Keppra vs Dilantin – Comparison of Side Effects & Uses

Keppra

It is the brand name of a drug called levetiracetam that belongs to a group of medications called anticonvulsants. The medication works by stabilizing electrical activity in the brain.

Uses

This anticonvulsant is used to treat epilepsy, occasionally in combination with other medicines. Epilepsy is a central nervous system disorder in which brain activity becomes abnormal, leading to seizures or periods of unusual sensations, behavior, and loss of awareness.

This condition is a fairly common neurological disorder which affects an estimated 3 million people in the United States and 65 million people worldwide.

The main symptom of epilepsy is repeated seizures. Other symptoms may include:

  • confused memory;
  • dizzy spells and blackouts;
  • a convulsion with no temperature;
  • sudden bouts of blinking without apparent stimuli;
  • intermittent fainting spells, during which bowel or bladder control is lost;
  • repetitive movements which seem inappropriate;
  • the person suddenly falls for no clear reason;
  • for a short period, the sufferer is unresponsive to questions or instructions;
  • peculiar changes in senses;
  • the sufferer becomes fearful for no apparent reason;
  • for a short time, the sufferer seems dazed and unable to communicate;
  • sudden bouts of chewing;
  • the person becomes stiff.

Dosage

It is given two times per day, once in the morning and once in the evening, 10–12 hours apart. The anticonvulsant can also be given as a drip into a vein when administration by mouth is not possible.

The effect of this medication lasts for around 18 to 24 hours. Its peak effect can be observed within about 240 minutes for an extended-release tablet and within 60 minutes for an immediate release tablet.

Side Effects and Precautions

Common side effects may include:

  • weakness;
  • sleepiness;
  • decreased appetite;
  • dizziness;
  • feeling tired;
  • infection;
  • becoming aggressive;
  • irritability;
  • nasal congestion.

Rare side effects may include:

  • loss of balance or coordination;
  • unusual changes in mood or behavior;
  • feeling very weak or tired;
  • hallucinations;
  • extreme drowsiness;
  • confusion;
  • problems with walking or movement;
  • muscle weakness;
  • swollen gums;
  • severe tingling;
  • pain when swallowing;
  • easy bruising;
  • trouble breathing;
  • skin sores;
  • painful mouth sores.

To make sure that this anticonvulsant is safe for you, tell your healthcare provider if you have:

  • depression or other mood problems;
  • kidney disease (or if you are on dialysis);
  • a history of suicidal thoughts or actions;
  • a history of mental illness or psychosis.

Pregnancy & Breastfeeding

Breastfeeding is not recommended while taking this anticonvulsant since it passes into breast milk. Also, there are no well-done studies to determine the safety of this anticonvulsant during pregnancy, hence, it is not recommended for use in pregnancy unless considered essential by your healthcare professional.

Drug Interactions

Let your healthcare provider know if you are taking anything that could cause you to become drowsy, especially:

  • Diazepam (Valium);
  • antihistamines, such as – cetirizine (Zyrtec or Alleroff);
  • narcotic pain relievers, like – codeine;
  • muscle relaxants;
  • amitriptyline;
  • Zolpidem (Edluar, Zolpimist, Intermezzo);
  • sleeping or anxiety medication, like – alprazolam (Niravam or Xanax);
  • diphenhydramine (Sominex, Benadryl, Diphenhist, Dicopanol, Banophen).

Dilantin

It is the brand name of phenytoin, an anti-epileptic medicine which is used to treat epilepsy. The medication works by stabilizing electrical activity in the brain.

The first production of this anti-epileptic medicine was in 1908. It is currently produced by Pfizer, Inc.

Uses

This prescription medication is used to treat tonic-clonic seizures, complex partial (temporal lobe or psychomotor) seizures. In addition, it used to treat and prevent seizures after or during brain surgery.

Dosage

It is available as:

  • Tablets – 100 mg;
  • Capsules – 25 mg, 50 mg, 100 mg, 300 mg;
  • Infatabs – 50 mg;
  • Liquid medicine – 90 mg in 5mL and 30 mg in 5 mL.

The suspension and chewable tablets are taken 3 times a day. The extended-release capsules are taken 1 to 4 times a day.

