How long does it take for Keppra (levetiracetam) to become therapeutic?

From the Guidelines

Levetiracetam (Keppra) becomes therapeutic within 24 hours of loading, as evidenced by no seizures within 24 hours of loading in a study of oral loading 1. When considering the time it takes for Keppra to become therapeutic, it's essential to look at the pharmacokinetics and clinical efficacy of the medication.

• The medication achieves therapeutic levels quickly, with a loading dose of 1,500 mg oral load or rapid IV loading safe and well-tolerated in doses up to 60 mg/kg 1.
• The study found that there were no seizures within 24 hours of loading in patients who received oral loading 1.
• While the drug reaches therapeutic blood levels quickly, the full clinical effect in controlling seizures may take some time to develop.
• It's crucial to note that the choice of administration, whether oral or parenteral, is at the discretion of the emergency physician, as there is a lack of evidence to support one route over the other in terms of preventing early recurrent seizure 1. Some key points to consider when administering Keppra include:
• The standard loading dose and route of administration strategies for Keppra in the emergency department setting 1.
• The potential adverse effects of the medication, such as fatigue, dizziness, and rarely, pain at the infusion site 1.
• The importance of consistent dosing and not stopping the medication abruptly to maintain optimal seizure control.

From the FDA Drug Label

Plasma half-life of levetiracetam across studies is approximately 6 to 8 hours. Steady state is achieved after 2 days of multiple twice-daily dosing. The time it takes for Keppra (levetiracetam) to become therapeutic is not directly stated, but steady state is achieved after 2 days of multiple twice-daily dosing, and the plasma half-life is approximately 6 to 8 hours 2.

From the Research

Time to Therapeutic Effect of Keppra

The time it takes for Keppra (levetiracetam) to become therapeutic can vary depending on several factors, including the individual patient, the dosage, and the specific condition being treated.

• In a study published in 2008 3, a clinical effect, including a decrease in seizure frequency, was observed within the first 24 hours of treatment with Keppra.
• Another study from 2000 4 found that levetiracetam (Keppra) was effective in reducing seizure frequency at doses ranging from 1000 to 4000 mg per day, with a substantially lower median seizure frequency observed at all dosing periods compared to placebo treatment.
• A 2011 study 5 on the efficacy of intravenous levetiracetam as an add-on treatment in status epilepticus found that it was effective in approximately half of the patients, with a mean time to efficacy of 14.4 hours.

Factors Influencing Time to Therapeutic Effect

Several factors can influence the time it takes for Keppra to become therapeutic, including:

• Dosage: The dosage of Keppra can affect the time to therapeutic effect, with higher doses potentially leading to faster efficacy.
• Individual patient factors: The individual patient's response to Keppra can vary, with some patients experiencing a therapeutic effect more quickly than others.
• Condition being treated: The specific condition being treated, such as epilepsy or status epilepticus, can also influence the time to therapeutic effect.

Overall Efficacy of Keppra

Overall, Keppra has been shown to be an effective treatment for various conditions, including epilepsy and status epilepticus, with a therapeutic effect observed in many patients within a relatively short period of time.

• A study from 2012 6 found that levetiracetam (Keppra) was a valid alternative to carbamazepine in poststroke seizures, with a similar efficacy and fewer side effects.
• A 2003 study 7 found that levetiracetam (Keppra) offered sustained efficacy in patients with refractory partial seizures, with a median percent reduction from baseline in seizure frequency per week of 39.6% over the whole treatment period.