Levetiracetam and acute renal failure (ARF) was highlighted as a potential signal in the paediatric signal detection sprint. The paediatric population and ARF was the starting point for this assessment but the signal expanded to cover reports of all ages as well as encompassing interstitial nephritis.
There are more than 150 reports on levetiracetam with ARF and/or interstitial nephritis in the WHO Global database of Individual Case Safety Reports, VigiBase®, although many of these reports turned out to be duplicates (WHO,20212)
Levetiracetam is one of the newer generation antiepileptic drugs (AEDs). It is considered to be safer than many of the older AEDs. It is an effective anticonvulsant and its main adverse drug reactions are tiredness and behavioural changes. The active substance of levetiracetam is a pyrrolidone derivate.
The mechanism of action is not fully elucidated but in vitro studies suggest that an interaction between levetiracetam and the synaptic vesicle protein 2A results in antiseizure activity. Levetiracetam is excreted primarily via urine by glomerular filtration followed by tubular reabsorption. Elimination of levetiracetam is correlated to creatinine clearance.
Indications and usage
Levetiracetam is indicated as adjunctive therapy in the treatment of partial onset seizures in adults and children 4 years of age and older with epilepsy.
Is it best to take this medicine with food?
This medicine can be taken with or without food. Taking it with food may prevent stomach upset. Try to take it the same way each day, since taking this with food may change the time it takes to be absorbed.
What should I do if I miss a dose?
If you miss or forget a dose take it as soon as possible. However, if you have missed a dose and it is within a few hours before your next dose, take only the next scheduled dose. Do not double up or take extra medicine, unless instructed to do so by your doctor.
This product should not be administered to patients who have previously exhibited hypersensitivity to levetiracetam or any of the inactive ingredients in Levetiracetam tablets or oral solution.
Is this medicine safe to take during pregnancy?
Levetiracetam has an FDA pregnancy category of “C” meaning that the benefits of the medicine may outweigh the risks of harming the fetus. If you find or suspect you are pregnant, continue taking the medicine and contact your doctor right away. Talk to your doctor about the potential benefits and risks before making any decisions about use of this medicine. Seizures can be harmful to the mother and the developing baby, but these risks can be managed with proper care.
Does this medicine affect birth control pills?
Levetiracetam has not been reported to cause problems with hormonal contraceptives or birth control. Talk to your doctor if you start or stop hormonal birth control while taking this medicine. Call your doctor if you have any signs of breakthrough bleeding or symptoms of pregnancy.
Will the medicine affect my menstrual cycle?
This medicine should not affect the menstrual cycle. If your cycle becomes irregular, call your doctor.
Can I breast feed while taking this medicine?
In general, women taking levetiracetam can breastfeed while using this medicine. It is not known if this drug passes into the breast milk. According to the American Academy of Neurology, the benefits for the infant and mother are believed to outweigh the risk for adverse effects. Talk to your doctor regarding this option.