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levetiracetam (Spritam)

✓ Approved

Aprecia Pharmaceuticals, LLC. · SV2A · Small Molecule

What is levetiracetam?

levetiracetam is a small molecule developed by Aprecia Pharmaceuticals, LLC.. It is approved for therapeutic indications via oral (po) or sublingual (sl)/oral transmucosal.

Drug Profile

Brand NamesSpritam
CompanyAprecia Pharmaceuticals, LLC.
Drug ClassSmall Molecule
Molecular TargetSV2A
RouteOral (PO), Sublingual (SL)/Oral Transmucosal
StatusApproved
Sources: ClinicalTrials.gov, Aprecia Pharmaceuticals, LLC.

Mechanism of Action

Molecular Targets

levetiracetam acts on 1 molecular target:

SV2Asynaptic vesicle glycoprotein 2A (SLC22B1, DEE113)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

levetiracetam is developed for 3 unique indications across 1 therapeutic area.

Therapeutic AreaConditionPhase
Nervous system disordersGeneralised tonic-clonic seizure✓ Approved
Nervous system disordersMyoclonic epilepsy✓ Approved
Nervous system disordersPartial seizures✓ Approved

Related Research Articles

PubMedBMC neurology2026-11-11

Evaluation of factors affecting therapeutic levetiracetam drug levels in intensive care unit patients: a retrospective study.

Ayhan Yunus Emre YE, Küçük Rabia Sari RS, Ervatan Zekeriya Z, Bektay Muhammed Yunus MY

Levetiracetam (LEV) is a widely used anti-seizure medication (ASM) with linear pharmacokinetics and a wide therapeutic range. Although therapeutic drug monitoring (TDM) for LEV is not routinely recommended, critically ill patients in the intensive care unit (ICU) may experience altered pharmacokinetics. This study aimed to evaluate the factors influencing LEV serum levels in ICU patients and to identify predictors of therapeutic drug concentrations. This retrospective observational study included ICU patients aged ≥ 18 years who received LEV therapy and underwent TDM between January 2021 and July 2024 at a tertiary care hospital. LEV serum levels were categorized as subtherapeutic (< 12 mg/L), therapeutic (12-46 mg/L), or supratherapeutic (> 46 mg/L). Data on demographics, clinical parameters, renal function (estimated glomerular filtration rate [eGFR] calculated with the CKD-EPI 2009 equation and used as a surrogate for creatinine clearance), and concurrent ASM use were analyzed. Predictors of log-transformed LEV concentration were assessed using multiple linear regression. A total of 66 patients were included, with 59.1% achieving therapeutic LEV levels. Subtherapeutic and supratherapeutic levels were observed in 25.8% and 15.2% of patients, respectively. Advanced age and renal dysfunction (eGFR < 30 mL/min/1.73 m²) were significantly associated with supratherapeutic levels (p = 0.044 and p < 0.001, respectively). In multiple linear regression on log-transformed concentrations, renal dysfunction (+ 150%), in-hospital death, treatment rather than prophylactic indication, and daily LEV dose were independent predictors of serum LEV concentration (adjusted R² = 0.325, p < 0.001). LEV concentration did not discriminate seizure occurrence (area under the receiver operating characteristic curve 0.568, 95% CI 0.415-0.722). LEV concentrations showed substantial variability in ICU patients and were independently associated with renal function, LEV dose, indication, and discharge status. However, serum LEV concentration did not discriminate seizure occurrence. These findings support individualized interpretation of LEV TDM results, particularly at the extremes of renal function, but do not demonstrate that achieving the predefined reference range improves seizure control or clinical outcomes.

PMID 43009842
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PubMedPharmacoepidemiology and drug safety2026-11-11

Antiseizure Medication Dispensing Before and After Initiation of Antidementia Medicines: A Population-Based Matched Cohort Study.

Almeida Osvaldo P OP, Etherton-Beer Christopher C, Sanfilippo Frank M FM, Preen David B DB et al.

