Levetiracetam, 250 mg 30 pcs

The mechanism of action of levetiracetam has not been fully identified, but it differs from the mechanism of action of other anticonvulsants. In in vitro and in vivo experiments it is shown that levetiracetam does not affect the basic properties of the cell and normal nerve transmission.

In in vitro studies it has been shown that by partially reducing N-type calcium currents and reducing the release of calcium ions from intracellular neuronal depots, levetiracetam alters the concentration of calcium ions within neurons. In addition, it partially eliminates the reduction of currents induced by zinc- and B-carbolines through GABA- and glycine-dependent channels.

One proposed mechanism is based on the proven binding to the glycoprotein of synaptic vesicles SV2A contained in the gray matter of the brain and spinal cord. It is believed that in this way the anticonvulsant effect is realized, which is expressed in opposition to hypersynchronization of neuronal activity.

Levetiracetam also affects GABA and glycine receptors, modulating these receptors through various endogenous agents. do not alter normal neurotransmission, but suppress epileptiform neuronal bursts induced by the GABA agonist bicuculline, and excitation of glutamate receptors.

Indications

Active ingredient

Composition

How to take, the dosage

Ingestion with plenty of water, regardless of meals.

The daily dose is divided into two equal doses.

Dosing regimen

Monotherapy in adults and adolescents from 16 years of age The recommended starting dose is 250 mg twice daily, which should be increased after two weeks to an initial therapeutic dose of 500 mg twice daily. The dose may be increased in increments of 250 mg twice daily every two weeks depending on clinical response.

The maximum dose is 1500 mg twice daily.

Auxiliary therapy in adults (18 years and older) and adolescents (12-17 years) with a body weight of 50 kg or more

The initial therapeutic dose is 500 mg twice daily. This dose is allowed from the first day of treatment. Depending on clinical response and tolerability, the daily dose may be increased to 1500 mg twice daily.

The dose may be increased or decreased by 500 mg twice daily every 2 to 4 weeks. Special patient groups Children The drug is prescribed in the most convenient dosage form and dosage depending on the age, body weight and dose required.

The tablets are not intended for use in children under the age of 6 years. It is recommended that oral solution be prescribed in the dosage form for these patients.

In addition, the dosage forms available are not appropriate for initial dosing in children with a body weight less than 25 kg, patients who cannot swallow the tablets, or patients who require a dose lower than 250 mg. In all of these cases, oral solution is recommended.

Interaction

In co-administration with topiramate there is a higher probability of anorexia.

The completeness of absorption of levetiracetam is not affected by food, but the rate of absorption is slightly reduced.

Special Instructions

The concomitant antiepileptic drugs (during transfer of patients to levetiracetam) should preferably be withdrawn gradually.

Patients with renal disease and decompensated liver disease are recommended to have renal function tests before starting treatment. Because of the reported cases of suicide, suicidal ideation and suicide attempts during treatment with levetiracetam, patients should be warned to immediately report any symptoms of depression or suicidal ideation to the treating physician.

Impact on driving and operating ability

In view of the varying individual CNS sensitivity to levetiracetam, patients should refrain from driving and engaging in potentially hazardous activities requiring increased concentration and rapid psychomotor reactions during treatment.

Contraindications

Side effects

Blood system: infrequent – thrombocytopenia, leukopenia; rarely – neutropenia, pancytopemia.

Metabolism: frequently – anorexia; infrequently – weight gain/loss.

CNS: very common – somnolence, headache; common – mood swings, emotional lability, depression, aggressiveness, insomnia, nervousness; infrequent – behavioral disorders, embitteredness, anxiety, hallucinations, psychotic disorders, memory impairment, suicide attempt. Obsessive compulsions, amnesia, tactile sensitivity disorder, dizziness, headache, hyperkinesia, tremor, balance disorder, distraction, paresthesias; rarely – personality disorder, including thought disorder, suicide, hyperkinesia, choreoathetosis.

Sensory organs: frequently – dizziness; infrequently – diplopia, blurred vision.

Respiratory system: often – cough.

The digestive system: frequently – nausea, vomiting, diarrhea, abdominal pain, dyspepsia; infrequent – abnormal laboratory values of liver function; rarely – pancreatitis, hepatitis, liver failure.

Skin and subcutaneous tissue disorders: common – skin rash; infrequent – eczema, pruritus; rare – alopecia (in some cases resolving after levetiracetam withdrawal), toxic epidermal necrolysis, erythema multiforme, Stevens-Johnson syndrome.

Muscular system: infrequent – myalgia, muscle weakness.

Others: common – general weakness, fatigue; infrequent – nasopharyngitis, accidental injury.

In children most commonly: vomiting, agitation, mood swings, aggression, emotional lability, conduct disorder, lethargy.

Pregnancy use

Adequate and strictly controlled clinical studies on the safety of levetiracetam use in pregnant women have not been conducted, so levetiracetam should not be used in pregnancy unless absolutely necessary.

Physiological changes in the female body during pregnancy may affect plasma concentrations of levetiracetam as well as other antiepileptic drugs. A decrease in plasma concentrations of levetiracetam has been noted in pregnancy.

This decrease is more pronounced in the first trimester (up to 60% of the baseline concentration in the period prior to pregnancy).

The treatment with levetiracetam in pregnant women should be monitored specifically. Note that interruptions in antiepileptic therapy may worsen the course of the disease, which is harmful to both mother and fetus.

Levetiracetam is excreted with breast milk, so breastfeeding during treatment is not recommended. However, if treatment with levetiracetam is necessary during lactation, the risk/benefit ratio of treatment should be carefully weighed against the importance of breastfeeding.

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