Note – you should take this anti-epileptic medicine with a full glass of water.

Side Effects And Precautions

Common side effects may include:

  • mental confusion;
  • nervousness;
  • tender gums;
  • decreased coordination;
  • problems with speaking;
  • dizziness;
  • drowsiness;
  • slurred speech;
  • spinning sensation;
  • nervousness;
  • headaches;
  • sleep problems;
  • nausea;
  • breathing problems;
  • vomiting;
  • problems with muscle coordination or control;
  • constipation;
  • unsteadiness;
  • trembling.

Less common side effects may include:

  • easy bruising;
  • unusual eye movements;
  • an unexplained sore throat;
  • skin rash;
  • joint pain;
  • worsening seizures;
  • blurred vision;
  • unusual behavior.

To make sure that anti-epileptic medicine is safe for you, tell your healthcare provider if you have or have ever had:

  • type 2 diabetes mellitus;
  • liver disease;
  • suicidal thoughts or actions;
  • an abnormal heart rhythm;
  • a vitamin D deficiency;
  • depression;
  • porphyria.

Alcohol

Alcohol may interfere with this medication. You should talk to your healthcare provider about how much alcohol is safe to drink while taking this anti-epileptic medicine. In general, it is recommended to completely avoid alcohol.

Drug Interactions

It may negatively interact with other drugs, especially:

  • chloramphenicol;
  • antacids that contain calcium (Mylanta, Maalox, Tums);
  • chlordiazepoxide (Librium);
  • brilinta;
  • amiodarone (Cordarone, Pacerone);
  • disulfiram (Antabuse);
  • anticoagulants (blood thinners), like – warfarin (Coumadin);
  • digoxin (Lanoxin);
  • certain antidepressants, such as – amoxapine (Asendin), amitriptyline (Elavil), doxepin (Sinequan), desipramine (Norpramin), protriptyline (Vivactil), or nortriptyline (Pamelor);
  • furosemide (Lasix);
  • diazepam (Valium);
  • medications for mental illness and nausea;
  • doxycycline (Doryx, Monodox, Vibramycin);
  • isoniazid (in Rifamate, in Rifater);
  • fluoxetine (Prozac, Sarafem);
  • hormone replacement therapy (HRT);
  • h2 antagonists, like – famotidine (Pepcid), cimetidine (Tagamet), or nizatidine (Axid);
  • molindone (Moban);
  • hormonal contraceptives (birth control pills, rings, patches, or injections);
  • other medications for seizures, like – ethosuximide (Zarontin), carbamazepine (Carbatrol, Tegretol), methsuximide (Celontin), or valproic acid (Depacon, Depakene);
  • Quinidine;
  • methylphenidate (Concerta, Daytrana, Metadate, Ritalin);
  • Reserpine (Serpalan);
  • oral steroids, like – methylprednisolone (Medrol), dexamethasone (Decadron, Dexone), prednisolone;
  • sucralfate (Carafate);
  • paroxetine (Paxil, Pexeva);
  • tolbutamide;
  • rifampin (Rimactane);
  • vitamin D;
  • trazodone;
  • ticlopidine (Ticlid);
  • theophylline (Theo-Dur);
  • salicylate pain relievers, like – choline salicylate (Arthropan), aspirin, diflunisal (Dolobid), or salsalate (Argesic, Disalcid, Salgesic).

Bottom Line – Keppra vs Dilantin 

Keppra (active ingredient – levetiracetam) is an anticonvulsant which is used to prevent and treat seizures in adults and children. It belongs to a group of drugs called anticonvulsants.

Dilantin (active ingredient – phenytoin) is a prescription medication that is used to treat tonic-clonic and complex partial seizures.

According to a 2014 study conducted at the Edward B. Bromfield Epilepsy Program, Boston, USA, levetiracetam generally appears to have a similar efficacy to phenytoin in preventing clinical and/or electrographic seizures.

According to a 2016 study done at the Department of Neurosurgery, levetiracetam appears to have a similar efficacy to phenytoin on traumatic brain injury.

According to a 2008 study, levetiracetam is as effective as phenytoin in preventing early posttraumatic seizures.

References

https://www.ncbi.nlm.nih.gov/pubmed/11564123
http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Summary_fo
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2526377/

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