Matever: Uses, Dosage & Side Effects
Levetiracetam 250 mg film-coated tablets for the treatment and prevention of epileptic seizures in adults and children
Matever (levetiracetam) is a prescription antiepileptic drug (AED) used to treat and prevent epileptic seizures. It contains levetiracetam as the active ingredient, which works by binding to synaptic vesicle protein 2A (SV2A) in the brain, modulating neurotransmitter release and reducing abnormal neuronal hyperexcitability. Matever is available as 250 mg film-coated tablets and is used both as monotherapy in newly diagnosed epilepsy and as add-on therapy for partial-onset seizures, myoclonic seizures, and primary generalized tonic-clonic seizures. Levetiracetam is included on the WHO Model List of Essential Medicines and is one of the most widely prescribed antiepileptic drugs worldwide due to its favorable efficacy, tolerability, and minimal drug interaction profile.
Quick Facts: Matever
Key Takeaways
- Matever contains levetiracetam, an antiepileptic drug with a unique mechanism of action that targets synaptic vesicle protein 2A (SV2A), distinguishing it from traditional antiepileptic medications that act on sodium channels or GABA receptors.
- It is approved for monotherapy in newly diagnosed partial-onset seizures (ages 16+) and as adjunctive therapy for partial-onset seizures (from 1 month), myoclonic seizures in juvenile myoclonic epilepsy (ages 12+), and primary generalized tonic-clonic seizures (ages 12+).
- Levetiracetam has a favorable pharmacokinetic profile with near-complete oral bioavailability, minimal protein binding, and limited hepatic metabolism—resulting in fewer drug interactions compared to many other antiepileptic drugs.
- The most common side effects include drowsiness, headache, and dizziness. Behavioral and psychiatric effects such as irritability and mood changes should be monitored, especially during the initial treatment period.
- Treatment should never be stopped abruptly; the dose must be gradually reduced over at least 2–4 weeks under medical supervision to prevent breakthrough seizures or status epilepticus.
What Is Matever and What Is It Used For?
Matever contains the active substance levetiracetam, a member of the pyrrolidone class of antiepileptic drugs. Levetiracetam was first developed by UCB Pharma and received initial regulatory approval from the U.S. Food and Drug Administration (FDA) in 1999, followed by European Medicines Agency (EMA) approval in 2000. Since then, it has become one of the most commonly prescribed antiepileptic medications worldwide, available under the originator brand name Keppra as well as numerous generic formulations including Matever. It is listed on the World Health Organization (WHO) Model List of Essential Medicines, reflecting its importance in the global management of epilepsy.
Epilepsy is a chronic neurological disorder characterized by a predisposition to recurrent unprovoked seizures. It affects approximately 50 million people worldwide, making it one of the most common serious neurological conditions globally. Seizures arise from abnormal, excessive, or synchronous electrical activity in the brain and can manifest in a wide variety of ways depending on which parts of the brain are affected. Effective pharmacological treatment with antiepileptic drugs (AEDs) remains the cornerstone of epilepsy management, with the goal of achieving seizure freedom while minimizing side effects and preserving quality of life.
The mechanism of action of levetiracetam is distinct from that of most other antiepileptic drugs. While many traditional AEDs exert their effects through modulation of voltage-gated sodium channels (such as carbamazepine, phenytoin, and lamotrigine), enhancement of GABAergic inhibition (such as benzodiazepines and barbiturates), or blockade of glutamate receptors, levetiracetam primarily works by binding to synaptic vesicle protein 2A (SV2A). SV2A is an integral membrane glycoprotein found on synaptic vesicles throughout the central nervous system. It plays a crucial role in the regulation of neurotransmitter vesicle exocytosis—the process by which neurotransmitters are released from presynaptic neurons into the synaptic cleft. By modulating SV2A function, levetiracetam is thought to alter the rate and pattern of neurotransmitter release, thereby reducing the excessive neuronal synchronization that underlies seizure generation.
Research has demonstrated that levetiracetam's binding affinity for SV2A correlates strongly with its anticonvulsant potency in animal models, supporting SV2A as the primary molecular target responsible for its therapeutic effects. In addition to its SV2A-mediated action, levetiracetam has been shown to inhibit N-type calcium currents in neuronal cells and to reduce calcium release from intracellular stores, both of which may contribute to its anticonvulsant and potentially neuroprotective properties. These additional mechanisms may help explain why levetiracetam is effective across a broad spectrum of seizure types.
