Levetiracetam (Keppra)
Broad-spectrum anticonvulsant that binds synaptic vesicle protein SV2A, modulating neurotransmitter release. First-line for focal and generalized seizures and status epilepticus. Among the most-prescribed AEDs due to linear PK, near-complete oral bioavailability (~100%), minimal CYP metabolism, and few drug interactions, two-thirds excreted unchanged renally. Typical adult dosing 500-1500 mg twice daily (max 3000 mg/day). Key adverse effect: behavioral/mood changes ('keppra rage').
Projected serum levels — 500 mg, twice daily
Maintenance schedule: 500 mg twice daily (oral).
Modeled steady state after ~1 days: peak ≈ 424 mg, trough ≈ 36.9 mg body load. Population-based estimate over 15 days for a 500 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.
Key facts
- Category
- Anticonvulsant
- Route modeled
- Oral
- Model confidence
- inferred
- Half-life
- 7 h
- Common dose
- 500 mg
- Suggested maximum
- 3k mg/day
- Reference dose range
- 250–3k mg (single dose)
- Suggested cadence
- twice daily
- Validated against
- 500 mg oral — Cmax 15 mg/L at 1 h
Research behind this entry
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Clinical pharmacokinetics of levetiracetam
Comprehensive PK review establishing levetiracetam's near-complete oral bioavailability, 7-hour half-life, linear kinetics, minimal protein binding, and predominantly renal elimination, supporting its favorable…
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Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology: Update 2017
AGNP TDM consensus guidelines establishing therapeutic reference range for levetiracetam (12-46 mg/L plasma) and recommending TDM in selected clinical scenarios such as pregnancy, renal impairment, or breakthrough…
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A comparison of levetiracetam and phenytoin for second-line treatment of convulsive status epilepticus in children (EcLiPSE): a multicentre, open-label, randomised trial
Multicenter RCT of 286 children with convulsive status epilepticus found levetiracetam was not superior to phenytoin but demonstrated comparable efficacy and favorable safety profile, supporting its first-line use.
3 published studies referenced in the app, each with a plain-language summary.