LEVETIRACETAM ACCORD 250 mg FILM-COATED TABLETS

Introduction

Patient Information: Summary of Product Characteristics

Levetiracetam Accord 250 mg film-coated tablets EFG

Levetiracetam Accord 500 mg film-coated tablets EFG

Levetiracetam Accord 750 mg film-coated tablets EFG

Levetiracetam Accord 1000 mg film-coated tablets EFG

Levetiracetam

Read the entire patient information leaflet carefully before you or your child starts taking this medication because it contains important information for you.

• Keep this patient information leaflet, as you may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medication has been prescribed for you only and you should not pass it on to others, even if their symptoms are the same as yours, as it may harm them.
• If you experience any side effects, talk to your doctor or pharmacist, even if they are not listed in this patient information leaflet. See section 4.

Contents of the pack:

1. What is Levetiracetam Accord and what is it used for
2. What you need to know before taking Levetiracetam Accord
3. How to take Levetiracetam Accord
4. Possible side effects
5. Storage of Levetiracetam Accord
6. Contents of the pack and further information

1. What is Levetiracetam Accord and what is it used for

Levetiracetam Accord is an antiepileptic medication (a medication for the treatment of seizures in epilepsy).

Levetiracetam Accord is used:

• as monotherapy in adults and adolescents from 16 years of age with newly diagnosed epilepsy to treat a form of epilepsy. Epilepsy is a disease where patients have seizures. Levetiracetam is used for the form of epilepsy in which the seizures initially affect only one side of the brain but may later spread to larger areas on both sides of the brain (partial onset seizures with or without secondary generalization). Your doctor has prescribed levetiracetam to reduce the number of seizures.

• in combination with other antiepileptic medications to treat:

• partial onset seizures with or without secondary generalization in adults, adolescents, children, and infants
• myoclonic seizures (short, shock-like jerks of a muscle or group of muscles) in patients over 12 years of age with juvenile myoclonic epilepsy.
• primary generalized tonic-clonic seizures (major seizures, including loss of consciousness) in adults and adolescents from 12 years of age with idiopathic generalized epilepsy (a type of epilepsy thought to have a genetic cause).

2. What you need to know before taking Levetiracetam Accord

Do not take Levetiracetam Accord

• If you are allergic to levetiracetam, to pyrrolidone derivatives or to any of the other ingredients of this medication (listed in section 6).

Warnings and precautions

Talk to your doctor before starting to take Levetiracetam Accord

• If you have kidney problems, follow your doctor's instructions, who will decide if you need to adjust your dose.
• If you notice any decrease in your child's growth or an unexpected development of puberty, contact your doctor.
• A small number of people taking antiepileptics, such as Levetiracetam Accord, have had thoughts of harming themselves or suicide. If you have any symptoms of depression and/or suicidal thoughts, contact your doctor.
• If you have a medical history or family history of irregular heart rhythm (visible on an electrocardiogram), or if you have a disease and/or are taking a treatment that makes you prone to cardiac arrhythmias or electrolyte imbalances.

Tell your doctor or pharmacist if any of the following side effects get worse or last more than a few days:

• Abnormal thoughts, feeling irritable or reacting more aggressively than usual, or if you or your family and friends notice significant changes in your mood or behavior.
• Worsening of epilepsy

In rare cases, epileptic seizures may worsen or occur more frequently, mainly during the first month after starting treatment or increasing the dose. If you experience any of these new symptoms while taking Levetiracetam Accord, see a doctor as soon as possible.

In a very rare form of early-onset epilepsy (epilepsy associated with SCN8A mutations) that causes multiple types of epileptic seizures and loss of skills, you may notice that seizures persist or worsen during treatment.

Children and adolescents

• Monotherapy with Levetiracetam Accord is not indicated in children and adolescents under 16 years of age.

Using Levetiracetam Accord with other medications

Tell your doctor or pharmacist if you are using, have recently used, or might use any other medications.

Do not take macrogol (a medication used as a laxative) within one hour before and one hour after taking levetiracetam, as it may lose its effect.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor before using this medication. Levetiracetam should only be used during pregnancy if, after careful evaluation, your doctor considers it necessary.