Matever is indicated for the following clinical uses in the treatment of epilepsy:
- Monotherapy for partial-onset seizures: Matever is approved as monotherapy (sole antiepileptic medication) for the treatment of partial-onset seizures with or without secondary generalization in patients aged 16 years and older with newly diagnosed epilepsy. This indication is supported by a pivotal non-inferiority trial (N01057) comparing levetiracetam to controlled-release carbamazepine, which demonstrated that levetiracetam was non-inferior for the primary endpoint of 6-month seizure-free rate.
- Adjunctive therapy for partial-onset seizures: As add-on treatment for partial-onset seizures with or without secondary generalization in patients from 1 month of age. Multiple randomized, double-blind, placebo-controlled trials have demonstrated significant reductions in seizure frequency when levetiracetam is added to existing antiepileptic therapy.
- Adjunctive therapy for myoclonic seizures: As add-on treatment for myoclonic seizures in patients aged 12 years and older with juvenile myoclonic epilepsy (JME). The pivotal trial (N01057) showed a statistically significant reduction in myoclonic seizure days per week compared with placebo.
- Adjunctive therapy for primary generalized tonic-clonic seizures: As add-on treatment for primary generalized tonic-clonic (PGTC) seizures in patients aged 12 years and older with idiopathic generalized epilepsy (IGE). Clinical trials demonstrated significant reductions in PGTC seizure frequency.
The efficacy of levetiracetam has been extensively demonstrated in large-scale randomized controlled trials and in real-world observational studies. In the Standard and New Antiepileptic Drugs (SANAD II) trial, one of the largest pragmatic randomized epilepsy trials ever conducted, levetiracetam was shown to be an effective first-line treatment option for both focal and generalized epilepsy. The International League Against Epilepsy (ILAE) recognizes levetiracetam as a first-line treatment option for several seizure types, and it is recommended in clinical guidelines issued by the National Institute for Health and Care Excellence (NICE), the American Academy of Neurology (AAN), and the Scottish Intercollegiate Guidelines Network (SIGN).
Levetiracetam is included on the WHO Model List of Essential Medicines, recognizing its critical importance in the treatment of epilepsy worldwide. Its favorable pharmacokinetic profile, broad-spectrum efficacy, minimal drug interactions, and availability in generic formulations make it a particularly valuable treatment option in both high-resource and low-resource healthcare settings.
What Should You Know Before Taking Matever?
Contraindications
The primary contraindication to Matever is hypersensitivity (allergy) to levetiracetam, to other pyrrolidone derivatives (such as piracetam), or to any of the excipients (inactive ingredients) in the formulation. If you have experienced an allergic reaction to any of these substances in the past, you must not take Matever. Allergic reactions can range from mild skin rashes to severe systemic reactions. If you are unsure whether you have an allergy to any of these components, discuss this with your doctor or pharmacist before starting treatment.
The excipients in Matever 250 mg film-coated tablets typically include maize starch, povidone, talc, colloidal anhydrous silica, magnesium stearate (in the tablet core), and a film-coating that may contain polyvinyl alcohol, titanium dioxide, macrogol, and talc. Patients with known intolerances to any of these components should inform their healthcare provider. The tablets also contain a small amount of colouring agent (iron oxide yellow for some strengths). Always check the patient information leaflet provided with your specific product for the complete list of excipients.
Warnings and Precautions
Never stop taking Matever without consulting your doctor. Abrupt discontinuation of antiepileptic medication can trigger increased seizure frequency or status epilepticus—a prolonged seizure that constitutes a medical emergency. If treatment needs to be stopped, your doctor will reduce the dose gradually over at least 2–4 weeks.
Before and during treatment with Matever, the following precautions and considerations should be discussed with your healthcare provider:
- Kidney (renal) impairment: Levetiracetam is primarily eliminated through the kidneys. Patients with impaired kidney function may require dose reduction based on their creatinine clearance. Your doctor will assess your kidney function before starting treatment and may monitor it periodically. Patients on dialysis may require supplemental doses after hemodialysis sessions.
