Keppra

levetiracetam

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This is a summary of the European public assessment report (EPAR) for Keppra. It explains how the Committee for Medicinal Products for Human Use (CHMP) assessed the medicine to reach its opinion in favour of granting a marketing authorisation and its recommendations on the conditions of use for Keppra.

What is Keppra?

Keppra is a medicine that contains the active substance levetiracetam. It is available as tablets (250 mg, 500 mg, 750 mg and 1,000 mg), as an oral solution (100 mg/ml), and as a concentrate that is made up into a solution for infusion (drip into a vein, 100 mg/ml).

What is Keppra used for?

Keppra can be used on its own in patients from 16 years of age with newly diagnosed epilepsy, to treat partial-onset seizures (fits) with or without secondary generalisation. This is a type of epilepsy where too much electrical activity in one side of the brain causes symptoms such as sudden, jerky movements of one part of the body, distorted hearing, sense of smell or vision, numbness, or a sudden sense of fear. Secondary generalisation occurs when the overactivity later reaches the whole brain.

Keppra can also be used as an add-on to other anti-epileptic medicines to treat:

  • partial-onset seizures with or without generalisation in patients from one month of age;
  • myoclonic seizures (short, shock-like jerks of a muscle or group of muscles) in patients from 12 years of age with juvenile myoclonic epilepsy;
  • primary generalised tonic-clonic seizures (major fits, including loss of consciousness) in patients from 12 years of age with idiopathic generalised epilepsy (the type of epilepsy that is thought to have a genetic cause).

The medicine can only be obtained with a prescription.

How is Keppra used?

When Keppra is used on its own, the starting dose is 250 mg twice a day, increasing two weeks later to 500 mg twice a day. The dose can be further increased at two-week intervals according to the patient’s response, to a maximum dose of 1,500 mg twice a day.

When Keppra is added to another anti-epileptic treatment, the starting dose in patients over 12 years weighing more than 50 kg is 500 mg twice a day. The daily dose can be increased up to 1,500 mg twice a day. In patients aged between six months and 17 years weighing less than 50 kg, the starting dose is 10 mg per kilogram body weight twice a day, which can be increased up to 30 mg/kg twice a day. The oral solution is recommended when starting treatment in children under six years old or weighing less than 25 kg. In babies aged between one and six months, the starting dose is 7 mg/kg twice a day, using the oral solution. This can be increased up to 21 mg/kg twice a day.

Lower doses are used in patients who have problems with their kidneys (such as older patients).

Keppra tablets are swallowed with liquid. The oral solution may be mixed in a glass of water before it is taken. Keppra can be given as an infusion using the same doses at the same frequency when using the tablets or the oral solution is not possible. The use of the infusion should be temporary.

How does Keppra work?

The active substance in Keppra, levetiracetam, is an anti-epileptic medicine. Epilepsy is caused by excessive electrical activity in the brain. The exact way in which levetiracetam works is still unclear but it seems to interfere with a protein called synaptic vesicle protein 2A, which is found in the spaces between nerves and is involved in the release of chemical messengers from nerve cells. This helps Keppra to stabilise electrical activity in the brain and prevent seizures.

How has Keppra been studied?

Keppra used on its own has been studied in 579 patients with partial-onset seizures aged 16 years and over, who received either Keppra or carbamazepine (another anti-epileptic medicine) for up to two years. The study measured how many patients remained free of seizures for six months once they had reached their effective dose.

Keppra has also been studied as an add-on treatment:

  • in partial-onset seizures, it has been studied in three main studies in a total of 904 patients aged 16 years and over. In these studies, Keppra at doses of 1,000, 2,000 or 3,000 mg per day, was compared with placebo (a dummy treatment) over 12 to 14 weeks. All of the patients were taking at least one other anti-epileptic medicine. Keppra has also been compared with placebo in 314 patients aged between one month and 17 years;
  • in myoclonic seizures, Keppra was studied in 122 patients aged 12 years and over, who received either Keppra or placebo in addition to their normal anti-epileptic medicine for up to 30 weeks;
  • in primary generalised tonic-clonic seizures, Keppra was compared with placebo in 164 patients aged four years or over. The patient’s treatment was continued for 20 weeks once they were taking their full dose.

In all of these studies, the main measure of effectiveness was the change in the number of seizures before and during treatment.

What benefit has Keppra shown during the studies?

Keppra was as effective as carbamazepine in keeping patients free of seizures when taken on its own for partial onset seizures. In both groups, 73% of the patients experienced no seizures for six months once on an adequate dose.
As an add-on treatment, Keppra was more effective than placebo:

  • for partial-onset seizures, placebo treatment reduced the weekly number of seizures by 6 to 7%, while the reduction with Keppra at a dose of 1,000 mg per day was between 18 and 33%, depending on the study. With Keppra at a dose of 2,000 mg, the reduction was 27%, and with 3,000 mg, it was around 39%. Keppra was also more effective than placebo in children;
  • for myoclonic seizures, the number of seizure days per week was halved in 58% of the patients receiving Keppra and in 23% of the patients receiving placebo;
  • for tonic-clonic seizures, the number of seizures fell by an average of 28% in the patients receiving placebo, compared with 57% in those receiving Keppra. However, there were too few patients aged below 12 years to support the use of Keppra for this type of seizure in this age group.
What is the risk associated with Keppra?

The most common side effects with Keppra (seen in more than 1 patient in 10) are nasopharyngitis (inflammation of the nose and throat), somnolence (sleepiness), and headache. For the full list of all side effects reported with Keppra, see the package leaflet.

Keppra must not be used in people who are hypersensitive (allergic) to levetiracetam, to other pyrrolidone derivatives (medicines with a similar structure to levetiracetam), or to any of the other ingredients.

