Two medicines, side by side
Cenobamate vs levetiracetam
Cenobamate and levetiracetam are both labeled for seizures and epilepsy. Drugs@FDA records approvals of cenobamate since 2019 and of levetiracetam since 1999. Pharmacies paid $39.87 per Xcopri 100 mg tablet and $0.0736 per levetiracetam 500 mg tablet (NADAC, October 7, 2026); the strengths differ and one is a brand and one a generic, so the two prices are not like for like.
Check it at the source: the cenobamate FDA label on DailyMed (effective August 25, 2025); the levetiracetam FDA label on DailyMed (effective January 28, 2026).
Highlights of the cenobamate record
Cenobamate (Xcopri) · label of August 25, 2025
Used for
From the label: indicationsXCOPRI is indicated for the treatment of partial-onset seizures in adult patients. XCOPRI is indicated for the treatment of partial-onset seizures in adult patients.
On the market
- Earliest approval on file
- November 21, 2019
- Generic labelers
- none listed
- Pharmacy cost
- $39.87 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
Highlights of the levetiracetam record
Levetiracetam (Keppra) · label of January 28, 2026
Used for
From the label: indicationsKEPPRA is indicated for the treatment of partial-onset seizures in patients 1 month of age and older ( 1.1 ) KEPPRA is indicated for adjunctive therapy for the treatment of: Myoclonic seizures in patients 12 years of age and older with juvenile myoclonic epilepsy ( 1.2 ) Primary generalized tonic-clonic seizures in patients 6 years of age and older with idiopathic generalized epilepsy ( 1.3 ) 1.1 Partial-Onset […]
On the market
- Earliest approval on file
- November 30, 1999
- Generic labelers
- 84 labelers
- Pharmacy cost
- $0.0736 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 15
Source: FDA drug labels via openFDA (Cenobamate label of August 25, 2025, Levetiracetam label of January 28, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do cenobamate and levetiracetam differ on the record?
How each works, in its label's words: Cenobamate, “Cenobamate has been demonstrated to reduce repetitive neuronal firing by inhibiting voltage-gated sodium currents.”; Levetiracetam, “A saturable and stereoselective neuronal binding site in rat brain tissue has been described for levetiracetam.”
Half-life, in each label's words: Cenobamate, “Elimination The apparent terminal half-life of cenobamate is 50-60 hours and apparent oral clearance is approximately …”; Levetiracetam, “Following oral administration of twice-daily dosing for 10 days, total body clearance decreased by 38% and the …”
Generics: cenobamate none approved; levetiracetam since 2008 (Drugs@FDA).
DEA schedule: cenobamate CV; levetiracetam none.
| Cenobamate | Levetiracetam | |
|---|---|---|
| Labeled for | Seizures and epilepsy | Seizures and epilepsy |
| Pharmacologic class | n/a | n/a |
| How it works (label) | The precise mechanism by which cenobamate exerts its therapeutic effects in patients with partial-onset seizures is unknown. Cenobamate has been demonstrated to reduce repetitive neuronal firing by inhibiting voltage-gated sodium currents. | The precise mechanism(s) by which levetiracetam exerts its antiepileptic effect is unknown. A saturable and stereoselective neuronal binding site in rat brain tissue has been described for levetiracetam. |
| Half-life (label) | Elimination The apparent terminal half-life of cenobamate is 50-60 hours and apparent oral clearance is approximately 0.45-0.63 L/hour over a dose range from 100 mg/day to 400 mg/day. | Following oral administration of twice-daily dosing for 10 days, total body clearance decreased by 38% and the half-life was 2.5 hours longer in the elderly compared to healthy adults. |
| Earliest approval on file (Drugs@FDA) | November 21, 2019 | November 30, 1999 |
| First generic approved | none | November 4, 2008 |
| Generic labelers (NDC) | none listed | 84 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $39.87 per tablet (Xcopri 100 mg tablet) | $0.0736 per tablet (Levetiracetam 500 mg tablet) |
| 12-month price change | +3% | -5% |
| Boxed warning | No | No |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 0 | 15 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 8,296 | 132,823 |
| DEA schedule | CV | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Cenobamate label, drug interactionsDepressants and Alcohol Concomitant use of XCOPRI with other CNS depressants, including alcohol, may increase the risk of neurological adverse reactions, including sedation and somnolence [see Warnings and Precautions ( 5.5 )].
Source: FDA drug labels via openFDA
What next?
- Alternatives to cenobamate
- every medicine labeled for the same conditions