- Psychiatric and behavioral effects: Levetiracetam has been associated with psychiatric and behavioral adverse effects including irritability, aggression, agitation, anger, anxiety, emotional lability, depression, and, in rare cases, psychotic symptoms. These effects appear to be more common in patients with a pre-existing history of psychiatric disorders. Monitor for any changes in mood or behavior, particularly during the first weeks of treatment or during dose changes. Report any concerning psychiatric symptoms to your doctor promptly.
- Suicidal ideation and behavior: A pooled analysis by the FDA and EMA of clinical trial data for antiepileptic drugs, including levetiracetam, identified a small but statistically significant increased risk of suicidal thoughts and behavior. This risk applies to all antiepileptic drugs as a class. Patients and caregivers should be alert to any emergence or worsening of depression, suicidal thoughts, or unusual changes in mood or behavior, and should seek immediate medical advice if such symptoms occur.
- Hematological abnormalities: Rare cases of decreased blood cell counts (leukopenia, neutropenia, pancytopenia, thrombocytopenia, and agranulocytosis) have been reported with levetiracetam use. While routine blood monitoring is not typically required, your doctor may recommend periodic blood counts, particularly if you develop symptoms such as unexplained fever, sore throat, bruising, or unusual bleeding.
- Hepatic impairment: In patients with severe liver impairment, kidney function may not accurately reflect levetiracetam clearance. Dose adjustment based on creatinine clearance may underestimate the true clearance in these patients, and additional monitoring may be warranted.
Pregnancy and Breastfeeding
The use of antiepileptic drugs during pregnancy requires careful consideration of the balance between the risk of uncontrolled seizures to both mother and baby and the potential risk of the medication itself. Uncontrolled seizures during pregnancy, particularly generalized tonic-clonic seizures, can lead to serious complications including trauma from falls, placental abruption, fetal hypoxia, and in severe cases, death of the mother or baby. Therefore, antiepileptic treatment should generally not be discontinued during pregnancy without careful medical supervision.
Levetiracetam crosses the placenta and is present in umbilical cord blood at concentrations similar to maternal plasma levels. Data from pregnancy registries and observational studies suggest that levetiracetam, both as monotherapy and in combination with other AEDs, may carry a lower risk of major congenital malformations compared to some other antiepileptic drugs such as valproate, phenobarbital, and topiramate. The UK Epilepsy and Pregnancy Register and the International Registry of Antiepileptic Drugs and Pregnancy (EURAP) have reported rates of major congenital malformations with levetiracetam monotherapy that are broadly comparable to background population rates, though the total evidence base remains smaller than for older AEDs. A decrease in levetiracetam plasma concentrations has been observed during pregnancy, likely due to increased renal clearance, which may necessitate dose adjustments to maintain seizure control.
Levetiracetam is excreted in human breast milk at concentrations approximately 100% of maternal plasma concentrations. However, the calculated infant dose through breast milk is estimated to be low (approximately 3–7.5% of the maternal weight-adjusted dose). Limited data suggest that breastfed infants of mothers taking levetiracetam do not experience significant adverse effects. The decision to breastfeed during treatment should be made in consultation with your doctor, weighing the well-established benefits of breastfeeding against the theoretical risks of drug exposure.
Women of childbearing potential should discuss family planning with their doctor before starting levetiracetam. If pregnancy is planned, a pre-conception consultation with a neurologist experienced in epilepsy management is strongly recommended to optimize the treatment regimen and minimize risks. Folic acid supplementation (at least 0.4–5 mg daily) is generally recommended for all women with epilepsy who may become pregnant.
Driving and Operating Machinery
Matever may cause drowsiness, somnolence, dizziness, and impaired coordination, particularly during the initial weeks of treatment or after dose increases. These effects can impair the ability to drive, operate heavy machinery, or perform other activities requiring alertness and fine motor coordination. Patients should be advised not to drive or operate machinery until they have gained sufficient experience with the medication to determine whether it affects their ability to perform these activities safely. In many jurisdictions, separate legal requirements govern driving for individuals with epilepsy, and patients should be aware of and comply with local regulations.
Alcohol
The concomitant use of alcohol with levetiracetam is not recommended. Alcohol can lower the seizure threshold, potentially increasing the risk of seizures in patients with epilepsy. Additionally, both alcohol and levetiracetam can cause central nervous system depression, and their combined use may amplify effects such as drowsiness, dizziness, and impaired cognitive function. Patients should discuss their alcohol consumption with their doctor and follow medical advice regarding safe levels of use, if any.