Do not stop your treatment without discussing it with your doctor first.

The risk of birth defects for the baby cannot be completely ruled out. Breastfeeding is not recommended during treatment with Levetiracetam Accord.

Driving and using machines

Levetiracetam Accord may affect your ability to drive or operate tools or machinery, as it may cause drowsiness. This is more likely at the start of treatment or when the dose is increased. You should not drive or use machinery until it is established that your ability to perform these activities is not affected.

Important information about some of the ingredients of Levetiracetam AccordLevetiracetam Accord 750 mg film-coated tablet contains the yellow-orange colorant FCF (E110), which may cause allergic reactions. The other strengths of Levetiracetam Accord do not contain this excipient.

3. How to take Levetiracetam Accord

Follow the administration instructions of this medication exactly as indicated by your doctor or pharmacist. In case of doubt, consult your doctor or pharmacist again.

Take the number of tablets that your doctor has prescribed.

Levetiracetam Accord should be taken twice a day, once in the morning and once in the evening, approximately at the same time each day.

Concomitant therapy and monotherapy (from 16 years of age)

• Adults (≥18 years) and adolescents (from 12 to 17 years) with a weight of 50 kg or more:

Recommended dose: between 1000 mg and 3000 mg per day.

When you start taking Levetiracetam Accord, your doctor will prescribe a lower dose(500 mg per day) for 2 weeks before administering the lowest daily dose of 1000 mg.

For example: for a daily dose of 1000 mg, your reduced starting dose is 1 tablet of 250 mg in the morning and 1 tablet of 250 mg in the evening, and the dose should be gradually increased to 1000 mg per day after 2 weeks of treatment.

• Adolescents (from 12 to 17 years) with a weight of 50 kg or less:

Your doctor will prescribe the most suitable pharmaceutical form of Levetiracetam Accord according to weight and dose.

Dose in infants (from 1 month to 23 months) and children (from 2 to 11 years) with a weight below 50 kg:

Your doctor will prescribe the most suitable pharmaceutical form of Levetiracetam Accord according to age, weight, and dose.

An oral solution is a more suitable formulation for infants and children under 6 years of age and for children and adolescents (from 6 to 17 years) with a weight below 50 kg and when tablets do not allow for precise dosing.

Method of administration:

Swallow the Levetiracetam Accord tablets with a sufficient amount of liquid (e.g., a glass of water). You can take Levetiracetam Accord with or without food. After oral administration of levetiracetam, a bitter taste may be perceived.

Duration of treatment:

• Levetiracetam Accord is used as a chronic treatment. You should continue treatment with Levetiracetam Accord for the time indicated by your doctor.

Do not stop your treatment without your doctor's advice, as your seizures may increase.

If you take more Levetiracetam Accord than you should:

Possible side effects of an overdose of Levetiracetam are drowsiness, agitation, aggression, decreased alertness, respiratory depression, and coma.

Contact your doctor if you have taken more tablets than you should. Your doctor will establish the best possible treatment for the overdose.

If you forget to take a dose of Levetiracetam Accord:Contact your doctor if you have missed one or more doses. Do not take a double dose to make up for the missed doses.

If you stop taking Levetiracetam Accord:

Stopping treatment with Levetiracetam Accord should be done gradually to avoid an increase in seizures. If your doctor decides to stop your treatment with Levetiracetam Accord, he/she will give you instructions for the gradual withdrawal of Levetiracetam Accord.

If you have any further questions on the use of this medication, ask your doctor or pharmacist.

4. Possible side effects

Like all medications, this medication can cause side effects, although not everybody gets them.

