsions, hyperkinesia, tremor, imbalance, confusion, memory impairment, paresthesia.
○ On the part of the psyche:
- Excitement, depression, emotional instability, mood changes, hostility, aggressiveness, insomnia, nervousness, irritability, hallucinations, psychotic disorders.
○ From the digestive system:
- Abdominal pain, diarrhea, dyspepsia, nausea, vomiting, pancreatitis.
○ From the liver and biliary tract:
- Liver failure, hepatitis. The drug affects the results of liver tests.
○ From the side of metabolism:
- Anorexia (the risk increases with simultaneous application with topiramate), weight loss.
○ From the side of the hearing organ and the vestibular apparatus:
○ From the side of the organ of vision:
- Diplopia, blurred vision.
○ From the side of skeletal muscles and connective tissue:
○ Wounds, intoxication and complications:
- Accidental injuries.
○ Infections and infestations:
- Infectious diseases, nasopharyngitis.
○ From the respiratory system:
○ From the skin and their derivatives:
- Skin rash, separate reports - alopecia (in many cases, the restoration of the hairy cover was observed after the drug was discontinued).
○ On the part of the blood:
- Thrombocytopenia, leukopenia, neutropenia, pancytopenia.
Do not use the drug during pregnancy, except for prescription medications because it is necessary to take into account that interruptions in antiepileptic therapy can lead to deterioration, which can harm the health of both mother and fetus. The drug penetrates into breast milk, so if you need to use the drug, breastfeeding should be discontinued.
The drug Keppra is effective in the treatment of children over 16 years of age, adults with epilepsy who have observed partial seizures - seizures, which are accompanied by autonomic, sensory, motor, mental disorders.
Good reviews of Keppra, which is not used as a standalone tool, and include comprehensive treatment of partial seizures in adults and children over the age of 4 years (Keppra tablets) and children older than one month (solution Keppra).
Besides Keppra can be used for treating tonic-clonic seizures in adolescents over 12 years of age, adults suffering from idiopathic generalized epilepsy, myoclonic seizures in the same age group of patients with juvenile myoclonic epilepsy.
Keppra does not interact with other antiepileptic drugs (phenytoin, carbamazepine, valproic acid, phenobarbital, lamotrigine, gabapentin, primidone). It should be noted that the clearance of levetiracetam is 22% higher in children who take anticonvulsant drugs.
Levetiracetam (Keppra) in a daily dose of 1000 mg does not change the pharmacokinetics of oral contraceptives (ethinyl estradiol and levonorgestrel). Keppra in a daily dose of 200 mg does not change the pharmacokinetics of digoxin and warfarin. Digoxin, oral contraceptives and warfarin, in turn, do not affect the pharmacokinetics of Levetiracetam.
There is evidence that the probenicide (500 mg 4 times a day), blocking the secretion of the renal tubules, suppresses the renal clearance of the primary metabolite of levetiracetam. It is assumed that some other medicines, such as NSAIDs, sulfonamides, and methotrexate, also interact in the same way. There is no data on the effect of antacid preparations on the absorption of levetiracetam. Degree of absorption Keppra does not depend on food intake, but the rate of absorption decreases. Data on the interaction of Keppra (levetiracetam) with alcohol are absent.
Epilepsy is a condition characterized by repeated (more than two) epileptic seizures not provoked by any immediately identifiable causes. An epileptic attack is a clinical manifestation of an abnormal and excessive discharge of neurons in the brain causing sudden transient pathological phenomena (sensory, motor, mental, vegetative symptoms, changes in consciousness). It should be remembered that several provoked or conditioned by any clear reasons (brain tumor, TBI) epileptic seizures do not indicate the patient has epilepsy.
According to the international classification of epileptic seizures, partial (local, focal) forms and generalized epilepsy are isolated. Attacks of focal epilepsy are divided into: simple (without disorders of consciousness) - with motor, somatosensory, vegetative and psychic symptoms and complicated - accompanied by a violation of consciousness. Primary-generalized seizures occur with involvement in the pathological process of both hemispheres of the brain. Types of generalized seizures: myoclonic, clonic, absences, atypical absences, tonic, tonic-clonic, atonic.