How Does Matever Interact with Other Drugs?
One of the key clinical advantages of levetiracetam compared to many older antiepileptic drugs is its favorable pharmacokinetic profile, which translates into a low potential for drug–drug interactions. Many traditional antiepileptic drugs, such as carbamazepine, phenytoin, phenobarbital, and valproate, are potent inducers or inhibitors of hepatic cytochrome P450 (CYP) enzymes and can significantly alter the metabolism and plasma concentrations of co-administered medications. Levetiracetam, by contrast, does not undergo significant CYP-mediated metabolism. It is hydrolyzed primarily by enzymatic hydrolysis of the acetamide group, yielding the pharmacologically inactive carboxylic acid metabolite ucb L057, a process that does not involve hepatic CYP enzymes.
Levetiracetam does not inhibit or induce any of the major CYP isoenzymes (CYP1A2, CYP2A6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP2E1, CYP3A4) or the UDP-glucuronosyltransferase (UGT) enzymes at clinically relevant concentrations. This means it is unlikely to affect the plasma concentrations or efficacy of other drugs metabolized by these pathways. Similarly, because levetiracetam is minimally bound to plasma proteins (<10%), it is not expected to displace other highly protein-bound drugs from their binding sites, which is another common source of drug interactions with older AEDs.
The following table summarizes the key known and potential interactions with levetiracetam:
| Drug / Category | Nature of Interaction | Clinical Significance |
|---|---|---|
| Probenecid | Inhibits renal tubular secretion of the primary metabolite ucb L057, reducing its clearance by approximately 60% | Low (metabolite is inactive); monitor if co-administered |
| Methotrexate | Co-administration may reduce methotrexate clearance, potentially increasing methotrexate toxicity | Moderate; monitor methotrexate levels closely |
| Other AEDs (carbamazepine, phenytoin, valproate, lamotrigine) | No clinically significant pharmacokinetic interactions identified in controlled studies | Low; no dose adjustment required |
| Oral contraceptives | No effect on ethinylestradiol or levonorgestrel pharmacokinetics | Low; contraceptive efficacy not affected |
| Digoxin | No pharmacokinetic interaction identified | Low; no dose adjustment required |
| Warfarin | No clinically significant effect on prothrombin time or INR | Low; standard monitoring recommended |
| CNS depressants (benzodiazepines, opioids, alcohol) | Potential additive CNS depressant effects (pharmacodynamic interaction) | Moderate; increased drowsiness and sedation possible |
It is important to note that while levetiracetam itself has minimal effects on the metabolism of other drugs, some co-administered antiepileptic drugs that are enzyme inducers (such as carbamazepine, phenytoin, and phenobarbital) can slightly increase the apparent clearance of levetiracetam by approximately 22%. However, this effect is modest and does not typically necessitate dose adjustment. Similarly, other enzyme-inducing medications (such as rifampicin) may slightly reduce levetiracetam levels, though this has not been studied in formal interaction trials.
The practical significance of levetiracetam's favorable drug interaction profile should not be underestimated. Patients with epilepsy frequently have comorbid conditions requiring treatment with multiple medications. Women of childbearing age, in particular, benefit from the fact that levetiracetam does not reduce the efficacy of hormonal contraceptives—an important advantage over enzyme-inducing AEDs such as carbamazepine, phenytoin, and phenobarbital, which can cause contraceptive failure.
Unlike enzyme-inducing antiepileptic drugs (carbamazepine, phenytoin, phenobarbital), levetiracetam does not reduce the efficacy of hormonal contraceptives, does not interact with anticoagulants in a clinically significant manner, and does not require routine therapeutic drug monitoring. This makes it a practical choice for polytherapy regimens and for patients on complex medication regimens.
What Is the Correct Dosage of Matever?
Matever should always be taken exactly as prescribed by your doctor. The tablets should be swallowed whole with a sufficient quantity of liquid and may be taken with or without food. The total daily dose is divided into two equal doses, one in the morning and one in the evening, at approximately the same times each day to maintain stable blood levels throughout the day and night.
