Levetiracetam

S-Etriacetam / Pyrrolidone-derivative

AnticonvulsivoPOIVRectalPerrosGatos

También conocido como: Keppra XR · Desitrend · S-Etriacetam · UCB-22059 · UCBL059 · S-Etiracetam

Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia

20 mg/kg PO every 8 hoursPO· q8h

Peso corporal— 🐕

Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.

Dosis por especie

🌎 NA — North America🌍 EU — Europe

Perros

Indicación	Dosis	Vía	Frecuencia	Duración	Región
As an add-on treatment for epilepsy in dogs refractory to phenobarbital and bromides	20 mg/kg PO every 8 hours	PO	q8h	—	🌎 NA
As an add-on treatment for epilepsy in dogs refractory to phenobarbital and/or bromides	7.1-23.8 mg/kg PO every 8 hours	PO	q8h	—	🌎 NA
Seizure management	10-20 mg/kg PO q8h	PO	q8h	—	🌎 NA
Seizure management	Initially, 20 mg/kg PO q8h. May increase dose in 20 mg/kg increments until efficacy achieved, side effects become apparent, or the drug becomes cost prohibitive.	PO	q8h	—	🌎 NA
Seizure management	20 mg/kg PO q8h; may also be given as an IV bolus (20 mg/kg).	PO/IV	q8h	—	🌎 NA
Single-dose pharmacokinetic study	60 mg/kg IV bolus dose	IV	Once	—	🌎 NA
For status epilepticus	Initially, lorazepam at 0.2 mg/kg IV once, followed by a bolus IV loading dose of levetiracetam at 60 mg/kg.	IV	Once	—	🌎 NA

Single-dose pharmacokinetic study: Well tolerated and achieves plasma drug concentrations within or above the therapeutic range reported for humans for at least 8 hours.

Gatos

Indicación	Dosis	Vía	Frecuencia	Duración	Región
As an add-on to phenobarbital treatment for epilepsy	Initially, 20 mg/kg PO three times daily; slowly increase to effect	PO	TID	—	🌎 NA
As an adjunct to phenobarbital in suspected idiopathic epilepsy	Initially, 20 mg/kg PO three times daily. Monitor as below. If ineffective, increase dose in 20 mg/kg increments.	PO	TID	—	🌎 NA

Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.

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Resumen

Levetiracetam es un anticonvulsivo novedoso y estructuralmente único, utilizado principalmente como terapia adyuvante en medicina veterinaria.

Perros: Se utiliza como agente de tercera línea para la epilepsia refractaria o cuando el fenobarbital o el bromuro de potasio están contraindicados o son mal tolerados. Tenga en cuenta que los perros pueden desarrollar un 'efecto luna de miel' donde la eficacia disminuye con el tiempo.
Gatos: Se utiliza típicamente como complemento de segunda línea cuando el fenobarbital es insuficiente, o como monoterapia si el fenobarbital no es tolerado.

Perla clínica: El levetiracetam es altamente preferido para pacientes con insuficiencia hepática porque experimenta un metabolismo hepático mínimo y no depende del sistema enzimático del citocromo P450. Sin embargo, su vida media corta requiere una dosificación frecuente (TID), lo cual puede ser un desafío para los propietarios.

Mecanismo de acción

The exact mechanism of levetiracetam's antiseizure activity is not fully elucidated, but it is distinct from traditional anticonvulsants (which typically affect GABA or ion channels).

Binds specifically to Synaptic Vesicle Protein 2A (SV2A) in the central nervous system.
Binding to SV2A → modulates neurotransmitter release into the synaptic cleft → selectively prevents hypersynchronization of epileptiform burst-firing and propagation of seizure activity.
It does not affect normal neuronal excitability.

