Keppra
levetiracetam
Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor or pharmacist.
This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
If you get any side effects talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
What Keppra is and what it is used for
What you need to know before you take Keppra
How to take Keppra
Possible side effects
How to store Keppra
Contents of the pack and other information
Levetiracetam is an antiepileptic medicine (a medicine used to treat seizures in epilepsy). Keppra is used:
on its own in adults and adolescents from 16 years of age with newly diagnosed epilepsy, to
treat a certain form of epilepsy. Epilepsy is a condition where the patients have repeated fits (seizures). Levetiracetam is used for the epilepsy form in which the fits initially affect only one side of the brain but could thereafter extend to larger areas on both sides of the brain (partial onset seizure with or without secondary generalisation). Levetiracetam has been given to you by your doctor to reduce the number of fits.
as an add-on to other antiepileptic medicines to treat:
partial onset seizures with or without generalisation in adults, adolescents, children and infants from one month of age;
myoclonic seizures (short, shock-like jerks of a muscle or group of muscles) in adults and adolescents from 12 years of age with juvenile myoclonic epilepsy;
primary generalised tonic-clonic seizures (major fits, including loss of consciousness) in adults and adolescents from 12 years of age with idiopathic generalised epilepsy (the type of epilepsy that is thought to have a genetic cause).
If you are allergic to levetiracetam, pyrrolidone derivatives or any of the other ingredients of this medicine (listed in Section 6).
Talk to your doctor before taking Keppra
If you suffer from kidney problems, follow your doctor’s instructions. He/she may decide if your dose should be adjusted.
If you notice any slowdown in the growth or unexpected puberty development of your child, please contact your doctor.
A small number of people being treated with anti-epileptics such as Keppra have had thoughts of harming or killing themselves. If you have any symptoms of depression and/or suicidal ideation, please contact your doctor.
If you have a family or medical history of irregular heart rhythm (visible on an electrocardiogram), or if you have a disease and/or take a treatment that make(s) you prone to heartbeat irregularities or salt imbalances.
Tell your doctor or pharmacist if any of the following side effects gets serious or last longer than a few days:
Abnormal thoughts, feeling irritable or reacting more aggressively than usually, or if you or your family and friends notice important changes in mood or behaviour.
Aggravation of epilepsy
Your seizures may rarely become worse or happen more often, mainly during the first month after the start of the treatment or increase of the dose. If you experience any of these new symptoms while taking Keppra, see a doctor as soon as possible.
Keppra is not indicated in children and adolescents below 16 years on its own (monotherapy).
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
Do not take macrogol (a drug used as laxative) for one hour before and one hour after taking levetiracetam as this may results in a loss of its effect.
If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine. Levetiracetam can be used during pregnancy, only if after careful assessment it is considered necessary by your doctor.
You should not stop your treatment without discussing this with your doctor. A risk of birth defects for your unborn child cannot be completely excluded. Breast-feeding is not recommended during treatment.
Keppra may impair your ability to drive or operate any tools or machinery, as it may make you feel sleepy. This is more likely at the beginning of treatment or after an increase in the dose. You should not drive or use machines until it is established that your ability to perform such activities is not affected.
Sunset Yellow FCF (E110) colouring agent may cause allergic reactions.
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
Take the number of tablets following your doctor’s instructions.
Keppra must be taken twice a day, once in the morning and once in the evening, at about the same time each day.
Adjunctive Therapy and monotherapy (from 16 years of age)
Recommended dose: between 1000 mg and 3000 mg each day.
When you will first start taking Keppra, your doctor will prescribe you a lower dose during 2 weeks before giving you the lowest daily dose.
Example: if your daily dose is intended to be 1000 mg, your reduced starting dose is 1 tablet of 250 mg in the morning and 1 tablet of 250 mg in the evening, and the dose will be gradually incremented to reach 1000 mg daily after 2 weeks.
Your doctor will prescribe the most appropriate pharmaceutical form of Keppra according to weight and dose.
Your doctor will prescribe the most appropriate pharmaceutical form of Keppra according to the age, weight and dose.
Keppra 100 mg/ml oral solution is a formulation more appropriate to infants and children under the age of 6 years and to children and adolescent (from 6 to 17 years) weighing less than 50kg and when tablets don’t allow accurate dosage.
Method of administration
Swallow Keppra tablets with a sufficient quantity of liquid (e.g. a glass of water). You may take Keppra with or without food. After oral administration the bitter taste of levetiracetam may be experienced.
Duration of treatment
Keppra is used as a chronic treatment. You should continue Keppra treatment for as long as your doctor has told you.
Do not stop your treatment without your doctor’s advice as this could increase your seizures.
The possible side effects of an overdose of Keppra are sleepiness, agitation, aggression, decrease of alertness, inhibition of breathing and coma.
Contact your doctor if you took more tablets than you should. Your doctor will establish the best possible treatment of overdose.
Contact your doctor if you have missed one or more doses. Do not take a double dose to make up for a forgotten tablet.