There are unclassified epileptic seizures - not suited to any of the above described types of seizures, and also some neonatal seizures (chewing movements, rhythmic eye movements). There are also repeated epileptic seizures (provoked, cyclical, accidental) and prolonged seizures (epileptic status).
All methods of treatment of epilepsy are aimed at stopping seizures, improving the quality of life and stopping medication (at the stage of remission). In 70% of cases, adequate and timely treatment leads to the cessation of epileptic seizures. Before appointing antiepileptic drugs, a detailed clinical examination should be performed, and the results of MRI and EEG should be analyzed. The patient and his family should be informed not only about the rules for taking medications, but also about possible side effects. Indications for hospitalization are: for the first time in life a developed epileptic attack, epileptic status and the need for surgical treatment of epilepsy.
One of the principles of drug treatment of epilepsy is monotherapy. The drug is prescribed in a minimal dose with a subsequent increase in it until the seizures stop. In case of insufficiency of the dose, it is necessary to check the regularity of taking the drug and to find out if the maximum tolerated dose has been achieved. The use of most antiepileptic drugs requires constant monitoring of their concentration in the blood. Treatment with pregabalin, levetiracetam, valproic acid begins with a clinically effective dose, with the appointment of lamotrigine, topiramate, carbamazepine, slow titration of the dose is necessary.
Treatment of newly diagnosed epilepsy begins with both traditional (carbamazepine and valproic acid) and with the latest antiepileptic drugs (topiramate, oxcarbazepine, levetiracetam) registered for monotherapy. When choosing between traditional and newer drugs, it is necessary to take into account the individual characteristics of the patient (age, sex, concomitant pathology). To treat unidentified seizures of epilepsy, valproic acid is used. When prescribing a particular antiepileptic drug should strive for the minimum possible frequency of its reception (up to 2 times / day). Due to the stable concentration in the plasma, sustained-release drugs are more effective. The dose of the drug prescribed to an elderly patient creates a higher concentration in the blood than a similar dose of the drug prescribed to a young patient, so it is necessary to start treatment with small doses and then titrate them. The withdrawal of the drug is carried out gradually, taking into account the form of epilepsy, its prognosis and the possibility of resuming seizures.
Pharmacoresistant epilepsies (continued seizures, inefficiency of adequate antiepileptic treatment) require additional examination of the patient to decide on the question of surgical treatment. Preoperative examination should include video EEG recording of seizures, obtaining reliable data on localization, anatomical features and the nature of the spread of the epileptogenic zone (MRI).
Based on the results of the above studies, the nature of surgical intervention is determined:
There are strict indications for each of the above surgical procedures. They can only be carried out in specialized neurosurgical clinics that have the appropriate equipment, and with the participation of highly qualified specialists (neurosurgeons, neuro-radiologists, neuropsychologists, neurophysiologists, etc.)
Prevention of epilepsy involves the possible prevention of TBI, intoxications and infectious diseases, the prevention of possible marriages between patients with epilepsy, adequate temperature reduction in children to prevent fever, the consequence of which may be epilepsy.
It should immediately be said about the rather complex problem of age limits in the use of this drug. In international practice keppra authorized for use as adjunctive therapy in the treatment of partial seizures with secondary generalization and without adults and children 4 years and older. As monotherapy is widely used in Europe.
Given the extensive international experience of application, good tolerability and high effectiveness, the drug during the last 3 years, appointed us children over 2 years of age with epilepsy. As a rule, it is the patients who first monotherapy or polytherapy previous attempts proved to be extremely ineffective or poorly tolerated.
Prerequisite purpose of the drug is to inform our parents of the patient about the difficulties associated with the time of registration of the drug and age restrictions. The first experience of Keppra was associated with children, which this drug was appointed abroad.
We do not accidentally give preference to levetiracetam other new antiepileptic drugs.
