LEVETIRACETAM ZENTIVA 1000 MG FILM-COATED TABLETS - patient leaflet, side effects, dosage

1. WHAT LEVETIRACETAM IS AND WHAT IT IS USED FOR

Levetiracetam Zentiva 250 mg, 500 mg, 750 mg and 1000 mg film-coated tablets is an antiepileptic medicine (a medicine used to treat seizures in epilepsy).

Levetiracetam is used:

• on its own in adults and adolescents from 16 years of age with newly diagnosed epilepsy, to treat a certain form of epilepsy. Epilepsy is a condition where patients have repeated fits (seizures). Levetiracetam is used for the epilepsy form in which the fits initially affect only one side of the brain, but could thereafter extend to larger areas on both sides of the brain (partial onset seizures with or without secondary generalisation). Levetiracetam has been given to you by your doctor to reduce the number of fits.
• as an add-on to other antiepileptic medicines to treat:

• ■ partial onset seizures with or without generalisation in adults, adolescents, children and infants from one month of age.

• ■ myoclonic seizures (short, shock-like jerks of a muscle or group of muscles) in adults and adolescents from 12 years of age with juvenile myoclonic epilepsy

• ■ primary generalised tonic-clonic seizures (major fits, including loss of consciousness) in adults and adolescents from 12 years of age with idiopathic generalised epilepsy (the type of epilepsy that is thought to have a genetic cause).

2. what you need to know before you take levetiracetam

Do not take Levetiracetam:

• If you are allergic to levetiracetam, pyrrolidone derivatives or any of the other ingredients of this medicine (listed in section 6).

Warnings and precautions

Talk to your doctor before taking Levetiracetam:

• If you suffer from kidney problems, follow your doctor’s instruc­tions. He/she may decide if your dose should be adjusted.
• If you notice any slow down in the growth or unexpected puberty development of your child, please contact your doctor.
• A small number of people being treated with anti-epileptics such as levetiracetam have had thoughts of harming or killing themselves. If you have any symptoms of depression and/or suicidal ideation, please contact your doctor.
• If you have a family or medical history of irregular heart rhythm (visible on an electrocardiogram), or if you have a disease and/or take a treatment that make(s) you prone to heartbeat irregularities or salt imbalances.

Tell your doctor or pharmacist if any of the following side effects gets serious or last longer than a few days:

• Abnormal thoughts, feeling irritable or reacting more aggressively than usual, or if you or your family and friends notice important changes in mood or behaviour.
• Aggravation of epilepsy

Your seizures may rarely become worse or happen more often, mainly during the first month after the start of the treatment or increase of the dose. If you experience any of these new symptoms while taking levetiracetam, see a doctor as soon as possible.

Children and adolescents

• Levetiracetam is not indicated in children and adolescents below 16 years on its own (monotherapy).

Other medicines and Levetiracetam:

Please tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

Do not take macrogol (a drug used as a laxative) for one hour before and one hour after taking levetiracetam as this may result in a loss of its effect.

Taking Levetiracetam with food, drink and alcohol

You may take levetiracetam with or without food. You may feel a bitter taste of levetiracetam after oral use. As a safety precaution, do not take levetiracetam with alcohol.

Pregnancy and breast-feeding

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Levetiracetam can be used during pregnancy, only if after careful assessment it is considered necessary by your doctor. You should not stop your treatment without discussing this with your doctor.

A risk of birth defects for your unborn child cannot be completely excluded.

Breast-feeding is not recommended during treatment.

Driving and using machines

Levetiracetam may impair your ability to drive or operate any tools or machinery, as levetiracetam may make you feel sleepy. This is more likely at the beginning of treatment or after an increase in the dose. You should not drive or use machines until it is established that your ability to perform such activities is not affected.

Levetiracetam contains sodium

This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially ‘sodium-free’.

3. how to take levetiracetam

Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.

Levetiracetam must be taken twice a day, half of the daily dose in the morning and half of the daily dose in the evening, at about the same time each day.

Take the number of tablets following your doctor’s instruc­tions.

Adjunctive therapy and monotherapy (from 16 years of age)

• Adults (>18 years) and adolescents (12 to

17 years) weighing 50 kg or more General dose: between 1 000 mg and 3 000 mg each day.

When you will first start taking levetiracetam, your doctor will prescribe you a lower dose during 2 weeks before giving you the lowest general dose.