Seguridad y advertencias

Contraindicaciones

Hypersensitivity to levetiracetam or any of its components
Severe renal disease

Efectos adversos

Sedation (most common in dogs)
Lethargy (most common in cats)
Decreased appetite (most common in cats)
Behavior changes
Gastrointestinal effects
Sedation (dogs)
Ataxia (dogs)
Reduced appetite (cats)
Hypersalivation (cats)
Lethargy (cats)

Precauciones

Renal Impairment: Clearance is primarily renal (glomerular filtration and active tubular secretion). Dosage amounts or intervals must be adjusted in patients with decreased creatinine clearance.

Pregnancy/Nursing: FDA Category C. High doses in animal models showed embryofetal mortality and minor skeletal abnormalities. Excreted in maternal milk; use with caution in nursing patients.
Withdrawal: Abrupt discontinuation may precipitate withdrawal seizures; taper slowly if discontinuing.

Interacciones farmacológicas

NSAIDs (naproxen, ketorolac)

May increase the risk for seizures (reported in humans; veterinary significance unclear).

PhenobarbitalModerate

Significantly increases levetiracetam clearance and reduces its half-life in dogs (from 3.43 hrs to 1.73 hrs); dosage adjustments may be required.

Monitorización

Therapeutic drug monitoring (target range 5-45 mcg/mL) approximately one week after starting, then every 6-12 months (primarily to adjust dosage)
Seizure activity log (frequency, duration, severity)
Routine CBC and basic metabolic panel every 6 months
Adverse effects (sedation, lethargy, appetite changes)
Seizure frequency and severity
Renal function (BUN, Creatinine, SDMA) especially in older patients
Therapeutic drug monitoring is rarely required but can be performed

Farmacocinética

Vida media

Gatos~3 hours (wide inter-patient variation)Perros2-5 hours

Absorción

Well absorbed after oral dosing; peak levels occur in about 2 hours in dogs and cats. In humans, food delays the rate but not the extent of absorption.

Distribución

Volume of distribution is about 0.9 L/kg in dogs. Less than 10% bound to plasma proteins in humans.

Metabolismo

Not extensively metabolized. The acetamide group is enzymatically hydrolyzed to an inactive carboxylic acid metabolite. Hepatic CYP P450 isoenzymes are not involved.

Eliminación

Primarily excreted unchanged via renal mechanisms (glomerular filtration and active tubular secretion). Clearance is significantly reduced in renal impairment.

Sobredosis

Levetiracetam is a relatively safe agent.

Dogs: Doses of 1200 mg/kg/day (~20x therapeutic dose) caused only salivation and vomiting.
Humans: Doses of 6000 mg/kg caused drowsiness. Other reported effects include depressed consciousness, agitation, aggression, and respiratory depression.
Treatment: Basically supportive. The drug can be removed with hemodialysis. Contact an animal poison control center for significant overdoses.

Productos disponibles

Formulaciones

Oral Tablets (film-coated, scored)
Extended-Release Oral Tablets
Concentrate for Injection
Oral tablets: 250 mg, 500 mg, 750 mg, 1 g
Oral solution: 100 mg/ml (300 ml bottle)
Coated granules: 250 mg/sachet
Injectable solution: 100 mg/ml (5 ml vial)
Infusion solution: formulated with sodium chloride at 500 mg/100 ml, 1000 mg/100 ml, 1500 mg/100 ml

Etiquetado para humanos

Levetiracetam Oral Tablets (film-coated, scored): 250 mg, 500 mg, 750 mg & 1000 mg (Keppra, generic)
Levetiracetam Extended-Release Oral Tablets: 500 mg & 750 mg (Keppra XR)
Levetiracetam Oral Solution: 100 mg/mL (Keppra, generic)
Levetiracetam Concentrate for Injection: 100 mg/mL in 5 mL single-use vials (Keppra)
Desitrend
Keppra (250 mg, 500 mg, 750 mg, 1 g tablets; 100 mg/ml oral solution; 100 mg/ml IV solution)

Estado regulador

European Union✓ AprobadoMedicamento de prescripciónEMA

🐕 Dogs🐈 Cats

POM (Prescription Only Medicine)

United Kingdom✓ AprobadoMedicamento de prescripciónVMD