Keppra has a broad spectrum of therapeutic activity and can be used in almost all generalized and focal (idiopathic and symptomatic) epilepsy syndromes.
We have confirmed the high efficacy of Keppra in the treatment of particularly severe epileptic myoclonus.
In severe myoclonic epilepsy of infancy malignant received Keppra 6 people. (Age 2 to 4 years). In 2 children with seizures monotherapy fully cropped. Dose was 40-50 mg / kg / day in two divided doses. 3 children there was a significant reduction in seizure frequency in the treatment of adding syrup depakine circuit 20 mg / kg / day. Keppra The dose was 30-50 mg / kg / day. In one case, we did not achieve the desired effect. The treatment was administered at a dose depot sinakten keppra 80 mg / kg / day.
Keppra was appointed 4 people. with Lennox - Gastaut syndrome (age 5-8 years). One child was able to completely arrest the seizures (monotherapy). In 2 cases, there was a sharp decrease in the number of attacks (in combination with chrono Depakinum at 30 / mg / kg / day).
3 children with myoclonic-astatic epilepsy of early childhood Dooze (age 2-3 years) showed the maximum positive results when taking Keppra. Dose in all cases was 40-60 mg / kg / day. All children achieved clinical remission for 2 years. Two patients were on at the same time prolonged use of corticosteroids (sinakten depot / m for 8-10 months.). In 5 children with juvenile myoclonic epilepsy Gerpina - Janz (age 9-14 years) use of Keppra results were as follows: 2 persons. - The absence of seizures within 18 months. (Dose - 70 mg / kg / day) .; 2 people. - Total absence seizures achieved in combination with chrono Depakinum (35 mg / kg / day); 1 person. - Reduction in seizure frequency combined with valproate.
Successful application Keppra as we alone have been reported in the treatment of not only severe epileptic syndromes, and benign focal epilepsy centrotemporal spikes (2 males at the age of 8 and 10 years old, a dose - 40 mg / kg / day), as well as polytherapy - when its resistance flow (in conjunction with enkoratom Depakine chrono chrono or 30 mg / kg / day).
Keppra can be effective in the treatment of epilepsy resistant in relation to other anticonvulsants and provides fast, sometimes very fast, the therapeutic effect. It is a drug with a rapid rate of administration, and dose titration is not necessary.
According to our data, if the child weighs 20 to 40 kg, the drug once prescribed 250 mg 2 times a day, for 3-4-th week - 500 mg 2 times a day, if necessary, the dose can be increased further. But when using a dose of 500 mg / day, we noted the clinical effect of reducing the frequency of seizures, ie starting dose has a therapeutic and did not require further purpose of maximum doses. In children weighing 40-60 kg administered once Keppra 500 mg 2 times a day, 2 weeks - 1000 mg 2 times a day.
The exact dose determined by the particular clinical situation, and in our practice ranged from 20 to 80 mg / kg / day in two divided doses. Our clinical experience allows us to confirm the widespread view that keppra starts from the first day of treatment.
The minimum period of clinical remission in patients taking levetiracetam our clinic was 3 months. (Severe myoclonic epilepsy of infancy malignant Drava), the maximum - 2 years (myoclonic-astatic epilepsy Dooze).
Keppra is well combined with other anti-epileptic drugs. According to our data, the drug does not affect the concentration of other anticonvulsants. With his admission were observed clinically significant fluctuations in blood drug. We used a successful combination with valproate levetiracetam.
Keppra - one of the well-tolerated anticonvulsant. It does not suppress, but rather stimulates cognitive functions that cognitive evoked potentials confirmed by (P300). In our clinic, in any case, there was no side effect that would require discontinuation of the drug. Of the 18 cases of Keppra in one patient (12 years old boy) was observed sleepiness during the week of the administration, and in 2 cases the children complained of nausea. These effects were reversible.
It is extremely important to note the fact that Keppra did not break the function of the liver (for the entire course of treatment did not change the level of bilirubin, transaminases and liver enzymes) and did not have a negative impact on cognitive abilities of patients.