Seizures and behavioural and psychiatric features may prompt antiseizure medication (ASM) use in dementia. We examined whether increased ASM dispensing precedes or follows initiation of antidementia treatment to inform hypotheses about when these indications emerge. Using the Australian Pharmaceutical Benefits Scheme (PBS) 10% sample, we matched people aged ≥ 50 years with incident antidementia dispensing in 2018-2021 1:1 to controls without antidementia dispensing (2013-2024) by age, sex, index year and diabetes and hypertension treatment. We compared annual ASM dispensing (ATC N03, excluding gabapentinoids) from 5 years before to 3 years after initiation using McNemar's test and interrupted time series analysis. Sensitivity analyses re-matched on Rx-Risk comorbidity and removed the survival requirement. Among 4385 matched pairs (59.8% women; mean age 78.3 years), ASM dispensing was higher in cases 5 years before initiation (2.7% vs. 1.8%; ratio 1.53, 95% CI = 1.15-2.03) and the difference widened after initiation (year 3: 9.1% vs. 2.4%; ratio 3.85, 95% CI = 3.13-4.75). Valproate accounted for most of the excess (year 3 ratio 6.97, 95% CI = 4.80-10.12). Levetiracetam dispensing rose gradually from year -3 and was higher after initiation (year 3 ratio 2.30, 95% CI = 1.51-3.50). Matching on comorbidity attenuated pre-initiation differences (year -5 ratio 1.42). The excess was greater at ages 50-79 years. ASM dispensing, most noticeably valproate, was higher in people with antidementia medicine dispensing than in controls, modestly before and markedly after initiation. Behavioural and psychiatric indications seem to predominate, with a smaller seizure-related contribution possibly beginning before treatment, although dispensing data cannot confirm indications. Valproate use warrants review.

PMID 43010636
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PubMedNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2026-11-10

From phenytoin to pragmatism: evolution of second-line antiseizure medications for established convulsive status epilepticus.

Ngadimon Irma Wati IW, Lim Kheng-Seang KS, Yow Hui-Yin HY, Fong Si-Lei SL

The choice of intravenous (IV) second‑line antiseizure medication (ASM) in established convulsive status epilepticus (CSE) remains a key determinant of outcome yet has evolved largely in response to pragmatic constraints rather than definitive comparative superiority. Over the past seven decades, management has shifted from barbiturates and paraldehyde to phenytoin, and subsequently to fosphenytoin, valproate, levetiracetam, and, more recently, lacosamide. Early International League Against Epilepsy (ILAE) task force reports highlighted marked global variability in practice and emphasised rapid treatment escalation but did not endorse a preferred second-line agent. Contemporary evidence, including the American Epilepsy Society (AES) guideline and the Established Status Epilepticus Treatment Trial (ESETT), has reshaped second-line treatment, with ESETT demonstrating similar observed treatment success with fosphenytoin, valproate, and levetiracetam. Lacosamide has also emerged as a potential alternative, although randomised evidence is derived from nonconvulsive seizures and is therefore indirect for established CSE. This review synthesises the evolution of second‑line ASMs in established CSE following adequate benzodiazepine treatment, integrating pharmacological rationale, clinical trial evidence, and guideline development, while highlighting ongoing uncertainties in optimal agent selection and the positioning of newer therapies.

PMID 43004026
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PubMedEpilepsy & behavior : E&B2026-11-10

Optimizing antiseizure treatment in women of reproductive age and during pregnancy: Nationwide practice versus specialized epilepsy care in Poland.

Wójcik-Kawa Katarzyna K, Sienkiewicz-Jarosz Halina H, Słowik Agnieszka A, Bosak Katarzyna K et al.

To compare antiseizure medication (ASM) treatment patterns among women with epilepsy (WWE) of reproductive age and pregnant WWE using nationwide administrative data and a university epilepsy referral center cohort in Poland. This retrospective study analyzed two complementary datasets. Nationwide data were obtained from the Polish National Health Fund, including 44,951 WWE aged 20-49 years in 2024 and 594 pregnant WWE who delivered in 2022. Referral center data were collected from medical records of 277 WWE aged 20-49 years treated in 2024 and 112 pregnancies managed between 2019 and 2026. Levetiracetam and lamotrigine were the most frequently prescribed ASMs in both cohorts. Compared with the nationwide population, women of reproductive age treated at the epilepsy center were significantly less likely to receive valproate (18.4 % vs. 31.1 %, p < 0.001) or carbamazepine (6.5 % vs 16 %p < 0.001), while lacosamide, brivaracetam, and cenobamate were prescribed more frequently. The proportion of women receiving monotherapy was similar in both cohorts. Among pregnant WWE, non-valproate monotherapy predominated in both groups but was significantly more common at the referral center (77.7 % vs. 62.0 %, p < 0.001). Valproate use during pregnancy was markedly lower in the referral center than in the nationwide cohort (2.7 % vs. 16.0 %, p < 0.001), whereas levetiracetam and lamotrigine use was comparable. Women managed at an epilepsy referral center were substantially less likely to receive potentially teratogenic ASMs, particularly valproate, despite representing a more clinically complex population. These findings highlight the contribution of specialized epilepsy care to optimizing pharmacological management for women of reproductive age and during pregnancy while supporting adherence to contemporary treatment recommendations.

