For doctors

What is it?

Keppra is a medicine that contains the active substance levetiracetam. It is available as oblong tablets (blue: 250 mg; yellow: 500 mg; orange: 750 mg; white: 1,000 mg), as an oral solution (100 mg/ml), and as a concentrate that is made up into a solution for infusion (drip into a vein, 100 mg/ml).

What is it used for?

Keppra can be used on its own in patients from 16 years of age with newly diagnosed epilepsy, to treat partial-onset seizures (fits) with or without secondary generalisation. This is a type of epilepsy where too much electrical activity in one side of the brain causes symptoms such as sudden, jerky movements of one part of the body, distorted hearing, sense of smell or vision, numbness, or a sudden sense of fear. Secondary generalisation occurs when the overactivity later reaches the whole brain.

Keppra can also be used as an add-on to other anti-epileptic medicines to treat:

The medicine can only be obtained with a prescription.

How is it used?

When Keppra is used on its own, the starting dose is 250 mg twice a day, increasing two weeks later to 500 mg twice a day. The dose can be further increased at two-week intervals according to the patient’s response, to a maximum dose of 1,500 mg twice a day.

When Keppra is added to another anti-epileptic treatment, the starting dose in patients over 12 years weighing more than 50 kg is 500 mg twice a day. The daily dose can be increased up to 1,500 mg twice a day. In patients aged between six months and 17 years weighing less than 50 kg, the starting dose is 10 mg per kilogram body weight twice a day, which can be increased up to 30 mg/kg twice a day. The oral solution is recommended when starting treatment in children weighing less than 20 kg. In babies aged between one and six months, the starting dose is 7 mg/kg twice a day, using the oral solution. This can be increased up to 21 mg/kg twice a day.

Lower doses are used in patients who have problems with their kidneys (such as older patients).

Keppra tablets are swallowed with liquid. The oral solution may be mixed in a glass of water before it is taken. Keppra can be given as an infusion using the same doses at the same frequency when using the tablets or the oral solution is not possible. The use of the infusion should be temporary.

How does it work?

The active substance in Keppra, levetiracetam, is an anti-epileptic medicine. Epilepsy is caused by excessive electrical activity in the brain. The exact way in which levetiracetam works is still unclear but it seems to interfere with a protein called synaptic vesicle protein 2A, which is found in the spaces between nerves and is involved in the release of chemical messengers from nerve cells. This helps Keppra to stabilise electrical activity in the brain and prevent seizures.

How has it been studied?

Keppra used on its own has been studied in 579 patients with partial-onset seizures aged 16 years and over, who received either Keppra or carbamazepine (another anti-epileptic medicine) for up to two years. The study measured how many patients remained free of seizures for six months once they had reached their effective dose.

Keppra has also been studied as an add-on treatment:

In all of these studies, the main measure of effectiveness was the change in the number of seizures before and during treatment.

What benefits has it shown during the studies?

Keppra was as effective as carbamazepine in keeping patients free of seizures when taken on its own for partial onset seizures. In both groups, 73% of the patients experienced no seizures for six months once on an adequate dose.

As an add-on treatment, Keppra was more effective than placebo:

What is the risk associated?

The most common side effects with Keppra (seen in more than 1 patient in 10) are somnolence (sleepiness), and asthenia (weakness) or fatigue (tiredness). For the full list of all side effects reported with Keppra, see the package leaflet.

Keppra should not be used in people who may be hypersensitive (allergic) to levetiracetam, to other pyrrolidone derivatives (medicines with a similar structure to levetiracetam), or to any of the other ingredients.

Why has it been approved?

The CHMP decided that Keppra’s benefits are greater than its risks and recommended that it be given marketing authorisation.

Further information

The European Commission granted a marketing authorisation valid throughout the European Union for Keppra on 29 September 2000. The marketing authorisation holder is UCB Pharma SA. After 10 years, the marketing authorisation was renewed for a further five years.

For more information about treatment with Keppra, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist.

This summary was last updated in 07-2010.

Name

Keppra 100 mg/ml concentrate for solution for infusion

Composition

Each ml contains 100 mg of levetiracetam.
Each 5 ml vial contains 500 mg of levetiracetam.

Excipients:
Each dose contains 57 mg of sodium.

For a full list of excipients, see section 6.1.

Pharmaceutical Form

Concentrate for solution for infusion (sterile concentrate).

Clear, colourless, concentrate.