Levetiracetam Noridem (Levetiracetam)

• Levetiracetam is used in the management of several seizure types within the epilepsy disease family.
• Partial seizures: reduces frequency and severity of focal onset seizures.
• Generalized tonic‑clonic seizures: helps control convulsive episodes.
• Myoclonic seizures: decreases occurrence of rapid, involuntary muscle jerks.

• Levetiracetam binds to the synaptic vesicle protein SV2A, modulating neurotransmitter release and stabilising neuronal membranes. This action reduces abnormal neuronal firing and excitability, thereby preventing the propagation of seizure activity across neural networks.

Levetiracetam may cause a range of adverse reactions, which are categorized by frequency and severity.

Common Side Effects

• Fatigue: feeling of tiredness or lack of energy.
• Dizziness: sensation of light‑headedness or unsteadiness.
• Somnolence: increased sleepiness or drowsiness.
• Irritability: mood changes including agitation or hostility.
• Headache: mild to moderate cranial pain.
• Nausea: feeling of stomach upset.

Serious or Rare Side Effects

• Severe allergic reaction: rash, swelling, or difficulty breathing.
• Stevens‑Johnson syndrome: rare but serious skin disorder.
• Suicidal thoughts or behavior: emergence of depressive symptoms.
• Severe depression or mood disorders.
• Blood dyscrasias: low blood cell counts such as neutropenia.

• When prescribing levetiracetam, clinicians should consider several precautionary measures.
• Renal impairment: adjust monitoring and dosage as needed.
• Hepatic impairment: observe liver function tests regularly.
• Psychiatric symptoms: monitor for mood changes, irritability, or depression.
• Pregnancy: discuss potential risks with the prescriber before use.
• Concomitant CNS depressants: use caution to avoid excessive sedation.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Levetiracetam can interact with other medicines, requiring attention to avoid reduced efficacy or increased toxicity.

Major Interactions (Avoid)

• Enzyme‑inducing antiepileptics (e.g., carbamazepine, phenytoin): may lower levetiracetam plasma levels.
• Strong CYP inhibitors (e.g., valproate): potential for increased levetiracetam exposure.
• Other CNS depressants (e.g., opioids, benzodiazepines): risk of profound sedation.

Moderate Interactions (Monitor Closely)

• Oral contraceptives: levetiracetam may reduce hormonal efficacy.
• Alcohol: may enhance central nervous system effects.
• Antidepressants: watch for additive mood‑related side effects.