Comparative Pharmacology
Head-to-head clinical analysis: LEVETIRACETAM versus VALPROATE SODIUM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LEVETIRACETAM versus VALPROATE SODIUM.
LEVETIRACETAM vs VALPROATE SODIUM
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Levetiracetam's precise mechanism of action is unknown. It binds to synaptic vesicle protein 2A (SV2A), which may modulate neurotransmitter release and reduce neuronal excitability. It also inhibits N-type calcium channels and reduces calcium influx, contributing to antiepileptic effects.
Increases GABA levels by inhibiting GABA transaminase and blocking voltage-gated sodium channels; also modulates T-type calcium channels.
500-1500 mg PO/IV BID; initial 500 mg BID, titrate by 500 mg BID every 2 weeks as tolerated; maximum 3000 mg/day.
10-15 mg/kg/day orally or intravenously in 2-3 divided doses; increase by 5-10 mg/kg/day weekly to therapeutic range of 50-100 mcg/mL. Maximum dose 60 mg/kg/day.
None Documented
None Documented
Clinical Note
moderateLevetiracetam + Venlafaxine
"The risk or severity of adverse effects can be increased when Levetiracetam is combined with Venlafaxine."
Clinical Note
moderateLevetiracetam + Nefazodone
"The risk or severity of adverse effects can be increased when Levetiracetam is combined with Nefazodone."
Clinical Note
moderateLevetiracetam + Ranolazine
"The serum concentration of Ranolazine can be increased when it is combined with Levetiracetam."
Clinical Note
moderateLevetiracetam + Stiripentol
6–8 hours in adults; prolonged to 10–11 hours in mild-to-moderate renal impairment (CrCl 30–50 mL/min) and 16–24 hours in severe impairment (CrCl <30 mL/min); neonates up to 16 hours.
Terminal elimination half-life is 9–16 hours in adults; may be shorter in children (5–12 hours) and prolonged in hepatic impairment or elderly (up to 18 hours). Neonatal half-life: 10–67 hours. Clinically, twice-daily dosing is typical.
Primarily renal (66% unchanged, 27% as inactive metabolite); minimal fecal (<2%).
Primarily renal (90% as glucuronide conjugates, 3-oxo derivative, and other metabolites; <3% unchanged). Biliary/fecal excretion accounts for <10%.
Category A/B
Category C
Anticonvulsant
Anticonvulsant
"The risk or severity of adverse effects can be increased when Levetiracetam is combined with Stiripentol."