Last update: Nov. 16, 2014

Levetiracetam

Very Low Risk for breastfeeding


Safe. Compatible.
Not risky for breastfeeding or infant.

Piracetam analog with nootropic and anti-epileptic effect. Authorized for use in children in Europe.

Excreted into breast milk but infant serum levels were shown to be low. No other side effect than one case of hypotonia in a 7 days old premature whose mother was also on anti-epileptic medication.

Seizures along with neonatal abstinence syndrome in a botlle fed neonate whose mother had taken Levetiracetam and Phenobarbital in pregnancy ocurred. Symptoms disappeared after initiation of breastfeeding.

Alternatives

We do not have alternatives for Levetiracetam since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Group

Levetiracetam belongs to this group or family:

Tradenames

Main tradenames from several countries containing Levetiracetam in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 170 daltons
Protein Binding 10 %
VD 0,5 - 0,7 l/Kg
Tmax 1,3 hours
T1/2 6 - 8 hours
M/P ratio 0,9 - 1,4 -
Theoretical Dose 2 - 3,9 mg/Kg/d
Relative Dose 4 - 8 %
Relat.Ped.Dose 5 - 10 %

References

  1. Crettenand M, Rossetti AO, Buclin T, Winterfeld U. [Use of antiepileptic drugs during breastfeeding : What do we tell the mother?] Nervenarzt. 2018 Abstract
  2. Kohn E, Brandriss N, Soback S, Bar-Haim A, Berkovitch M. Levetiracetam and lamotrigine excretion in breast milk. Reprod Toxicol. 2016;60:184. 2016
  3. Jacob S, Nair AB. An Updated Overview on Therapeutic Drug Monitoring of Recent Antiepileptic Drugs. Drugs R D. 2016 Abstract Full text (link to original source) Full text (in our servers)
  4. Agencia europea del medicamento. Levetiracetam. Ficha técnica. 2014 Full text (in our servers)
  5. European Medicines Agency. Levetiracetam. Drug summary 2014 Full text (in our servers)
  6. Reimers A. New antiepileptic drugs and women. Seizure. 2014 Abstract Full text (link to original source) Full text (in our servers)
  7. Paret N, Gouraud A, Bernard N, Bruel M, Cottin J, Descotes J, Vial T. Long-term follow-up of infants exposed to levetiracetam during breastfeeding: Comparison to a control group. (The 2nd International OTIS-ENTIS Conference at The Hospital for Sick Children, Toronto, Canada) Birth Defects Res A Clin Mol Teratol. 2014;100:537-8. Abstract 38. DOI: doi:10.1002/bdra.23258 2014
  8. Rapcencu AE, Lindhout D, Bulk S. Frequently asked questions on epilepsy, pregnancy and lactation: a EURAP-NL report. Seizure. 2012 Abstract Full text (link to original source) Full text (in our servers)
  9. Rauchenzauner M, Kiechl-Kohlendorfer U, Rostasy K, Luef G. Old and new antiepileptic drugs during pregnancy and lactation--report of a case. Epilepsy Behav. 2011 Abstract
  10. López-Fraile IP, Cid AO, Juste AO, Modrego PJ. Levetiracetam plasma level monitoring during pregnancy, delivery, and postpartum: clinical and outcome implications. Epilepsy Behav. 2009 Abstract
  11. O'Connor SE, Zupanc ML. Women and epilepsy. J Pediatr Pharmacol Ther. 2009 Abstract Full text (link to original source) Full text (in our servers)
  12. Harden CL, Pennell PB, Koppel BS, Hovinga CA, Gidal B, Meador KJ, Hopp J, Ting TY, Hauser WA, Thurman D, Kaplan PW, Robinson JN, French JA, Wiebe S, Wilner AN, Vazquez B, Holmes L, Krumholz A, Finnell R, Shafer PO, Le Guen C; American Academy of Neurology; et al. Practice parameter update: management issues for women with epilepsy--focus on pregnancy (an evidence-based review): vitamin K, folic acid, blood levels, and breastfeeding: report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of... Neurology. 2009 Abstract Full text (link to original source) Full text (in our servers)
  13. Crawford PM. Managing epilepsy in women of childbearing age. Drug Saf. 2009 Abstract
  14. Sabers A, Tomson T. Managing antiepileptic drugs during pregnancy and lactation. Curr Opin Neurol. 2009 Abstract
  15. Tomson T, Palm R, Källén K, Ben-Menachem E, Söderfeldt B, Danielsson B, Johansson R, Luef G, Ohman I. Pharmacokinetics of levetiracetam during pregnancy, delivery, in the neonatal period, and lactation. Epilepsia. 2007 Jun;48(6):1111-6. Epub 2007 Mar 22. Abstract Full text (link to original source) Full text (in our servers)
  16. Pennell PB. Is breast milk the best for babies of mothers on levetiracetam? Epilepsy Curr. 2006 Abstract
  17. Pennell PB. 2005 AES annual course: evidence used to treat women with epilepsy. Epilepsia. 2006 Abstract Full text (link to original source) Full text (in our servers)
  18. Pack AM. Therapy insight: clinical management of pregnant women with epilepsy. Nat Clin Pract Neurol. 2006 Abstract
  19. Tomson T. Gender aspects of pharmacokinetics of new and old AEDs: pregnancy and breast-feeding. Ther Drug Monit. 2005 Abstract
  20. O'Brien MD, Gilmour-White SK. Management of epilepsy in women. Postgrad Med J. 2005 Abstract Full text (link to original source) Full text (in our servers)
  21. Crawford P. Best practice guidelines for the management of women with epilepsy. Epilepsia. 2005 Abstract Full text (link to original source) Full text (in our servers)
  22. Johannessen SI, Helde G, Brodtkorb E. Levetiracetam concentrations in serum and in breast milk at birth and during lactation. Epilepsia. 2005 Abstract Full text (link to original source) Full text (in our servers)
  23. Greenhill L, Betts T, Yarrow H et al. Breast milk levels of levetiracetam after delivery. Epilepsia. 2004;45 (suppl 7):230. Abstract 2115. 2004 Full text (in our servers)
  24. Pennell PB. Antiepileptic drug pharmacokinetics during pregnancy and lactation. Neurology. 2003 Abstract
  25. Kramer G, Hosli I, Glanzmann R et al. Levetiracetam accumulation in human breast milk. Epilepsia. 2002;43 (Suppl 7):105. Abstract 1288. 2002 Full text (in our servers)

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