Included in the formulation
Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):VED
АТХ:N.03.A.X Other antiepileptic drugs
N.03.A.X.14 Levetiracetam
Pharmacodynamics:Selectively enhances inactivation of voltage-dependent sodium channels, neuronal hyperexcitability stabilizing shell.
It binds to phosphoprotein CRMP-2 - a mediator of collapsin-2, which is expressed in the nervous system and participates in the process of differentiation and controls axonal growth.
Pharmacokinetics:After oral administration, it is completely absorbed from the gastrointestinal tract. The maximum concentration in the plasma is reached after 0.5-4 h. It binds to blood plasma proteins by 10%.
The half-life is 7 hours.
Elimination with urine unchanged is 66%, about 30% - in the form of an inactive UCB L057 metabolite, less than 0.5% is excreted with feces.
In patients on hemodialysis, about 4% of the standard procedure removes about 50% of levetiracetam from the body.
Indications:It is used in the complex therapy of partial epileptic seizures in patients from 16 years of age and older.
Contraindications:Atrioventricular blockade of II-III degree.
Individual intolerance.
Carefully:For patients with severe renal failure (creatinine clearance less than 30 ml / min), a maximum dose of not more than 300 mg per day is required. Patients on hemodialysis should be increased by 50% immediately after the end of the procedure.
Pregnancy and lactation:Recommendations for FDA - Category C. During pregnancy and lactation, the drug is contraindicated.
Dosing and Administration:Inside regardless of the meal. The starting dose is 250-750 mg 2 times a day.
The highest daily dose: 1500 mg.
The highest single dose: 750 mg.
Side effects:Central nervous system: dizziness, irritability, depression, cognitive impairment, movement coordination disorders, tremor, dysarthria, nystagmus.
Gastrointestinal tract: nausea, vomiting, dyspepsia, dry mouth.
Musculoskeletal system: muscle spasms.
Sense organs: diplopia, blurred vision, tinnitus.
Allergic reactions.
Overdose:Symptoms: increased side effects.Treatment: symptomatic, hemodialysis.
Interaction:Combines with all antiepileptic drugs.
Simultaneous use of inducers of microsomal liver enzymes (carbamazepine, pregabalinum, lamotrigine) causes a decrease in the systemic concentration of levetiracetam.
Rifampicin and St. John's wort (Hypericum perforatum) also cause a decrease in the concentration of levetiracetam.
Special instructions:Taking levetiracetam is often accompanied by dizziness, which can lead to falls and injuries. Patients should be careful.
Persons caring for patients receiving levetiracetam, should be warned about the possibility of patients appearing suicidal thoughts and attempts.