Tell your doctor immediately, or go to the emergency department of your nearest hospital if you experience:

• weakness, dizziness, or difficulty breathing, as these may be signs of a severe allergic reaction (anaphylaxis)
• swelling of the face, lips, tongue, or throat (angioedema)
• flu-like symptoms and rash on the face followed by a prolonged rash with high temperature, elevated liver enzymes in blood tests, and an increase in a type of white blood cells (eosinophilia) and enlarged lymph nodes (Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS))
• symptoms such as low urine output, fatigue, nausea, vomiting, confusion, and swelling of legs, arms, or feet, as this may be a sign of sudden decrease in kidney function
• a skin rash that may form blisters and may appear as small targets (dark central spots surrounded by a paler area, with a dark ring around the edge) (erythema multiforme)
• a widespread rash with blisters and skin peeling, especially around the mouth, nose, eyes, and genitals (Stevens-Johnson syndrome)
• a more severe form that causes skin peeling on more than 30% of the body surface (toxic epidermal necrolysis)
• signs of severe mental changes or if someone around you notices signs of confusion, drowsiness (drowsiness), amnesia (memory loss), memory impairment (forgetfulness), abnormal behavior, or other neurological signs including involuntary or uncontrolled movements. These may be symptoms of encephalopathy.

The most frequently reported side effects are nasopharyngitis, somnolence (feeling of sleep), headache, fatigue, and dizziness. Side effects such as drowsiness, weakness, and dizziness may be more frequent when starting treatment or increasing the dose. However, these side effects should decrease over time.

Very commonmay affect more than 1 in 10 people:

• nasopharyngitis;
• somnolence (feeling of sleep), headache.

Commonmay affect up to 1 in 100 people:

• anorexia (loss of appetite);
• depression, hostility or aggression, anxiety, insomnia, nervousness or irritability;
• seizures, balance disorder, dizziness (feeling of instability), lethargy (lack of energy and enthusiasm), tremor (involuntary tremor);
• vertigo (feeling of rotation);
• cough;
• abdominal pain, diarrhea, dyspepsia (indigestion, heartburn, and acid reflux), vomiting, nausea;
• skin rash;
• asthenia/fatigue (feeling of weakness).

Uncommonmay affect up to 1 in 1000 patients:

• decreased platelet count, decreased white blood cell count;
• weight loss, weight gain;
• suicidal attempt and suicidal thoughts, mental disorders, abnormal behavior, hallucinations, anger, confusion, panic attack, emotional instability/mood changes, agitation;
• amnesia (memory loss), memory impairment (forgetfulness), abnormal coordination/ataxia (altered movement coordination), paresthesia (tingling), attention disorders (loss of concentration);
• diplopia (double vision), blurred vision;
• elevated/abnormal liver function test values;
• hair loss, eczema, itching;
• muscle weakness, myalgia (muscle pain);
• injury.

Raremay affect up to 1 in 1000 people:

• infection;
• decrease in all types of blood cells;
• severe allergic reactions (DRESS, anaphylactic reaction (severe and important allergic reaction), angioedema (swelling of face, lips, tongue, and throat));
• decrease in sodium concentration in the blood;
• suicide, personality disorders (behavioral problems), abnormal thinking (slow thinking, difficulty concentrating);
• delirium;
• encephalopathy (see subsection "Tell your doctor immediately" for a detailed description of symptoms);
• epileptic seizures may worsen or occur more frequently;
• uncontrolled muscle spasms affecting the head, torso, and limbs, difficulty controlling movements, hyperkinesia (hyperactivity);
• change in heart rhythm (electrocardiogram);
• pancreatitis (inflammation of the pancreas);
• liver failure, hepatitis (inflammation of the liver);
• sudden decrease in kidney function;
• skin rash, which may form blisters and may appear as small targets (dark central spots surrounded by a paler area, with a dark ring around the edge) (erythema multiforme), a widespread rash with blisters and skin peeling, especially around the mouth, nose, eyes, and genitals (Stevens-Johnson syndrome), and a more severe form that causes skin peeling on more than 30% of the body surface (toxic epidermal necrolysis).
• rhabdomyolysis (breakdown of muscle tissue) and increased creatine phosphokinase in the blood. The prevalence is significantly higher in Japanese patients compared to non-Japanese patients.
• limping or difficulty walking;
• a combination of fever, muscle stiffness, unstable blood pressure, and heart rate, confusion, low level of consciousness (may be signs of a disorder called neuroleptic malignant syndrome). The prevalence is significantly higher in Japanese patients compared to non-Japanese patients.

