Levetiracetam

Levetiracetam is an active substance used against epileptic seizures. In dogs, the vet mainly uses it when phenobarbital or potassium bromide does not prevent seizures well enough or is not tolerated. Levetiracetam is then usually added to the existing treatment.

Levetiracetam binds to a protein in the nerve cells of the brain (SV2A) that is involved in signal transmission. Exactly how it prevents seizures is not yet fully understood. The substance is hardly broken down by the liver and leaves the body mainly via the kidneys. This is why it can also be an option for dogs with reduced liver function.

Emergency: If a seizure does not stop after a few minutes, if one seizure follows another without your dog recovering in between, or if he has several seizures within one day, call the veterinary practice or animal hospital straight away and drive there directly. That way the team is prepared.

According to CliniPharm (University of Zurich, accessed October 2026), no veterinary medicine containing levetiracetam is currently authorised in Switzerland. We are also not aware of any authorised veterinary medicine with this substance in Germany or Austria. If no authorised veterinary medicine is available, the vet may switch to another medicine in individual cases. A fixed order applies to this, and a product for humans is the last option. This is called off-label use (known as cascade use in Europe), and it is reserved for vets. Never give your dog levetiracetam that was not prescribed for him, and that includes tablets from your own medicine cabinet or tablets meant for humans.

How is levetiracetam given?

The dose and timing are always set by the vet. They depend on weight, seizure frequency, kidney values, tolerance and which other medicines your dog receives. If the vet has prescribed levetiracetam, give it only as instructed and do not change the amount on your own.

Levetiracetam is eliminated quickly from a dog’s body. This is why it is given several times a day, and the times should be kept as precisely as possible. With food, the substance is absorbed somewhat more slowly. Always give it the same way, as your vet has instructed.

Levetiracetam is available for oral use and as a solution for injection into a vein. The veterinary practice gives the injection in an emergency, diluted and slowly. For cluster seizures, your vet may give you a plan to use at home. Never increase the amount on your own.

Do not stop suddenly: If a medicine against seizures is stopped abruptly, this can trigger seizures or status epilepticus. If levetiracetam is to be stopped, the vet reduces the amount gradually over a few weeks. If you are running out of the medicine, contact the practice in good time.

How well does levetiracetam work against seizures?

As an add-on to phenobarbital or potassium bromide, levetiracetam clearly reduced the number of seizures in some dogs in studies, and hardly at all in others. Given alone, it prevented seizures less well than phenobarbital alone in one study. How well it works for your dog only becomes clear over time.

In some dogs in which levetiracetam works well at first, the effect wears off over time. So keep a seizure diary with the date, time, duration and course of each seizure. This helps the vet see whether the treatment needs to be adjusted.

What side effects are possible?

According to CliniPharm and MSD, many dogs tolerate levetiracetam well. The main possible effects are:

• Tiredness: mild drowsiness, especially at the start of treatment.
• Coordination: unsteady, wobbly gait.
• Digestion: vomiting, reduced appetite.
• Drinking: Some dogs drink more and need to pass urine more often.
• Behaviour: restlessness, anxiety, irritability or aggression, aimless wandering. Existing behaviour problems may become stronger or weaker.

Watch out for: If your dog is unusually tired, walks noticeably unsteadily, his behaviour changes, he vomits repeatedly or the seizures become more frequent, contact the veterinary practice. Do not stop the medicine yourself.

When does the vet use levetiracetam?

As an add-on: when phenobarbital or potassium bromide alone does not prevent seizures well enough. Because levetiracetam is hardly broken down by the liver, the vet can use it to reduce the amount of phenobarbital if liver problems develop under phenobarbital.

With liver problems: for example in dogs with reduced liver function or before surgery on a liver blood vessel (portosystemic shunt).

For cluster seizures and in emergencies: as an injection for status epilepticus, or with a plan for home use when seizures occur in clusters.

Alone: in some cases, for example when the seizures have an identifiable cause in the brain. Whether levetiracetam alone or together with other medicines will make your dog seizure-free cannot be predicted.

When is caution needed?

• with kidney disease, because the substance is excreted via the kidneys. The vet then adjusts the dose
• in pregnant or nursing bitches, because the substance passes into the milk and the effects on the puppies are not known

Interactions and what the vet needs to know

Hardly any interactions with other medicines are known. Phenobarbital, however, speeds up its breakdown, so the vet adjusts the amount.

So tell the vet which other medicines your dog receives, whether he has kidney problems and whether your bitch is pregnant or nursing.