Levetiracetam

What is this medication for?

• Add-on anticonvulsant for refractory epilepsy (esp. when phenobarbital/bromide fail or not tolerated); status epilepticus
• Add-on to phenobarbital, or sole therapy if phenobarbital not tolerated

How is it given?

Give exactly as your veterinarian prescribed — never change the dose or stop on your own unless your veterinarian has told you to.

What if I miss a dose?

• Give it as soon as you remember — unless it is almost time for the next dose (then skip the missed one; never double up).
• Call your clinic if you miss more than one dose in a row.

Side effects — what should I watch for?

Effects listed as common in this handout

• Overall very well tolerated

Worth a phone call to your veterinarian

• Sedation (Uncommon, may be transient)
• Decreased appetite, low energy/tiredness, hypersalivation (Uncommon)

⚠️ Contact your veterinarian or an emergency clinic IMMEDIATELY if you notice

• Trouble breathing, collapse, seizures, severe vomiting or diarrhea, facial swelling, or pale gums

Before starting (or refilling), tell your veterinarian if your pet:

• has or has had: Known hypersensitivity
• has or has had: Renal impairment — adjust dose/frequency; taper slowly if discontinuing (withdrawal seizures reported in humans)

• is pregnant, nursing, or used for breeding
• is taking any other medications, supplements, or flea/tick products, including:
  • Phenobarbital
  • NSAIDs (naproxen, ketorolac — human data)

Storage and handling

Store 25°C (excursions 15–30°C).

Good to know

• every 8 hours dosing is the biggest compliance barrier — discuss realistic scheduling with owners before prescribing; XR formulation (every 12 hours) is an option in dogs if compliance is a concern.
• "Honeymoon effect" — some dogs show reduced efficacy over time; be prepared to adjust the regimen.
• One of the safest/best-tolerated add-on anticonvulsants available — good choice when phenobarbital liver damage is a concern.