LEVETIRACETAM EXELTIS 750 mg COATED GRANULES IN SACHET

2. What you need to know before taking Levetiracetam Exeltis

Do not take Levetiracetam Exeltis

Warnings and precautions

Talk to your doctor before taking Levetiracetam Exeltis

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 mood or behaviour
• worsening of epilepsy

Rarely, epileptic seizures may worsen or occur more frequently, mainly during the first month after starting treatment or increasing the dose. In a very rare form of early-onset epilepsy (epilepsy associated with SCN8A mutations) that causes multiple types of seizures and loss of skills, you may notice that seizures persist or worsen during treatment

If you experience any of these new symptoms while taking Levetiracetam Exeltis, see a doctor as soon as possible

Children and adolescents

Levetiracetam Exeltis coated granules are not indicated in children and adolescents under 16 years of age as monotherapy, and are not recommended in children under 6 years of age as well as in the initial treatment of children under 25 kg

Other medicines and Levetiracetam Exeltis

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines

Do not take macrogol (a medicine used as a laxative) for one hour before and one hour after taking levetiracetam, as it may reduce its effect

Using Levetiracetam Exeltis with food, drinks, and alcohol

As a precaution, do not take Levetiracetam Exeltis with alcohol

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 medicine. Levetiracetam can be used during pregnancy only if, after careful evaluation, your doctor considers it necessary

Do not stop treatment without consulting your doctor. The risk of birth defects for the baby cannot be completely excluded

Driving and using machines

Levetiracetam Exeltis may affect your ability to drive or use any tool 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

3. How to take Levetiracetam Exeltis

Follow exactly the administration instructions of this medicine given by your doctor or pharmacist. In case of doubt, consult your doctor or pharmacist

Take the number of sachets that your doctor has indicated

Levetiracetam Exeltis 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:

General dose: between 1,000 mg and 3,000 mg per day

When starting Levetiracetam Exeltis, your doctor will prescribe a lower dose for two weeks before administering the lowest general dose

For example: for a daily dose of 1,000 mg, the reduced starting dose is 1 sachet of 250 mg in the morning and 1 sachet of 250 mg in the evening, and the dose should be gradually increased to 1,000 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 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 Exeltis according to age, weight, and dose

Levetiracetam 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 sachets do not allow for precise dosing

Method of administration:

1. Hold the sachet above the arrow and shake to make the contents fall
2. Tear along the incision (at the arrow) and cut along the dotted line
3. Empty the contents directly into the mouth and swallow the granules immediately with a sufficient amount of liquid (e.g. a glass of water). Do not chew the granules, as they may have a slightly bitter taste. You can take levetiracetam with or without food

The coated granules can also be suspended in at least 10 ml of water, shaking for at least 2 minutes, and administered through a feeding tube, which should be rinsed twice with 10 ml of water immediately after administration. If this method of administration is used, the suspension should be prepared just before administration

Each sachet is for single use

Duration of treatment:

• Levetiracetam Exeltis is used as a chronic treatment. You should continue treatment with Levetiracetam Exeltis for the time indicated by your doctor
• Do not stop treatment without your doctor's advice, as your seizures may increase

If you take more Levetiracetam Exeltis than you should:

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicology Information Service, phone: 91 562 04 20, indicating the medicine and the amount taken

The possible side effects of an overdose of Levetiracetam Exeltis are drowsiness, agitation, aggression, decreased alertness, respiratory inhibition, and coma. Contact your doctor if you have taken more sachets than you should. Your doctor will establish the best possible treatment for the overdose

If you forget to take Levetiracetam Exeltis:

Contact your doctor if you have missed one or more doses

Do not take a double dose to make up for forgotten doses

If you stop taking Levetiracetam Exeltis:

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

If you have any further questions about the use of this medicine, ask your doctor or pharmacist

4. Possible side effects

Like all medicines, Levetiracetam Exeltis 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 (anaphylactic reaction)
• swelling of the face, lips, tongue, or throat (Quincke's edema)
• 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 these may be signs of sudden kidney function decrease

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 behaviour, 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 common:may affect more than 1 in 10 people

• nasopharyngitis (inflammation of the nose or throat)
• somnolence (feeling of sleep), headache

Common:may affect up to 1 in 10 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), vomiting, nausea
• skin rash
• asthenia/fatigue (feeling of weakness)

Uncommon:may affect up to 1 in 100 people

• decrease in platelet count, decrease in white blood cell count
• weight loss, weight gain
• suicidal attempt and suicidal thoughts, mental disorders, abnormal behaviour, 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 tests
• hair loss, eczema, itching
• muscle weakness, myalgia (muscle pain)
• injury

Rare:may affect up to 1 in 1,000 people

• infection
• decrease in certain types of white blood cells (neutrophils, granulocytes) or decrease in the number of all types of blood cells
• severe allergic reactions (DRESS, anaphylactic reaction, Quincke's edema)
• decrease in sodium concentration in the blood
• suicide, personality disorders (behavioural 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
• muscle spasms that cannot be controlled, affecting the head, torso, and limbs, difficulty controlling movements, hyperkinesia (hyperactivity)
• change in heart rhythm (electrocardiogram)
• pancreatitis
• liver failure, hepatitis
• sudden decrease in kidney function
• 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), and a more severe form that causes skin peeling on more than 30% of the body surface (toxic epidermal necrolysis)
• rhabdomyolysis (muscle tissue breakdown) and increased creatine phosphokinase in the blood. The prevalence is significantly higher in Japanese patients compared to non-Japanese patients
• limping or difficulty walking
• combination of fever, muscle stiffness, unstable blood pressure and heart rate, confusion, low level of consciousness (may be signs of a disorder called malignant neuroleptic 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 repetitive thoughts or urges 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. This includes any possible side effects not listed in this package leaflet

You can also report side effects directly to the Spanish Medicines Monitoring System for Human Use: https://www.notificaram.es. By reporting side effects, you can help provide more information on the safety of this medicine

5. Storage of Levetiracetam Exeltis

Keep this medicine out of the sight and reach of children

Do not use this medicine after the expiry date which is stated on the carton and on the sachets after EXP

The expiry date is the last day of the month shown

This medicine does not require any 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. These measures will help protect the environment

6. Packaging Content and Additional Information

Composition of Levetiracetam Exeltis

The active ingredient is levetiracetam. Each sachet contains 750 mg of levetiracetam.

The other components are:

Povidone K30

Microcrystalline cellulose

Anhydrous colloidal silica

Magnesium stearate

Polyvinyl alcohol

Titanium dioxide (E 171)

Macrogol 3350

Talc

Appearance of the Product and Packaging Content

Coated granules in a sachet; the coated granules are white or almost white and round (approximately 2 mm in diameter).

Levetiracetam Exeltis750 mg coated granules in a sachet

Packaging of 20, 30, 50, 60, 100, 200 sachets

Only some packaging sizes may be marketed

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder

Exeltis Healthcare, S.L.

Miralcampo Avenue 7

Miralcampo Industrial Estate 19200

Azuqueca de Henares (Guadalajara)

Spain

Manufacturer

Desitin Arzneimittel GmbH,

Weg beim Jäger 214,

22335 Hamburg,

Germany

This medicinal product is authorized in the Member States of the European Economic Area under the following names:

Germany: Levetiracetam Desitin 750 mg coated granules in a sachet

Portugal: Lovos 750 mg coated granules in a sachet

Romania: Levetiracetam Desitin 750 mg granules, in a sachet

Spain: Levetiracetam Exeltis 750 mg coated granules in a sachet

Date of the Last Revision of this Leaflet: January 2024

Detailed and updated information on this medicinal product is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/