Levetiracetam

Levetiracetam
Systematic (IUPAC) name
(S)-2-(2-oxopyrrolidin-1-yl)butanamide
Identifiers
CAS number 102767-28-2
ATC code N03AX14
PubChem CID 5284583
ChemSpider 4447633
UNII 44YRR34555
KEGG D00709
Chemical data
Formula C8H14N2O2 
Mol. mass 170.209 g/mol
SMILES eMolecules & PubChem
Pharmacokinetic data
Bioavailability ~100%
Protein binding <10%
Metabolism Enzymatic hydrolysis of acetamide group
Half-life 6 - 8 hr
Excretion Urinary
Therapeutic considerations
Pregnancy cat. C(US)
Legal status Prescription only
Routes Oral, intravenous
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Levetiracetam (INN) () is an anticonvulsant medication used to treat epilepsy.[1] It is the S-enantiomer of etiracetam, structurally similar to the prototypical nootropic drug piracetam.

Levetiracetam is marketed under the trade name Keppra. Keppra is manufactured by UCB Pharmaceuticals Inc. Since November of 2008 the drug has been available as a generic brand in the United States.

Contents


Uses

Along with other anticonvulsants like gabapentin, it is also sometimes used to treat neuropathic pain.

Levetiracetam has been approved in the United Kingdom as a monotherapy treatment for epilepsy in the case of partial seizures, or as an adjunctive therapy for partial, myoclonic and tonic-clonic seizures.[2] It is also used in veterinary medicine for similar purposes.

Levetiracetam has potential benefits for other psychiatric and neurologic conditions such as Tourette syndrome, autism, bipolar disorder and anxiety disorder, but its most serious adverse effects are behavioral and its benefit-risk ratio in these conditions is not well understood.[3]

Mechanism of action

The exact mechanism by which levetiracetam acts to treat epilepsy is unknown. However, the drug binds to a synaptic vesicle protein, SV2A,[4] which is believed to impede nerve conduction across synapses.[5]

Side effects

Side effects include: hair loss; pins and needles sensation in the extremities; anxiety and psychiatric symptoms ranging from irritability to depression; and other common side effects like headache and nausea. Recent literature[6] suggests that the addition of pyridoxine (vitamin B6) may curtail some of the psychiatric symptoms.

Levetiracetam is generally well tolerated[7] but may cause sleepiness, weakness, dizziness, and infection. In children, the most common side effects are sleepiness, accidental injury, hostility, irritability, and weakness. [8]

References

  1. Abou-Khalil B (June 2008). . Neuropsychiatr Dis Treat 4 (3): 507–23. . 
  2. . BMA & RPSGB. 2010. 
  3. Farooq MU, Bhatt A, Majid A, Gupta R, Khasnis A, Kassab MY (2009). . Am J Health Syst Pharm 66 (6): 541–61. . . 
  4. Lynch BA, Lambeng N, Nocka K, et al. (June 2004). . Proc Natl Acad Sci USA. 101 (26): 9861–6. . . 
  5. Rogawski, MA (June 2006). . Epilepsy Research 69 (3): 273–94. . . 
  6. . Epilepsia 46 (s8): 142–67. 2005. . http://www3.interscience.wiley.com/journal/118734483/abstract. 
  7. Gambardella A, Labate A, Colosimo E, Ambrosio R, Quattrone A (February 2008). . Neuropsychiatr Dis Treat 4 (1): 33–8. . 
  8. . http://www.keppra.com/pc/home/default.asp. Retrieved 2008-12-14. 

See also