If stopping treatment, Keppra should be discontinued gradually to avoid an increase of seizures. Should your doctor decide to stop your Keppra treatment, he/she will instruct you about the gradual withdrawal of Keppra.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
Like all medicines, this medicine can cause side effects, although not everybody gets them.
weakness, feel light-headed or dizzy or have difficulty breathing, as these may be signs of a serious allergic (anaphylactic) reaction
swelling of the face, lips, tongue and throat (Quincke’s oedema)
flu-like symptoms and a rash on the face followed by an extended rash with a high temperature, increased levels of liver enzymes seen in blood tests and an increase in a type of white blood cell (eosinophilia) and enlarged lymph nodes (Drug Reaction with Eosinophilia and Systemic Symptoms [DRESS])
symptoms such as low urine volume, tiredness, nausea, vomiting, confusion and swelling in the legs, ankles or feet, as this may be a sign of sudden decrease of kidney function
a skin rash which may form blisters and look like small targets (central dark spots surrounded by a paler area, with a dark ring around the edge) (erythema multiforme)
a widespread rash with blisters and peeling skin, particularly around the mouth, nose, eyes and genitals (Stevens-Johnson syndrome)
a more severe form of rash causing skin peeling in more than 30% of the body surface (toxic epidermal necrolysis)
signs of serious mental changes or if someone around you notices signs of confusion, somnolence (sleepiness), amnesia (loss of memory), memory impairment (forgetfulness), abnormal behaviour or other neurological signs including involuntary or uncontrolled movements. These could be symptoms of an encephalopathy.
The most frequently reported side effects are nasopharyngitis, somnolence (sleepiness), headache, fatigue and dizziness. At the beginning of the treatment or at dose increase side effects like sleepiness, tiredness and dizziness may be more common. These effects should however decrease over time.
nasopharyngitis;
somnolence (sleepiness), headache.
anorexia (loss of appetite);
depression, hostility or aggression, anxiety, insomnia, nervousness or irritability;
convulsion, balance disorder (equilibrium disorder), dizziness (sensation of unsteadiness), lethargy (lack of energy and enthusiasm), tremor (involuntary trembling);
vertigo (sensation of rotation);
cough;
abdominal pain, diarrhoea, dyspepsia (indigestion), vomiting, nausea;
rash;
asthenia/fatigue (tiredness).
decreased number of blood platelets, decreased number of white blood cells;
weight decrease, weight increase;
suicide attempt and suicidal ideation, mental disorder, abnormal behaviour, hallucination, anger, confusion, panic attack, emotional instability/mood swings, agitation;
amnesia (loss of memory), memory impairment (forgetfulness), abnormal coordination/ataxia (impaired coordinated movements), paraesthesia (tingling), disturbance in attention (loss of concentration);
diplopia (double vision), vision blurred;
elevated/abnormal values in a liver function test;
hair loss, eczema, pruritus;
muscle weakness, myalgia (muscle pain);
injury.
infection;
decreased number of all blood cell types;
severe allergic reactions (DRESS, anaphylactic reaction [severe and important allergic reaction], Quincke’s oedema [swelling of the face, lips, tongue and throat]);
decreased blood sodium concentration;
suicide, personality disorders (behavioural problems), thinking abnormal (slow thinking, unable to concentrate);
delirium;
encephalopathy (see sub-section “Tell your doctor immediately” for a detailed description of symptoms);
seizures may become worse or happen more often;
uncontrollable muscle spasms affecting the head, torso and limbs, difficulty in controlling movements, hyperkinesia (hyperactivity);
change of the heart rhythm (Electrocardiogram);
pancreatitis;
liver failure, hepatitis;
sudden decrease in kidney function;
skin rash, which may form blisters and looks like small targets (central dark spots surrounded by a paler area, with a dark ring around the edge) (erythema multiforme), a widespread rash with blisters and peeling skin, particularly around the mouth, nose, eyes and genitals (Stevens– Johnson syndrome), and a more severe form causing skin peeling in more than 30% of the body surface (toxic epidermal necrolysis);
rhabdomyolysis (breakdown of muscle tissue) and associated blood creatine phosphokinase increase. Prevalence is significantly higher in Japanese patients when compared to non- Japanese patients.
limp or difficulty walking;
combination of fever, muscle stiffness, unstable blood pressure and heart rate, confusion, low level of consciousness (may be signs of a disorder called neuroleptic malignant syndrome). Prevalence is significantly higher in Japanese patients when compared to non-Japanese patients.
If you get any side effects talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix V. By reporting side effects you can help provide more information on the safety of this medicine.
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date stated on the carton box and blister after EXP. The expiry date refers to the last day of the month.
This medicine does not require any special storage conditions.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to
throw away medicines you no longer use. These measures will help protect the environment.
The active substance is called levetiracetam.
One tablet of Keppra 250 mg contains 250 mg of levetiracetam. One tablet of Keppra 500 mg contains 500 mg of levetiracetam. One tablet of Keppra 750 mg contains 750 mg of levetiracetam. One tablet of Keppra 1000 mg contains 1000 mg of levetiracetam.
