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A saturable and stereoselective neuronal binding site in rat brain tissue has been described for levetiracetamExperimental data indicate that this binding site is the synaptic vesicle protein SV2Athought to be involved in the regulation of vesicle exocytosisAlthough the molecular significance of levetiracetam binding to SV2A is not understoodlevetiracetam and related analogs showed a rank order of affinity for SV2A which correlated with the potency of their antiseizure activity in audiogenic seizure-prone miceThese findings suggest that the interaction of levetiracetam with the SV2A protein may contribute to the antiepileptic mechanism of action of the drug.
Thereforepatients should be monitored for signs of depression and/or suicidal ideation and behaviours and appropriate treatment should be consideredPatientsand caregivers of patientsshould be advised to seek medical advice should signs of depression and/or suicidal ideation or behaviour emerge.
Table 3 lists adverse reactions that occurred in at least 1of adult epilepsy patients receiving KEPPRA in placebocontrolled studies and were numerically more common than in patients treated with placeboIn these studieseither KEPPRA or placebo was added to concurrent AED therapy.
Pre-marketing data from clinical studies conducted in adults indicate that levetiracetam did not influence the serum concentrations of existing antiepileptic medicinal productsphenytoincarbamazepinevalproic acidphenobarbitallamotriginegabapentin and primidoneand that these antiepileptic medicinal products did not influence the pharmacokinetics of levetiracetam.
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.
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your doctor may suggest you avoid alcohol while you are being treated with keppra.