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Serious dermatological reactionsincluding Stevens-Johnson syndromeSJSand toxic epidermal necrolysisTENhave been reported in both pediatric and adult patients treated with KEPPRAThe median time of onset is reported to be 14 to 17 daysbut cases have been reported at least four months after initiation of treatmentRecurrence of the serious skin reactions following rechallenge with KEPPRA has also been reportedKEPPRA should be discontinued at the first sign of a rashunless the rash is clearly not drug-relatedIf signs or symptoms suggest SJS/TENuse of this drug should not be resumed and alternative therapy should be considered.
The precise mechanism(sby which levetiracetam exerts its antiepileptic effect is unknownThe antiepileptic activity of levetiracetam was assessed in a number of animal models of epileptic seizuresLevetiracetam did not inhibit single seizures induced by maximal stimulation with electrical current or different chemoconvulsants and showed only minimal activity in submaximal stimulation and in threshold testsProtection was observedhoweveragainst secondarily generalized activity from focal seizures induced by pilocarpine and kainic acidtwo chemoconvulsants that induce seizures that mimic some features of human complex partial seizures with secondary generalizationLevetiracetam also displayed inhibitory properties in the kindling model in ratsanother model of human complex partial seizuresboth during kindling development and in the fully kindled stateThe predictive value of these animal models for specific types of human epilepsy is uncertain.
Potential pharmacokinetic interactions of or with levetiracetam were assessed in clinical pharmacokinetic studiesphenytoinvalproatewarfarindigoxinoral contraceptiveprobenecidand through pharmacokinetic screening in the placebo-controlled clinical studies in epilepsy patients.
Psychiatric Symptomssee WARNINGS AND PRECAUTIONSSuicidal Behavior and Ideationsee WARNINGS AND PRECAUTIONSSomnolence and Fatiguesee WARNINGS AND PRECAUTIONSAnaphylaxis and Angioedemasee WARNINGS AND PRECAUTIONSSerious Dermatological Reactionssee WARNINGS AND PRECAUTIONSCoordination Difficultiessee WARNINGS AND PRECAUTIONSHematologic Abnormalitiessee WARNINGS AND PRECAUTIONSIncrease in Blood Pressuresee WARNINGS AND PRECAUTIONS
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in dogs, keppra has undergone extensive studies on the pharmacokinetics and safety in healthy dogs but clinical trials evaluating this drug in dogs with epilepsy are still being done.