Adults and Adolescents (16 Years and Older) – Monotherapy
For adults with newly diagnosed partial-onset seizures using Matever as monotherapy:
Monotherapy Dosing
Starting dose: 250 mg twice daily (500 mg/day). After 2 weeks, increase to the initial therapeutic dose of 500 mg twice daily (1000 mg/day). The dose may be further increased every 2 weeks by 250 mg twice daily increments as needed, up to a maximum recommended dose of 1500 mg twice daily (3000 mg/day).
Adults and Adolescents (12 Years and Older) – Adjunctive Therapy
| Phase | Dose | Frequency | Total Daily Dose |
|---|---|---|---|
| Starting dose | 500 mg | Twice daily | 1000 mg/day |
| Therapeutic range | 500–1500 mg | Twice daily | 1000–3000 mg/day |
| Maximum dose | 1500 mg | Twice daily | 3000 mg/day |
The dose can be increased or decreased by 500 mg twice daily every 2–4 weeks, depending on clinical response and tolerability. Some patients may achieve satisfactory seizure control at the initial dose of 500 mg twice daily, while others may require the maximum dose of 1500 mg twice daily. Your doctor will determine the optimal dose based on your individual seizure pattern, tolerability, and any concomitant medications.
Children (1 Month to <12 Years) – Adjunctive Therapy
For pediatric patients, the dose of levetiracetam is calculated based on body weight (mg/kg/day). The film-coated tablets may not be suitable for very young children or those who cannot swallow tablets; oral solution formulations are available for these patients. Dosing recommendations for children are as follows:
| Age Group | Starting Dose | Target/Maximum Dose | Dose Increments |
|---|---|---|---|
| 1 month to <6 months | 7 mg/kg twice daily | 21 mg/kg twice daily | Increase by 7 mg/kg twice daily every 2 weeks |
| 6 months to <4 years | 10 mg/kg twice daily | 30 mg/kg twice daily | Increase by 10 mg/kg twice daily every 2 weeks |
| 4 years to <12 years | 10 mg/kg twice daily | 30 mg/kg twice daily (max 3000 mg/day) | Increase by 10 mg/kg twice daily every 2 weeks |
| ≥12 years / ≥50 kg | 500 mg twice daily | 1500 mg twice daily (3000 mg/day) | Increase by 500 mg twice daily every 2–4 weeks |
Elderly Patients
In elderly patients with normal kidney function, no dose adjustment is required based on age alone. However, because kidney function naturally declines with age, elderly patients are more likely to have reduced renal clearance of levetiracetam. Your doctor should assess your kidney function (creatinine clearance) and adjust the dose accordingly if renal impairment is present. Elderly patients may also be more susceptible to central nervous system side effects such as drowsiness and dizziness, and a more gradual dose titration may be advisable.
Dose Adjustment in Kidney Impairment
Because levetiracetam is primarily excreted by the kidneys, dose reduction is necessary in patients with impaired renal function. The dose should be adjusted based on creatinine clearance (CLcr) as follows:
| Renal Function Group | Creatinine Clearance | Dose | Dosing Interval |
|---|---|---|---|
| Normal | >80 mL/min | 500–1500 mg | Twice daily |
| Mild impairment | 50–80 mL/min | 500–1000 mg | Twice daily |
| Moderate impairment | 30–50 mL/min | 250–750 mg | Twice daily |
| Severe impairment | <30 mL/min | 250–500 mg | Twice daily |
| End-stage renal disease (on dialysis) | — | 500–1000 mg once daily + 250–500 mg supplemental dose after dialysis | Once daily + post-dialysis |
Missed Dose
If you forget to take a dose of Matever, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and take the next one at the regular time. Do not take a double dose to make up for a forgotten dose. Maintaining a consistent dosing schedule is important for optimal seizure control. Using a pill organizer, alarm, or mobile phone reminder may help you remember to take your medication on time.
Overdose
If you suspect an overdose of Matever, seek immediate medical attention or contact your local poison control center. The symptoms of levetiracetam overdose may include severe drowsiness (somnolence), agitation, aggression, decreased level of consciousness, respiratory depression, and coma. There is no specific antidote for levetiracetam overdose. Treatment is supportive and may include gastric lavage or activated charcoal if the overdose is recent, along with monitoring of vital signs and clinical status. Levetiracetam can be removed from the body by hemodialysis (approximately 60% of the drug and 74% of the metabolite are removed during a 4-hour hemodialysis session), which may be considered in severe cases.
