Keppra 250 mg (Levetiracetam)

Adult dose

Kepiram Tablets 250mg is administered orally and may be taken with or without food, with a sufficient amount of water. The daily dose is divided into 2 equal doses and administered twice daily. For monotherapy and adjunctive therapy for partial-onset seizures, initiate treatment with 500mg twice daily; the dose may be increased or decreased every 2 to 4 weeks according to clinical response. The maximum recommended dose is 3000mg per day. For adjunctive therapy for primary generalized tonic-clonic seizures, initiate treatment with 1000mg per day (500mg twice daily); the dose may be increased or decreased according to clinical response, up to the maximum recommended dose of 3000mg per day. For patients with renal impairment, adjust the dose according to creatinine clearance: in patients with normal renal function, 500-1500mg twice daily; for mild impairment, 500-1000mg twice daily; for moderate impairment, 250-750mg twice daily; for severe impairment, 250-500mg twice daily; patients with end-stage renal disease undergoing dialysis should receive 500-1000mg once daily. An initial loading dose of 750mg is recommended on the first day of treatment, followed by an additional dose of 250-500mg after dialysis. The drug may be administered orally or intravenously. When switching the route of administration, maintain the same total daily dose and dosing frequency without dose adjustment.

Child dose

Monotherapy and adjunctive therapy for partial-onset seizures (aged 4 years or older): For children aged 4 to 11 years and adolescents aged 12 to 17 years weighing less than 50 kg, initiate treatment with 10mg/kg twice daily. The dose may be increased up to 60mg/kg per day according to clinical response and tolerability; dose changes should not exceed 20mg/kg per day every 2 weeks. For children weighing 20kg or less, it is recommended to initiate treatment with the 100mg/ml oral solution. For children weighing 20~40kg, initiate treatment with 250mg twice daily and increase the dose by 500mg per day every 2 weeks, up to a maximum of 1500mg per day. For children weighing more than 40kg, initiate treatment with 500mg twice daily and increase the dose by 1000mg per day every 2 weeks, up to a maximum of 3000mg per day. The dose for children weighing 50kg or more is the same as that for adults. Adjunctive therapy for myoclonic seizures (aged 12 years or older): Initiate treatment with 500mg twice daily; following the physician's assessment, the initial dose may be reduced to 250mg twice daily. The dose may be increased or decreased every 2 weeks according to clinical response, up to a maximum of 3000mg per day. Adjunctive therapy for primary generalized tonic-clonic seizures (aged 12 years or older): For adolescents aged 12-17 years weighing less than 50 kg, initiate treatment with 10mg/kg twice daily and increase the dose by 20mg/kg per day every 2 weeks, up to a maximum of 60mg/kg per day. For children with renal impairment and adolescents weighing less than 50 kg, adjust the dose according to creatinine clearance: in patients with normal renal function, 10-30mg/kg twice daily; for mild impairment, 10-20mg/kg twice daily; for moderate impairment, 5-15mg/kg twice daily; for severe impairment, 5-10mg/kg twice daily; patients with end-stage renal disease undergoing dialysis should receive 10-20mg/kg once daily. A loading dose of 15mg/kg on the first day is recommended, followed by an additional 5-10mg/kg after dialysis. Not recommended for infants younger than 1 month. Tablets are not suitable for children 4 years or younger; the oral solution should be administered. Injection is not recommended for children younger than 16 years.

As this medication is used for treating epilepsy, there may be an increased risk of suicidal thoughts or behaviors during treatment, therefore patients and guardians should carefully monitor for mood changes or abnormal behaviors. Psychiatric side effects such as drowsiness, fatigue, coordination problems, and behavioral disturbances may occur during treatment, especially within the first 4 weeks. Sudden discontinuation of the medication may worsen seizures; thus, the dosage should be reduced gradually according to a physician's instructions. Patients with allergies to the components or related ingredients of this drug should not take it. Patients with suicidal thoughts or depressive symptoms should consult their physician, and dose adjustments may be necessary for patients with impaired kidney function. Blood cell counts may decrease, and symptoms such as abnormal behaviors, aggression, and worsening seizures have been reported; therefore, consultation with healthcare professionals is required if these symptoms occur. Caution is required when prescribed to patients with heart-related conditions or prolonged QT intervals. Drowsiness or decreased concentration may occur when taking this medication, so caution is advised when driving or operating hazardous machinery. In case of overdose, vomiting or gastric lavage can help remove the drug, and dialysis may be necessary if required. Women who are pregnant or breastfeeding should consult their physician prior to taking this medication, and breastfeeding should be discontinued if taking this drug. In children, the liquid form may be administered from 1 month of age; safety has not been established for infants under 1 month or children under 16 years. In the elderly, dosing should be determined carefully, taking impaired kidney function into consideration. This drug has minimal drug interactions, but blood concentrations should be monitored closely when taken with methotrexate. Hypersensitivity reactions associated with this drug, such as skin rash, fever, and lymphadenopathy, may occur; if any of these symptoms appear, immediate discontinuation and hospital visit are necessary.

• suicidal impulses
• suicidal behavior
• depression
• abnormal changes in mood and behavior
• drowsiness
• fatigue
• coordinative motor disorder
• behavioral abnormalities
• asthenia
• psychotic symptoms

This medication should be stored in a tightly closed container to protect it from air and moisture. Keeping the storage temperature between 1°C and 30°C at room temperature is recommended.

Appearance

Blue oval film-coated tablet

Package unit

30 tablets/bottle