Example: if your daily dose is intended to be 1 000 mg, your reduced starting dose is 1 tablet of 250 mg in the morning and 1 tablet of 250 mg in the evening, and the dose will be gradually incremented to reach 1 000 mg daily after 2 weeks.

• Adolescents (12 to 17 years) weighing

50 kg or less

Your doctor will prescribe the most appropriate pharmaceutical form of levetiracetam according to weight and dose.

• Dose in infants (1 month to 23 months) and children (2 to 11 years) weighing less than 50 kg

Your doctor will prescribe the most appropriate pharmaceutical form of levetiracetam according to the age, weight and dose.

Oral solution is a formulation more appropriate to infants and children under the age of 6 years and to children and adolescents (from 6 to 17 years) weighing less than 50 kg and when tablets don’t allow accurate dosage.

Method of administration

Swallow Levetiracetam tablets with a sufficient quantity of liquid (e.g. a glass of water).

Duration of treatment:

• Levetiracetam is used as a chronic treatment. You should continue levetiracetam treatment for as long as your doctor has told you.

Do not stop your treatment without your doctor’s advice as this could increase your seizures.

The score line is only there to help you break the tablet if you have difficulty swallowing it whole.

If you take more Levetiracetam than you should

The possible side effects of an overdose of levetiracetam are sleepiness, agitation, aggression, decrease of alertness, inhibition of breathing and coma.

Contact your doctor if you took more tablets than you should. Your doctor will establish the best possible treatment of overdose.

If you forget to take Levetiracetam

Contact your doctor if you have missed one or more doses.

Do not take a double dose to make up for a forgotten tablet.

If you stop taking Levetiracetam

If stopping treatment, as with other antiepileptic medicines, levetiracetam should be discontinued gradually to avoid an increase of seizures. Should your doctor decide to stop your levetiracetam treatment, he/she will instruct you about the gradual withdrawal of levetiracetam.

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If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Tell your doctor immediately, or go to your nearest emergency department, if you experience:

• weakness, feel light-headed or dizzy or have difficulty breathing, as these may be signs of a serious allergic (anaphylactic) reaction
• swelling of the face, lips, tongue and throat (Quincke’s oedema)
• flu-like symptoms and a rash on the face followed by an extended rash with a high temperature, increased levels of liver enzymes seen in blood tests and an increase in a type of white blood cell (eosinophilia) and enlarged lymph nodes (drug reaction with eosinophilia and systemic symptoms [DRESS]).
• symptoms such as low urine volume, tiredness, nausea, vomiting, confusion and swelling in the legs, ankles or feet, as this may be a sign of sudden decrease of kidney function
• a skin rash which may form blisters and look like small targets (central dark spots surrounded by a paler area, with a dark ring around the edge) (erythema multiforme)
• a widespread rash with blisters and peeling skin, particularly around the mouth, nose, eyes and genitals (Stevens-Johnson syndrome)
• a more severe form of rash causing skin peeling in more than 30% of the body surface (toxic epidermal necrolysis)
• signs of serious mental changes or if someone around you notices signs of confusion, somnolence (sleepiness), amnesia (loss of memory), memory impairment (forgetfulness), abnormal behaviour or other neurological signs including involuntary or uncontrolled movements). These could be symptoms of an encephalopathy.
• The most frequently reported side effects are nasopharyngitis, somnolence (sleepiness), headache, fatigue and dizziness. At the beginning of the treatment or dose increase side effects like sleepiness, tiredness and dizziness may be more common. These effects should however decrease over time. Very common (may affect more than 1 user in 10 people): nasopharyngitis
• somnolence (sleepiness), headache

Common (may affect 1 to 10 users in 100 people):

• anorexia (loss of appetite)
• depression, hostility or aggression, anxiety, insomnia, nervousness or irritability
• convulsion, balance disorder (equilibrium disorder), dizziness (sensation of unsteadiness), lethargy (lack of energy and enthusiasm), tremor (involuntary trembling)
• vertigo (sensation of rotation)
• cough
• abdominal pain, diarrhoea, dyspepsia (indigestion), vomiting, nausea
• rash
• asthenia/fatigue (tiredness)

Uncommon (may affect 1 to 10 users in 1,000 people):