If your doctor decides to discontinue Matever treatment, the dose should be reduced gradually over a period of at least 2–4 weeks. In adults, the recommended reduction is 500 mg twice daily decrements every 2–4 weeks. Abrupt withdrawal may lead to rebound seizures, including potentially dangerous status epilepticus.
What Are the Side Effects of Matever?
Like all medicines, Matever can cause side effects, although not everybody who takes it will experience them. The safety profile of levetiracetam has been established through extensive clinical trials involving thousands of patients, as well as decades of post-marketing surveillance since its initial approval in 1999. Overall, levetiracetam is considered to have a favorable tolerability profile compared with many other antiepileptic drugs. Most side effects are mild to moderate, dose-related, and tend to occur during the first weeks of treatment or following dose increases, often improving spontaneously with continued use or dose adjustment.
The following side effects have been reported with levetiracetam, categorized by their frequency of occurrence based on clinical trial data and post-marketing surveillance:
Very Common
May affect more than 1 in 10 people
- Somnolence (drowsiness, sleepiness)
- Headache
- Nasopharyngitis (common cold, runny nose, sore throat)
Common
May affect up to 1 in 10 people
- Fatigue (tiredness)
- Dizziness
- Irritability
- Depression
- Aggression or hostility
- Anxiety
- Insomnia (difficulty sleeping)
- Nervousness
- Tremor
- Vertigo (sensation of spinning)
- Abdominal pain
- Nausea
- Vomiting
- Diarrhea
- Dyspepsia (indigestion)
- Anorexia (loss of appetite)
- Cough
- Rash
- Convulsion (seizure worsening in rare circumstances)
Uncommon
May affect up to 1 in 100 people
- Ataxia (impaired coordination)
- Paraesthesia (tingling or numbness)
- Diplopia (double vision)
- Blurred vision
- Emotional lability (mood swings)
- Psychotic disorder
- Alopecia (hair loss)
- Eczema
- Pruritus (itching)
- Muscle weakness
- Myalgia (muscle pain)
- Thrombocytopenia (low platelet count)
- Leukopenia (low white blood cell count)
- Weight increase
Rare
May affect up to 1 in 1,000 people
- Suicidal ideation and suicidal behavior
- Personality disorder
- Abnormal thinking
- Hallucinations
- Pancreatitis
- Hepatic failure and hepatitis
- Neutropenia and agranulocytosis
- Pancytopenia
Not Known
Frequency cannot be estimated from available data
- Toxic epidermal necrolysis (TEN)
- Stevens-Johnson syndrome (SJS)
- Drug reaction with eosinophilia and systemic symptoms (DRESS)
- Erythema multiforme
- Hyponatraemia (low blood sodium)
- Rhabdomyolysis and elevated creatine kinase
The psychiatric and behavioral side effects of levetiracetam deserve particular attention. In clinical trials, irritability was reported in approximately 3–13% of patients (compared with 0–2% on placebo), and aggression/hostility in approximately 1–3% (compared with less than 1% on placebo). Depression was reported in approximately 4–7% of patients. These effects tend to be more common in patients with a pre-existing history of psychiatric conditions, but they can also occur in patients without such a history. They typically develop within the first 4 weeks of treatment and may improve with dose reduction or, in some cases, may require treatment discontinuation.
A prospective observational study published in Epilepsia found that approximately 10–16% of patients starting levetiracetam reported behavioral side effects of sufficient severity to consider dose reduction or discontinuation. Strategies to manage these effects include slower dose titration, dose reduction, and in some cases, the addition of a low-dose B-vitamin supplement (pyridoxine/vitamin B6), which some clinical reports have suggested may help ameliorate levetiracetam-associated irritability, though this has not been confirmed in randomized controlled trials.
Somnolence is the single most commonly reported adverse effect and tends to be dose-related. In clinical trials, somnolence was reported in approximately 14–23% of patients receiving levetiracetam, compared with 8–10% on placebo. This effect is usually most prominent during the initial titration phase and often diminishes over the first weeks of treatment as tolerance develops. Taking the larger portion of the daily dose in the evening may help mitigate daytime drowsiness in some patients.
Seek medical attention immediately if you experience: suicidal thoughts or behavior; severe skin reactions (widespread rash with blistering, peeling skin, or mouth sores); signs of severe allergic reaction (difficulty breathing, swelling of face, lips, or throat); unusual bruising or bleeding; yellowing of the skin or eyes (jaundice); severe muscle pain or weakness with dark-colored urine; or signs of infection with persistent fever and sore throat.
