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Levetiracetam for Dogs

By Barbara Forney, VMD

Commonly prescribed for: Refractory Epilepsy

Species: Dogs

Therapeutic Class: Anti-convulsant


Basic Information

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.

Precautions

  • 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.

Drug Interactions

No drug interactions were found in humans or dogs in the literature.

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