Why has Keppra been approved?

The CHMP decided that Keppra’s benefits are greater than its risks and recommended that it be given marketing authorisation.

Other information about Keppra

The European Commission granted a marketing authorisation valid throughout the European Union for Keppra on 29 September 2000.

For more information about treatment with Keppra, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist.

Name Language First published Last updated
Keppra : EPAR - Summary for the public BG = bălgarski 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public ES = español 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public CS = čeština 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public DA = dansk 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public DE = Deutsch 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public ET = eesti keel 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public EL = elliniká 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public EN = English 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public FR = français 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public IT = italiano 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public LV = latviešu valoda 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public LT = lietuvių kalba 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public HU = magyar 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public MT = Malti 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public NL = Nederlands 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public PL = polski 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public PT = português 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public RO = română 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public SK = slovenčina 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public SL = slovenščina 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public FI = suomi 18/09/2009 03/10/2013
Keppra : EPAR - Summary for the public SV = svenska 18/09/2009 03/10/2013

This EPAR was last updated on 03/08/2016 .

Authorisation details

Product details

Product details for Keppra
NameKeppra
Agency product numberEMEA/H/C/000277
Active substance

levetiracetam

International non-proprietary name (INN) or common name

levetiracetam

Therapeutic area Epilepsy
Anatomical therapeutic chemical (ATC) code N03AX14

Publication details

Publication details for Keppra
Marketing-authorisation holder

UCB Pharma SA

Revision37
Date of issue of marketing authorisation valid throughout the European Union29/09/2000

Contact address:

UCB Pharma SA
Allée de la Recherche 60
B-1070 Bruxelles
Belgium

Product information

Product information

23/06/2016  Keppra -EMEA/H/C/000277 -P46/0083

Name Language First published Last updated
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015
Keppra : EPAR - Product Information SV = svenska 18/09/2009 16/10/2015

Contents

  • Annex I - Summary of product characteristics
  • Annex IIA - Manufacturing-authorisation holder responsible for batch release
  • Annex IIB - Conditions of the marketing authorisation
  • Annex IIIA - Labelling
  • Annex IIIB - Package leaflet

Please note that the size of the above document can exceed 50 pages.

You are therefore advised to be selective about which sections or pages you wish to print.


Name Language First published Last updated
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013
Keppra : EPAR - All Authorised presentations SV = svenska 18/09/2009 06/02/2013

Pharmacotherapeutic group

Anti-epileptics

Therapeutic indication

Keppra is indicated as monotherapy in the treatment of partial-onset seizures with or without secondary generalisation in patients from 16 years of age with newly diagnosed epilepsy.

Keppra is indicated as adjunctive therapy:

  • in the treatment of partial-onset seizures with or without secondary generalisation in adults, children and infants from one month of age with epilepsy;
  • in the treatment of myoclonic seizures in adults and adolescents from 12 years of age with juvenile myoclonic epilepsy;
  • in the treatment of primary generalised tonic-clonic seizures in adults and adolescents from 12 years of age with idiopathic generalised epilepsy.

Assessment History

Changes since initial authorisation of medicine

Name Language First published Last updated
Keppra : EPAR - Procedural steps taken and scientific information after authorisation SV = svenska 18/09/2009 16/10/2015
Keppra-H-C-P46-083 : EPAR - Assessment Report SV = svenska 03/08/2016  
Keppra-H-C-277-P46-0079 : EPAR - Assessment Report SV = svenska 17/03/2016  
Keppra-H-C-277-P46-0080: EPAR - Assessment Report - Variation SV = svenska 16/02/2016  
Keppra-H-C-277-P46-0078 : EPAR - Assessment report SV = svenska 30/07/2015  
Keppra-H-C-277-P46-0077: EPAR - Assessment report SV = svenska 05/06/2015  
Keppra-H-C-277-P46-0072-0075 : EPAR - Scientific Discussion - Variation SV = svenska 01/08/2014  
Keppra-H-C-277-PSUV-0140 : EPAR - Scientific conclusions and grounds recommending the variation to the terms of the marketing authorisation SV = svenska 03/10/2013  
Keppra-H-C-277-P46-0062 : EPAR - Assessment Report SV = svenska 05/04/2013  
Keppra-H-C-277-P46-0060 : EPAR - Assessment Report SV = svenska 05/04/2013  
Keppra-H-C-277-P46-0065 : EPAR - Assessment Report SV = svenska 21/03/2013  
Keppra-H-C-277-P45-0052: EPAR - Assessment Report SV = svenska 05/11/2012  
Keppra-H-C-277-II-0097 : EPAR - Assessment Report - Variation SV = svenska 18/09/2009  
CHMP post-authorisation summary of positive opinion for Keppra on 23 July 2009 SV = svenska 24/07/2009  
Keppra-H-C-277-II-0071 : EPAR - Scientific Discussion - Variation SV = svenska 13/02/2007  
Keppra-H-C-277-X-0046 : EPAR - Scientific Discussion - Extension SV = svenska 12/09/2006  
Keppra-H-C-277-II-0061 : EPAR - Scientific Discussion - Variation SV = svenska 12/09/2006  
Keppra-H-C-277-II-0063 : EPAR - Scientific Discussion - Variation SV = svenska 12/09/2006  
Keppra-H-C-277-II-0044 : EPAR - Scientific Discussion - Variation SV = svenska 09/12/2005  
Keppra : EPAR - Steps taken after authorisation when a cutoff date has been used SV = svenska 21/10/2005  

Initial marketing-authorisation documents

Name Language First published Last updated
Keppra : EPAR - Procedural steps taken before authorisation SV = svenska 21/10/2005  
Keppra : EPAR - Scientific Discussion SV = svenska 21/10/2005  

Authorised

This medicine is approved for use in the European Union