On Keppra Due To Seizure. How To Taper Off This Medicine?

Posted on Fri, 27 Sep 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 27 Sep 2013 Answered on

Mon, 21 Oct 2013 Last reviewed on

Question : My husband has been on Keppra for about a month due to one seizure while he was intubated and septic following a near fatal arrythmia. He has a couple of doctors giving us conflicting information on weaning the Keppra. He is on 1000 MG bid. one says to decrease the evening dose to 500 and keep am at 1000 for 2 days, then 500 bid for a couple of days, then250 PM, 500 AM, etc..
The other says he can just stop it. Makes me a little nervous
for some reason this is under cancer. It should be under seizure in ICU

Answered by Dr. Sudhir Kumar (3 hours later)

Brief Answer:
Taper could be done over a week or so.

Detailed Answer:
Hi,

Thank you for posting your query.

The careful and slow tapering of levetiracetam is usually done in cases of epilepsy, where we have used the drug for three years or more.

In your husband's case, he only had a single seizure, in the ICU, and he can not be labeled as an epileptic. Moreover, he has used levetiracetam for only a month.

Therefore, in his case, rapid taper of the drug over 7-8 days can be done, and that would be safe. The dose can be reduced by 250 mg per day and stopped after a week.

I hope it helps. Please get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar