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No dose adjustment is needed in patients with mild to moderate hepatic impairmentIn patients with severe hepatic impairmentthe creatinine clearance may underestimate the renal insufficiencyTherefore a 50reduction of the daily maintenance dose is recommended when the creatinine clearance is 2

In vitro data on metabolic interactions indicate that levetiracetam is unlikely to produceor be subject topharmacokinetic interactionsLevetiracetam and its major metaboliteat concentrations well above Cmax levels achieved within the therapeutic dose rangeare neither inhibitors ofnor high affinity substrates forhuman liver cytochrome P450 isoformsepoxide hydrolase or UDP-glucuronidation enzymesIn additionlevetiracetam does not affect the in vitro glucuronidation of valproic acid.

Table 4Adverse Reactions that Resulted in Discontinuation or Dose Reduction in Placebo-Controlled Studies in Adult Patients Experiencing Partial Onset Seizures.

Ks0.45 in Term infants to 1 year oldks0.55 in Children to less than 13 years and in adolescent femaleks0.7 in adolescent male.

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