The other ingredients are:
Tablet core: croscarmellose sodium, macrogol 6000, silica colloidal anhydrous, magnesium stearate. Film-coating: Polyvinyl alcohol-part. hydrolyzed, titanium dioxide (E171), macrogol 3350, talc, colourants*.
* The colourants are:
250 mg tablet: indigo carmine aluminium lake (E132) 500 mg tablet: iron oxide yellow (E172)
750 mg tablet: sunset yellow FCF aluminium lake (E110), iron oxide red (E172)
Keppra 250 mg film-coated tablets are blue, 13 mm oblong, scored and debossed with the code “ucb” and “250” on one side.
The score line is only to facilitate breaking for ease of swallowing and not to divide into equal doses.
Keppra 500 mg film-coated tablets are yellow, 16 mm oblong, scored and debossed with the code “ucb” and “500” on one side.
The score line is only to facilitate breaking for ease of swallowing and not to divide into equal doses.
Keppra 750 mg film-coated tablets are orange, 18 mm oblong, scored and debossed with the code “ucb” and “750” on one side.
The score line is only to facilitate breaking for ease of swallowing and not to divide into equal doses.
Keppra 1000 mg film-coated tablets are white, 19 mm oblong, scored and debossed with the code “ucb” and “1000” on one side.
The score line is only to facilitate breaking for ease of swallowing and not to divide into equal doses.
Keppra tablets are packaged in blister packs supplied in cardboard boxes containing:
250 mg: 20, 30, 50, 60, 100 x 1, 100 film-coated tablets and multipacks containing 200 (2 packs of 100) film-coated tablets
500 mg: 10, 20, 30, 50, 60, 100 x 1, 100, 120 film-coated tablets and multipacks containing 200 (2 packs of 100) film-coated tablets
750 mg: 20, 30, 50, 60, 80, 100 x 1, 100 film-coated tablets and multipacks containing 200 (2 packs of 100) film-coated tablets
1000 mg: 10, 20, 30, 50, 60, 100 x 1, 100 film-coated tablets and multipacks containing 200 (2 packs of 100) film-coated tablets
The 100 x 1 tablet packs are available in aluminium/PVC perforated unit dose blisters. All other packs are available in standard aluminium/PVC blisters.
Not all pack sizes may be marketed.
UCB Pharma SA, Allée de la Recherche 60, B-1070 Brussels, Belgium.
UCB Pharma SA, Chemin du Foriest, B-1420 Braine-l’Alleud, Belgium.
or Aesica Pharmaceuticals S.r.l., Via Praglia 15, I-10044 Pianezza, Italy
For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder.
UCB Pharma Oy Finland
Tel: +358 9 2514 4231 (Suomija)
Ю СИ БИ България ЕООД Teл.: + 359 (0) 2 962 30 49
UCB s.r.o.
Tel: + 420 221 773 411
UCB Magyarország Kft. Tel.: + 36-(1) 391 0060
UCB Nordic A/S
Tlf: + 45 / 32 46 24 00
Pharmasud Ltd.
Tel: + 356 / 21 37 64 36
UCB Pharma GmbH
Tel: + 49 /(0) 2173 48 4848
UCB Pharma B.V.
Tel.: + 31 / (0)76-573 11 40
UCB Pharma Oy Finland
Tel: +358 9 2514 4231 (Soome)
UCB Nordic A/S
Tlf: + 45 / 32 46 24 00
UCB Α.Ε.
Τηλ: + 30 / 2109974000
UCB Pharma GmbH Tel: + 43 (0)1 291 80 00
UCB Pharma, S.A.
Tel: + 34 / 91 570 34 44
UCB Pharma Sp. z o.o. Tel: + 48 22 696 99 20
UCB Pharma S.A.
Tél: + 33 / (0)1 47 29 44 35
UCB Pharma (Produtos Farmacêuticos), Lda Tel: + 351 / 21 302 5300
Medis Adria d.o.o.
Tel: +385 (0) 1 230 34 46
UCB Pharma Romania S.R.L. Tel: + 40 21 300 29 04
UCB (Pharma) Ireland Ltd. Tel: + 353 / (0)1-46 37 395
Medis, d.o.o.
Tel: + 386 1 589 69 00
Vistor hf.
Tel: + 354 535 7000
UCB s.r.o., organizačná zložka Tel: + 421 (0) 2 5920 2020
UCB Pharma S.p.A. Tel: + 39 / 02 300 791
UCB Pharma Oy Finland Puh/Tel: +358 9 2514 4221
Lifepharma (Z.A.M.) Ltd Τηλ: + 357 22 34 74 40
UCB Nordic A/S
Tel: + 46 / (0) 40 29 49 00
UCB Pharma Oy Finland
Tel: +358 9 2514 4231 (Somija)
UCB (Pharma) Ireland Ltd Tel: + 353 / (0)1-46 37 395