Approved uses for Keppra and Briviact
The FDA approved Keppra in 1999 and Briviact in 2016. Both medications are manufactured by UCB but have different indications and are approved for use in different age groups. Keppra is FDA approved as an adjunct therapy for partial-onset (> 1-month old), myoclonic (> 12 years old), and generalized tonic-clonic seizures (> 6 years old) in adult and pediatric patients.
Briviact is also FDA approved as an adjunct therapy to treat partial-onset seizures but in people 16 years of age and older who have epilepsy.
Pharmacokinetics and dosing of Keppra and Briviact
Levetiracetam (Spritam, Keppra) can be administered orally (solid or liquid) or intravenously. Oral solid formulations include:
Keppra immediate release formulations are dosed twice a day without regard to meals. Keppra XR is administered once daily. Keppra is not extensively metabolized in humans. About 24% of an administered dose is metabolized to an inactive metabolite by hydrolysis of the acetamide group, which produces the carboxylic acid metabolite. Metabolites are inactive and excreted via the kidneys. Keppra reaches its maximum plasma concentration in approximately 1 hour. Keppra is excreted really (in urine), with 66% of the administered dose excreted unchanged and 27% as inactive compounds. The dose of Keppra is adjusted based on kidney function, meaning, patients with poor kidney function must have a reduced dose of Keppra. Patients with liver impairment do not require a dose reduction.
Briviact is also available orally (solid or liquid) or intravenously and requires twice daily dosing. Briviact is dosed with or without food. Briviact reaches its maximum blood concentration in about 1 hour. Brivaracetam is broken down into inactive compounds. Briviact is excreted in urine with less than 10% excreted unchanged in the urine. No dosage adjustment is necessary for mild to severe renal impairment. Mild to severe hepatic impairment requires a dose adjustment.