What Is Levetiracetam? Uses, Dosage, and What You Need to Know in 2026

Levetiracetam is one of the most prescribed antiepileptic drugs (AEDs) in the United States and worldwide. First approved by the FDA in 1999, it has become a cornerstone of epilepsy treatment for adults and children alike. Whether you've just been prescribed levetiracetam or you're researching it for a loved one, here's a comprehensive overview of what it is, how it works, and what you need to know.

What Is Levetiracetam?

Levetiracetam is a prescription antiepileptic drug classified as a pyrrolidine anticonvulsant. It is chemically unrelated to older AEDs like phenytoin, carbamazepine, or valproic acid, and works through a unique mechanism. In 2023, it was the 101st most commonly prescribed medication in the U.S., with over 6 million prescriptions written.

It is sold under the following brand names:

• Keppra (immediate-release tablets and oral solution)
• Keppra XR / Elepsia XR (extended-release tablets)
• Spritam (orally disintegrating tablets, manufactured using 3D printing)
• Roweepra (another immediate-release branded generic)

Generic levetiracetam has been available in the U.S. since 2008 and is far less expensive than the brand-name versions.

What Is Levetiracetam Used For?

The FDA has approved levetiracetam for three specific types of seizures:

1. Partial-onset seizures (also called focal seizures) — in patients 1 month of age and older. These are seizures that start in one area of the brain.
2. Myoclonic seizures — in patients 12 years and older with juvenile myoclonic epilepsy. These are brief, jerky muscle movements.
3. Primary generalized tonic-clonic seizures — in patients 6 years and older with idiopathic generalized epilepsy. These are the classic "grand mal" seizures.

Levetiracetam can be used as monotherapy (the only AED) or as adjunctive therapy (added to another AED). It is also used off-label for status epilepticus and seizure prevention after traumatic brain injury.

What Forms Does Levetiracetam Come In?

Levetiracetam is available in multiple formulations to accommodate different patients:

• Immediate-release tablets: 250 mg, 500 mg, 750 mg, 1000 mg. Taken twice daily.
• Extended-release tablets: 500 mg, 750 mg. Taken once daily. May cause less peak drowsiness.
• Oral solution: 100 mg/mL. Grape-flavored; useful for children and adults who can't swallow tablets.
• Orally disintegrating tablets (Spritam): 250 mg, 500 mg, 750 mg, 1000 mg. Manufactured using 3D printing; dissolves in water on the tongue.
• Intravenous (IV) solution: For use in hospital settings when oral administration is not possible. IV and oral doses are equivalent.

Typical Dosage

Dosage varies by age, weight, and seizure type. Always follow your doctor's specific instructions:

• Adults (16+): Typically start at 500 mg twice daily. Can be increased by 500 mg every 2 weeks. Maximum dose: 3,000 mg/day.
• Children (4–15 years): Weight-based dosing; typically 10 mg/kg twice daily at start; max 60 mg/kg/day.
• Renal impairment: Dose reduction required for creatinine clearance below 80 mL/min, since levetiracetam is 66% excreted unchanged by the kidneys.

How to Take Levetiracetam

Levetiracetam can be taken with or without food. Swallow tablets whole—do not crush or chew extended-release tablets. Take at the same times each day to maintain steady blood levels. If you miss a dose, take it as soon as you remember—unless it's almost time for your next dose.

Never stop levetiracetam abruptly. Even if you feel fine, sudden discontinuation can trigger breakthrough seizures. If you need to stop, your doctor will create a gradual tapering schedule.

Is Levetiracetam a Controlled Substance?

No. Levetiracetam is not a DEA-scheduled controlled substance. It has no recognized abuse or addiction potential. This means no restrictions on refills, no special prescription requirements, and no DEA registration needed to prescribe it. You can transfer your prescription freely between pharmacies.

If your pharmacy is ever out of levetiracetam, use medfinder to find nearby pharmacies with stock. Want to understand how it works in the brain? Read: How Does Levetiracetam Work?.