Levetiracetam for Veterinary Use
by Barbara Forney, VMD
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Levetiracetam is a newer antiepileptic drug that is used in the management of refractory epilepsy in dogs and cats. A pyrridoline derivative, levetiracetam has a number of favorable pharmacokinetic characteristics. It has excellent bioavailability, minimal protein binding and a rapid onset of action. Levetiracetam is not extensively metabolized by the liver and does not utilize the p450 hepatic cytochrome system. It may be used in humans or animals with decreased liver function. Levetiracetam is excreted in the urine and there are no known drug interactions.
Levetiracetam is used in humans for partial onset and generalized seizures. It may be used as monotherapy or as an add on for refractory epilepsy. There is some experimental work in humans using intravenous levetiracetam for refractory status epilepticus.
Dogs and Cats
Levetiracetam is used as an add on drug for dogs and cats whose seizures are not adequately controlled by phenobarbital or the bromides; as many as 60-70% of dogs and cats with epilepsy are not controlled adequately by these medications. Levetiracetam also may be useful to treat seizures due to hepatic encephalopathy or cases of phenobarbital induced liver damage. The addition of levetiracetam may permit a lower dose of phenobarbital without an increase in seizure frequency.
This is a relatively new drug in veterinary medicine and there is little long-term information available. There are indications that some animals may develop a "tolerance" to levetiracetam and, after the initial honeymoon, the seizure frequency may rebound. Although it has a relatively short half-life in dogs and cats, the pharmacodynamic effect is thought to exceed the half-life. Most authors recommend dosing every eight hours.
Levetiracetam Side Effects
Based on experience in human medicine, levetiracetam generally is well tolerated. The most likely side effects include changes in behavior, drowsiness and GI upset. In studies performed with children, the behavior changes included hyperactivity, somnolence and aggression.
- Levetiracetam has been shown to cause increased embryonal and fetal losses in laboratory animals. It should be used during pregnancy only when the benefits outweigh the possible risks.
- Levetiracetam should be used with caution in animals with decreased kidney function. Adjustments in dose and dose frequency may be necessary.
- When discontinuing use of levetiracetam, a gradual withdrawal is recommended to guard against the possibility of withdrawal seizures.
No drug interactions were found in humans or dogs in the literature.
About the Author
Dr. Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania. She has a master's degree in animal science from the University of Delaware and graduated from the University of Pennsylvania School of Veterinary Medicine in 1982.
She began to develop her interest in client education and medical writing in 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
You can purchase books by Dr. Forney at www.exclusivelyequine.com The information contained on this site is general in nature and is intended for use as an informational aid. It does not cover all possible uses, actions, precautions, side effects, or interactions of the products shown, nor is the information intended as medical advice or diagnosis for individual health problems or for making an evaluation as to the risks and benefits of using a particular product. You should consult your doctor about diagnosis and treatment of any health problems. Information and statements have not been evaluated by the Food and Drug Administration ("FDA"), nor has the FDA approved the products to diagnose, cure or prevent disease.
Wedgewood Pharmacy compounded veterinary preparations are not intended for use in food and food-producing animals.