• decreased number of blood platelets, decreased number of white blood cells
• weight decrease, weight increase
• suicide attempt and suicidal ideation, mental disorder, abnormal behaviour, hallucination, anger, confusion, panic attack, emotional instability/mood swings, agitation
• amnesia (loss of memory), memory impairment (forgetfulness), abnormal coordination/ataxia (impaired coordinated movements), paraesthesia (tingling), disturbance in attention (loss of concentration)
• diplopia (double vision), vision blurred
• elevated/abnormal values in liver function test
• hair loss, eczema, pruritus
• muscle weakness, myalgia (muscle pain)
• injury

Rare (may affect 1 to 10 users in 10,000 people):

• infection
• decreased number of all blood cell types
• severe allergic reactions (DRESS, anaphylactic reaction [severe and important allergic reaction], Quincke’s oedema [swelling of the face, lips, tongue and throat])
• suicide, personality disorders (behavioural problems), thinking abnormal (slow thinking, unable to concentrate)
• delirium
• encephalopathy (see sub-section “Tell your doctor immediately” for a detailed description of symptoms)
• seizures may become worse or happen more often
• uncontrollable muscle spasms affecting the head, torso and limbs, difficulty in controlling movements, hyperkinesia (hyperactivity)
• change of the heart rhythm (electrocardiogram)
• pancreatitis
• liver failure, hepatitis
• sudden decrease in kidney function
• skin rash, which may form blisters and looks like small targets (central dark spots surrounded by a paler area, with a dark ring around the edge) (erythema multiforme), a widespread rash with blisters and peeling skin, particularly around the mouth, nose, eyes and genitals (Stevens-Johnson syndrome), and a more severe form causing skin peeling in more than 30 % of the body surface (toxic epidermal necrolysis)
• decreased blood sodium concentration.
• rhabdomyolysis (breakdown of muscle tissue) and associated blood creatine phosphokinase increase. Prevalence is significantly higher in Japanese patients when compared to non-Japanese patients
• limp or difficulty walking.

5. how to store levetiracetam

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton box and blister after EXP:. The expiry date refers to the last day of the month.

This medicinal product does not require any special storage conditions

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. contents of the pack and other information

What Levetiracetam contains The active substance is levetiracetam. Levetiracetam Zentiva 250 mg: each film-coated tablet contains 250 mg levetiracetam. Levetiracetam Zentiva 500 mg: each film-coated tablet contains 500 mg levetiracetam. Levetiracetam Zentiva 750 mg: each film-coated tablet contains 750 mg levetiracetam. Levetiracetam Zentiva 1000 mg: each film-coated tablet contains 1000 mg levetiracetam. The other ingredients are: Tablet core povidone 30, croscarmellose sodium, silica, colloidal anhydrous, sodium stearyl fumarate Tablet coating hypromellose 2910/5, macrogol 6000, talc, titanium dioxide (E-171), simeticone emulsion (water, purified 67.4 %, simeticone 30.0 %, methylcellulose 2.5 %, sorbic acid 0.1 %) Levetiracetam Zentiva 250 mg also contains indigo carmine aluminium lake (E-132). Levetiracetam Zentiva 500 mg also contains iron oxide yellow (E-172).

Levetiracetam Zentiva 750 mg also contains iron oxide red (E-172), ion oxide yellow (E-172).

What Levetiracetam looks like and contents of the pack

Film-coated tablet.

Levetiracetam Zentiva 250 mg: blue oblong film-coated tablet, with length approx.

12.6 mm and width approx. 6.1 mm, scored on both sides.

Levetiracetam Zentiva 500 mg: yellow oblong film-coated tablet, with length approx.

16.1 mm and width approx. 7.6 mm, scored on both sides.

Levetiracetam Zentiva 750 mg: orange oblong film-coated tablet, with length approx.

18.6 mm and width approx. 8.6 mm, scored on both sides.

Levetiracetam Zentiva 1000 mg: white to off-white oblong, film-coated tablet, with length approx. 19.1 mm and width approx. 10.1 mm, scored on both sides.

The score line is only there to help you break the tablet if you have difficulty swallowing it whole.

Levetiracetam Zentiva 250, 500, 750, 1000 mg is packed in PVC/Al blisters with 20, 30, 60, 100, 200 tablets.

It means 2, 3, 6, 10, 20 blisters, each containing 10 tablets in one folding box. Not all pack sizes may be marketed.

Marketing Authorisation Holder Zentiva Pharma UK Limited, 12 New Fetter Lane, London, EC4A 1JP, UK.

Manufacturer

Zentiva, k.s., U kabelovny 130, 102 37, Praha 10 – Doinf Mecholupy, Czech Republic

This leaflet was updated in June 2021.

ZV/xxx xx

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