PMID 43008432
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PubMedPediatric health, medicine and therapeutics2026-11-09

Sustained Seizure Freedom and Associated Factors Among Children and Adolescents Attending a Pediatric Neurology Clinic in Uganda: A Retrospective Cross-Sectional Study.

Abraham Nyok Atong A, Augustine Okejomoe Owiny O, Namisi Patrick Charles PC, Sebunya Robert R

Sustained seizure freedom is a central aim of childhood epilepsy care, yet long-term outcome data from specialist pediatric services in Uganda remain limited. We estimated the prevalence of documented sustained seizure freedom and examined associated factors among children and adolescents attending a specialist pediatric neurology clinic in Uganda. We reviewed records of children and adolescents attending the Pediatric Neurology Clinic at St. Francis Hospital Nsambya. The outcome was documented freedom from all epileptic seizures for at least 24 consecutive months. Under the investigator-confirmed recording rule, blank outcome fields were classified as not achieving sustained seizure freedom. Exploratory modified Poisson models with robust standard errors examined associations among records with usable covariates. Of 520 records screened, 496 were included; 385 met the documented endpoint (77.6%; 95% CI 73.7-81.1). Structured medicine selections were available for 395 records. Levetiracetam, sodium valproate, carbamazepine, and lamotrigine were selected in both monotherapy and polytherapy records; clobazam and diazepam were additionally selected in polytherapy in these fields. The available-case adjusted analysis included 389 records, of which 379 met the endpoint. Onset at 1-4 years versus <1 year had an adjusted prevalence ratio (aPR) of 1.08 (95% CI 1.00-1.17); polytherapy versus monotherapy had an aPR of 0.93 (95% CI 0.86-1.00). Point estimates were similar across age-variable specifications, but confidence intervals were close to or crossed the null. More than three-quarters of reviewed records met the documented 24-month seizure-free endpoint. Estimated associations with onset age and polytherapy were small, with uncertainty close to the null across model specifications. They should be interpreted cautiously because the adjusted subset differed from the full cohort and contained few records not meeting the endpoint.

PMID 43001210
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PubMedBritish journal of clinical pharmacology2026-11-08

Assessing kidney function for drug dosing in critical illness.

Lin Ming-Shen MS, Liao Kuo-Fan KF

Kidney-function assessment supports drug dosing in critical illness but does not directly measure drug clearance. Reduced creatinine generation, fluid shifts and rapidly changing filtration can make creatinine-based estimates misleading, whereas genuinely augmented renal clearance can cause insufficient drug exposure. These processes can coexist. This narrative review distinguishes estimated glomerular filtration rate from estimated or measured creatinine clearance and explains how equation version, body-surface-area indexing and sampling time affect interpretation. It separates the 2021 creatinine, 2012 cystatin C and 2021 creatinine-cystatin C equations of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and considers when each can inform a clinical decision. Cystatin C provides complementary information, not an intensive-care reference standard; timed urinary creatinine clearance is also vulnerable to collection error and changing physiology. We present a resource-adapted assessment framework rather than a validated dosing algorithm. It accommodates delayed cystatin C results, unavailable or unreliable urine collections, non-steady-state kidney function and access to therapeutic drug monitoring. Augmented renal clearance is treated as a continuum, with drug-specific thresholds distinguished from research definitions. Examples involving antibiotics, levetiracetam and gabapentin show why a kidney-function estimate must match the metric used in the relevant label or pharmacokinetic model. The practical objective is a documented, revisable dosing decision that integrates estimated kidney function, drug exposure and the consequences of under- or over-treatment, without assuming that biomarker discordance identifies its own cause.

PMID 42995301
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