How Should You Store Matever?
Proper storage of medications is essential to maintain their quality, safety, and therapeutic effectiveness. Matever film-coated tablets should be stored under the following conditions:
- Temperature: Store at room temperature, not above 25°C (77°F). Do not refrigerate or freeze the tablets.
- Moisture protection: Keep the tablets in the original packaging (blister pack or bottle) to protect them from moisture. Do not transfer tablets to other containers unless those containers provide equivalent moisture protection.
- Light protection: Store in the original outer carton to protect from light exposure, which can degrade certain pharmaceutical ingredients over time.
- Keep out of reach of children: Store Matever in a secure location where children cannot access it. Accidental ingestion of antiepileptic medication by a child can be dangerous.
- Expiry date: Do not use Matever after the expiry date (EXP) printed on the blister pack and outer carton. The expiry date refers to the last day of the indicated month.
Do not dispose of medications by flushing them down the toilet or throwing them in household waste unless specifically instructed to do so. Return unused or expired medication to your pharmacy for safe disposal. Many pharmacies and municipalities offer medication take-back programs to ensure environmentally responsible disposal. Ask your pharmacist about how to properly dispose of medications that you no longer need.
If you notice any change in the appearance of the tablets (such as discoloration, crumbling, or unusual odor), do not use them and consult your pharmacist. Film-coated tablets should appear smooth and intact; any damage to the coating may affect the drug's release characteristics or stability.
What Does Matever Contain?
Understanding the complete composition of your medication is important, particularly if you have known allergies or intolerances to specific pharmaceutical excipients. The composition of Matever 250 mg film-coated tablets is as follows:
Active Ingredient
Each film-coated tablet contains 250 mg of levetiracetam. Levetiracetam is the S-enantiomer of alpha-ethyl-2-oxo-1-pyrrolidine acetamide. It is a white to off-white crystalline powder that is freely soluble in water and has a molecular formula of C8H14N2O2 with a molecular weight of 170.21 daltons. The compound has a single chiral center, and only the S-enantiomer (levetiracetam) possesses anticonvulsant activity; the R-enantiomer is essentially inactive.
Inactive Ingredients (Excipients)
Tablet core: Maize starch, povidone K30, talc, colloidal anhydrous silica, and magnesium stearate. These excipients serve as fillers, binders, glidants, and lubricants to ensure the tablet is compressed properly and disintegrates appropriately after ingestion.
Film-coating: Polyvinyl alcohol–partially hydrolyzed, titanium dioxide (E171), macrogol 3350 (polyethylene glycol), and talc. The film-coating protects the tablet core from moisture and light, masks any unpleasant taste, and facilitates swallowing. For the 250 mg tablet, iron oxide yellow (E172) may be included in the coating to provide the characteristic blue color, depending on the specific manufacturer's formulation.
Matever 250 mg film-coated tablets are typically oval or oblong in shape, blue-colored, and may have a score line on one side for identification purposes (not intended for dose splitting unless specified). The exact appearance may vary slightly between different manufacturers' generic versions of levetiracetam. Always verify that the tablets you receive match the description in the patient information leaflet provided with your specific product.
Matever does not contain lactose, gluten, or sucrose, making it suitable for patients with lactose intolerance, celiac disease, or diabetes (in terms of excipient content). However, always verify the complete excipient list with your pharmacist if you have specific dietary restrictions or allergies, as formulations may vary slightly between manufacturers.
Frequently Asked Questions About Matever
Matever (levetiracetam) is an antiepileptic medication used to treat epilepsy. It is prescribed for the treatment of partial-onset seizures (with or without secondary generalization) both as monotherapy in newly diagnosed patients aged 16 and older, and as add-on therapy in patients from 1 month of age. It is also used as adjunctive therapy for myoclonic seizures in juvenile myoclonic epilepsy and primary generalized tonic-clonic seizures in idiopathic generalized epilepsy, both in patients aged 12 and older.
No. You should never stop taking Matever suddenly without consulting your doctor. Abrupt discontinuation of any antiepileptic medication can lead to a significant increase in seizure frequency, including potentially dangerous status epilepticus. When discontinuation is necessary, your doctor will gradually reduce your dose over a period of at least 2–4 weeks to minimize the risk of breakthrough seizures.