Very rare: may affect up to 1 in 10,000 people:

• unwanted and repetitive thoughts or feelings or the urge to do something over and over again (obsessive-compulsive disorder).

Reporting of side effects

If you experience any side effects, talk to your doctor or pharmacist, even if they are not listed in this patient information leaflet. You can also report side effects directly through the national reporting system listed in Appendix V. By reporting side effects, you can help provide more information on the safety of this medication.

5. Storage of Levetiracetam Accord

Keep this medication out of the sight and reach of children.

Do not use this medication after the expiration date, which is stated on the carton and on the blister after EXP. The expiration date is the last day of the month indicated.

This medication does not require special storage conditions.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. This will help protect the environment.

6. Packaging Content and Additional Information

Composition of Levetiracetam Accord:

The active ingredient is levetiracetam.

Each film-coated tablet contains 250 mg, 500 mg, 750 mg, or 1,000 mg of levetiracetam.

Levetiracetam Accord 250mg film-coated tablets EFG:

Tablet core: sodium croscarmellose, povidone K-30, anhydrous colloidal silica, magnesium stearate (E470b)

Film coating: polyvinyl alcohol, titanium dioxide (E171), macrogol, talc

Levetiracetam Accord 500 mg film-coated tablets EFG:Tablet core: sodium croscarmellose, povidone K-30, anhydrous colloidal silica, magnesium stearate (E470b)

Film coating: polyvinyl alcohol, titanium dioxide (E171), macrogol, talc, yellow iron oxide (E172)

Levetiracetam Accord 750 mg film-coated tablets EFG:Tablet core: sodium croscarmellose, povidone K-30, anhydrous colloidal silica, magnesium stearate (E470b)

Film coating: polyvinyl alcohol, titanium dioxide (E171), macrogol, talc, red iron oxide (E172), orange yellow FCF (E110)

Levetiracetam Accord 1,000 mg film-coated tablets EFG:Tablet core: sodium croscarmellose, povidone K-30, anhydrous colloidal silica, magnesium stearate (E470b)

Film coating: polyvinyl alcohol, titanium dioxide (E171), macrogol, talc

Appearance of Levetiracetam Accord and Packaging Content

Levetiracetam Accord 250 mg film-coated tablets EFG:

White to off-white, oval, biconvex, film-coated tablet, engraved "L 64" and score line on one side and smooth on the other side.

Levetiracetam Accord 500 mg film-coated tablets EFG:

Yellow in color, oval, biconvex, film-coated tablet, engraved "L 65" and score line on one side and smooth on the other side.

Levetiracetam Accord 750 mg film-coated tablets EFG:

Pink in color, oval, biconvex, film-coated tablet, engraved "L 66" and score line on one side and smooth on the other side.

Levetiracetam Accord 1,000 mg film-coated tablets EFG:

White to off-white, oval, biconvex, film-coated tablet, engraved "L 67" and score line on one side and smooth on the other side.

Levetiracetam Accord film-coated tablets 250 mg, 500 mg, 750 mg, and 1,000 mg are packaged in PVC-Aluminum blisters. The blisters are packaged in a box with a leaflet in pack sizes of 10, 20, 30, 50, 60, 100, and 200 tablets per pack. Additionally, the tablets are also available in unit dose blisters for pack sizes of 30x1, 60x1, and 100x1 tablets.

Only some pack sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder

Accord Healthcare S.L.U.

World Trade Center, Moll de Barcelona, s/n, Edifici Est 6ª planta,

08039 Barcelona,

Spain

Manufacturer

Accord Healthcare Polska Sp.z o.o.,

ul. Lutomierska 50, 95-200 Pabianice,

Poland

Accord Healthcare Single Member S.A.

64th Km National Road Athens, Lamia, 32009,

Greece

Date of the Last Revision of this Leaflet: November 2024

Other Sources of Information

Detailed information on this medicinal product is available on the European Medicines Agency website: http://www.ema.europa.eu