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Howeverif levetiracetam treatment is needed during breastfeedingthe benefit/risk of the treatment should be weighed considering the importance of breastfeeding.
For children with renal impairmentlevetiracetam dose needs to be adjusted based on the renal function as levetiracetam clearance is related to renal functionThis recommendation is based on a study in adult renally impaired patients.
In controlled clinical studies in adults with partial onset seizuresthe most common adverse reactions in patients receiving KEPPRA in combination with other AEDsfor events with rates greater than placebowere somnolenceastheniainfectionand dizzinessOf the most common adverse reactions in adults experiencing partial onset seizuresastheniasomnolenceand dizziness occurred predominantly during the first 4 weeks of treatment with KEPPRA.
The lowest effective dose should be usedThe starting dose for a child or adolescent of 25kg should be 250mg twice daily with a maximum dose of 750mg twice dailyDose in children 50 kg or greater is the same as in adults.
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however, it seems that patients who switch from keppra to the generic, levetiracetam, are experiencing increased re-occurance of seizures after having been seizure-free on the brand name keppra.