Alternatives to Spritam If You Can't Fill Your Prescription

Spritam is an innovative 3D-printed anti-seizure medication that's genuinely hard to find at many retail pharmacies. If you can't get your Spritam prescription filled, knowing your options — and the right way to approach them — can make all the difference. This guide walks through the realistic alternatives to Spritam, from same-ingredient formulations to different medications entirely.

Important: Never stop taking your anti-seizure medication abruptly or switch formulations without consulting your neurologist or prescribing doctor. Sudden discontinuation can cause withdrawal seizures, including dangerous seizure clusters or status epilepticus.

Alternative 1: Standard Levetiracetam Tablets (Generic Keppra)

The most straightforward alternative is standard levetiracetam immediate-release tablets — sold under the brand name Keppra and widely available as a generic. This is the same active ingredient at the same doses (250 mg, 500 mg, 750 mg, 1000 mg). The critical difference is the formulation: standard levetiracetam tablets do not dissolve in seconds the way Spritam does. Standard tablets take up to 60 seconds to break down.

For patients who were prescribed Spritam specifically because they have difficulty swallowing conventional tablets — whether due to dysphagia, neurological conditions, or being a young child — switching to standard tablets may not be a viable option. But for patients who chose Spritam for convenience or seizure emergency use and can actually swallow a conventional tablet, this switch is usually safe and dramatically cheaper (generic levetiracetam can cost as little as $6–$7 per month with GoodRx).

Best for: Patients who can swallow conventional tablets and tolerate twice-daily levetiracetam

Availability: Widely available at virtually all pharmacies as a generic

Cost: As low as $6–$7/month with GoodRx or SingleCare coupons

Alternative 2: Keppra XR (Levetiracetam Extended-Release)

Keppra XR is the extended-release version of levetiracetam, taken once daily rather than twice. It's FDA-approved for adjunctive treatment of partial-onset seizures in adults and adolescents 12 and older. Generic versions are available, though some patients find the ER formulation causes different tolerability. The once-daily dosing can improve adherence. However, it cannot be crushed or dissolved, making it a poor choice for patients who need the rapid-dissolve feature of Spritam.

Best for: Adults and teens 12+ with partial-onset seizures who prefer once-daily dosing and can swallow tablets

Cost: ~$15–$22/month with coupons; generic available

Alternative 3: Levetiracetam Oral Solution

Levetiracetam oral solution (100 mg/mL) is another way to get the same active ingredient in a form that doesn't require swallowing a tablet. It can be measured and given via oral syringe or through a feeding tube. The liquid form is widely available as a generic. While it lacks the rapid-dissolve convenience of Spritam, it's a practical option for children and patients with severe swallowing difficulties. It must be measured carefully with each dose, which is a drawback compared to Spritam's pre-measured tablet form.

Best for: Children and patients who cannot swallow tablets at all, including those on tube feeds

Availability: Most pharmacies can order the oral solution; sometimes more available than Spritam

Alternative 4: Briviact (Brivaracetam)

Briviact (brivaracetam) is closely related to levetiracetam — it binds the same SV2A target but with 15–30 times higher affinity. It's approved for adjunctive treatment of focal (partial-onset) seizures in patients aged 1 month and older. Some neurologists prefer it for patients who experienced psychiatric side effects on levetiracetam, since clinical data suggest a somewhat lower risk of behavioral issues with brivaracetam. However, Briviact is a DEA Schedule V controlled substance and can also be difficult to find at retail pharmacies.

Best for: Patients with focal seizures who had behavioral side effects on levetiracetam

Note: Schedule V controlled substance; may require in-person prescription; also not widely stocked

Alternative 5: Vimpat (Lacosamide)

Vimpat (lacosamide) works differently from levetiracetam — it enhances the slow inactivation of voltage-gated sodium channels, reducing neuronal excitability. It's FDA-approved for focal-onset seizures in patients 1 month and older and primary generalized tonic-clonic seizures in patients 4 and older. It's available as tablets, an oral solution, and an IV formulation. Like Briviact, Vimpat is a Schedule V controlled substance. Generic versions of lacosamide are available.

Best for: Patients with focal or generalized tonic-clonic seizures; available in multiple formulations including IV

Alternative 6: Lamictal (Lamotrigine)

Lamotrigine (Lamictal) is a broad-spectrum antiepileptic that works by blocking voltage-gated sodium channels. It's FDA-approved for focal-onset seizures, generalized tonic-clonic seizures, and seizures in Lennox-Gastaut syndrome. Widely available as a generic, affordable, and not a controlled substance. The major drawback is that it requires a slow, careful titration over several weeks to reduce the risk of serious skin reactions (Stevens-Johnson syndrome). It is not a quick switch option if you need medication today.

Best for: Planned transitions with adequate titration time; broad-spectrum seizure coverage; not controlled

Note: NOT appropriate as an emergency same-day switch; requires slow titration

How to Discuss Alternatives With Your Neurologist

When you call your neurologist's office about a Spritam availability problem, be ready to answer these questions:

Why were you prescribed Spritam specifically? (Swallowing difficulty, rapid-dissolve need, tube feeding, etc.)

How much medication do you have left? (Days remaining determines urgency)

Have you had any seizure activity recently?

Can you swallow standard tablets, or is the rapid-dissolve feature medically necessary?

Before switching medications, it's worth exhausting every option to find Spritam. Try medfinder to search pharmacies near you, and read our guide: How to Find Spritam in Stock Near You. Many patients who think Spritam is unavailable in their area simply haven't found the right pharmacy yet.