The most common side effects are somnolence (drowsiness), headache, nasopharyngitis (cold symptoms), fatigue, and dizziness. Behavioral and psychiatric side effects, including irritability, aggression, anxiety, and mood changes, have also been reported. Most side effects are mild to moderate and often improve during the first weeks of treatment. Contact your doctor if any side effects are persistent, worsening, or concerning.
Matever should only be used during pregnancy after careful evaluation of the risks and benefits by your doctor. Levetiracetam crosses the placenta, but data from pregnancy registries suggest it may carry a lower risk of major congenital malformations compared to some other antiepileptic drugs. However, uncontrolled seizures during pregnancy also pose serious risks to mother and baby. Women of childbearing potential should discuss family planning with their doctor, and folic acid supplementation is strongly recommended.
Levetiracetam has a favorable drug interaction profile because it is minimally bound to plasma proteins and not significantly metabolized by hepatic cytochrome P450 enzymes. Unlike many older antiepileptic drugs, it does not affect the efficacy of hormonal contraceptives or significantly interact with anticoagulants. Probenecid can reduce clearance of the primary metabolite, and caution is advised with methotrexate. Always inform your doctor about all medications you are taking.
Levetiracetam is rapidly absorbed and reaches peak blood levels within about 1.3 hours. However, the full therapeutic effect for seizure control may take several weeks, particularly as the dose is gradually titrated upward. Your doctor will typically evaluate your response after several weeks at the target dose. It is important to take Matever consistently as prescribed and not to adjust the dose on your own.
References
- European Medicines Agency (EMA). Levetiracetam – Summary of Product Characteristics. Last updated 2025. Available from: www.ema.europa.eu
- U.S. Food and Drug Administration (FDA). Keppra (Levetiracetam) Prescribing Information. Revised 2024. Available from: www.fda.gov
- World Health Organization (WHO). Model List of Essential Medicines – 23rd List. Geneva: WHO; 2023.
- Marson AG, Al-Kharusi AM, Alwaidh M, et al. The SANAD II study of the effectiveness of valproate, lamotrigine, or levetiracetam for newly diagnosed generalised and unclassifiable epilepsy: an open-label, non-inferiority, multicentre, phase 4, randomised controlled trial. Lancet. 2021;397(10282):1375–1386.
- Brodie MJ, Perucca E, Ryvlin P, Ben-Menachem E, Meencke HJ; Levetiracetam Monotherapy Study Group. Comparison of levetiracetam and controlled-release carbamazepine in newly diagnosed epilepsy. Neurology. 2007;68(6):402–408.
- International League Against Epilepsy (ILAE). Updated ILAE evidence review of antiseizure medication efficacy and effectiveness as initial monotherapy for epileptic seizures and syndromes. Epilepsia. 2022;63(8):1925–1938.
- National Institute for Health and Care Excellence (NICE). Epilepsies in Children, Young People and Adults [NG217]. London: NICE; 2024.
- Tomson T, Battino D, Bonizzoni E, et al. Comparative risk of major congenital malformations with eight different antiepileptic drugs: a prospective cohort study of the EURAP registry. Lancet Neurol. 2018;17(6):530–538.
- Lynch BA, Lambeng N, Bhiara K, et al. The synaptic vesicle protein SV2A is the binding site for the antiepileptic drug levetiracetam. Proc Natl Acad Sci USA. 2004;101(26):9861–9866.
- British National Formulary (BNF). Levetiracetam. Updated 2025. Available from: bnf.nice.org.uk
Editorial Team
Medical Author
iMedic Medical Editorial Team – Specialists in Neurology and Clinical Pharmacology
Medical Reviewer
iMedic Medical Review Board – Independent expert panel following ILAE, NICE, WHO and GRADE guidelines
Fact-Checking
Verified against EMA SmPC, FDA label, BNF monograph, and peer-reviewed sources
Last Updated
– Next review scheduled within 12 months
Editorial Standards: All content is written in accordance with iMedic's editorial standards, based on evidence level 1A (systematic reviews and meta-analyses of randomized controlled trials), and reviewed by licensed medical professionals. We follow the GRADE evidence framework and adhere to WHO, EMA, ILAE, and NICE guidelines.