Iracet 250 mg Tablet, 1 strip

Overview

Iracet 250 mg Tablet contains Levetiracetam 250 mg, an antiepileptic drug used as monotherapy for partial-onset seizures in adults and adolescents ≥16 years with newly diagnosed epilepsy, and as adjunctive therapy for partial-onset seizures, myoclonic seizures (Juvenile Myoclonic Epilepsy), and primary generalized tonic-clonic seizures (Idiopathic Generalised Epilepsy). The 250 mg strength is commonly used as the initial starting dose and for dose titration. Levetiracetam selectively inhibits hypersynchronization of epileptiform burst firing and seizure propagation without affecting normal neuronal excitability.

Dosage and Administration

Adults and adolescents ≥16 years (monotherapy): The recommended starting dose is 250 mg twice daily, increased to 500 mg twice daily after two weeks. The dose can be further increased by 250 mg twice daily every two weeks up to a maximum of 1500 mg twice daily.

Children ≥25 kg (adjunct add-on therapy): Starting dose 250 mg twice daily, maximum 750 mg twice daily. For children ≥50 kg, adult dosing applies.

Administration: Swallow tablets whole with sufficient liquid. May be taken with or without food. Daily dose divided into two equal doses.

Interaction

Iracet does not significantly interact with phenytoin, carbamazepine, valproic acid, phenobarbital, lamotrigine, gabapentin, or primidone. Probenecid inhibits renal clearance of the primary metabolite. Concurrent methotrexate use may reduce methotrexate clearance — monitor both levels. Do not take osmotic laxatives (macrogol) within one hour of Iracet.

Contraindications

Hypersensitivity to Levetiracetam, other pyrrolidone derivatives, or any excipient in the formulation.

Side Effects

Common effects in adults include somnolence, asthenia, infection, and dizziness. In children: fatigue, aggression, nasal congestion, decreased appetite, and irritability. Rare blood count abnormalities (neutropenia, thrombocytopenia, pancytopenia) and suicidal ideation have been reported.

Pregnancy and Lactation

Not recommended during pregnancy unless clinically necessary. Levetiracetam is excreted in breast milk; breastfeeding is not recommended during therapy.

Precautions and Warnings

Dose adjustment required in renal impairment. In severe hepatic impairment, consider a 50% dose reduction when creatinine clearance is below 60 ml/min. Monitor patients for suicidal ideation and depression. Blood counts should be assessed if the patient develops weakness, fever, or recurrent infections.

Storage Conditions

Store at a cool temperature not exceeding 25°C, in a dry place, protected from light. Keep out of the reach of children.

Frequently Asked Questions

Q: Why is Iracet 250 mg prescribed instead of the 500 mg dose?
The 250 mg strength is typically used to initiate treatment and allow gradual dose titration. Starting at a lower dose helps assess tolerability and minimises the risk of early side effects such as somnolence or dizziness. After two weeks, the dose is usually increased to 500 mg twice daily as the initial therapeutic dose, with further increases guided by the clinical response.

Q: Is Iracet 250 mg suitable for children?
Yes. For children weighing ≥25 kg, Iracet 250 mg tablet is appropriate as a starting dose for adjunctive therapy. For infants, children below 6 years, or patients unable to swallow tablets, the oral solution is the preferred formulation. Always follow the physician's prescribed dosing regimen based on the child's weight and seizure type.