Two medicines, side by side
Lacosamide vs levetiracetam
Lacosamide and levetiracetam are both labeled for seizures and epilepsy. Drugs@FDA records approvals of lacosamide since 2008 and of levetiracetam since 1999. Pharmacies paid $0.174 per lacosamide 100 mg tablet and $0.0736 per levetiracetam 500 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like.
Check it at the source: the lacosamide FDA label on DailyMed (effective May 12, 2026); the levetiracetam FDA label on DailyMed (effective January 28, 2026).
Highlights of the lacosamide record
Lacosamide (Vimpat) · label of May 12, 2026
Used for
From the label: indicationsVIMPAT is indicated for: Treatment of partial-onset seizures in patients 1 month of age and older ( 1.1 ) Adjunctive therapy in the treatment of primary generalized tonic-clonic seizures in patients 4 years of age and older ( 1.2 ) 1.1 Partial-Onset Seizures VIMPAT is indicated for the treatment of partial-onset seizures in patients 1 month of age and older. 1.2 Primary Generalized Tonic-Clonic Seizures VIMPAT is indicated as adjunctive therapy in the treatment of primary generalized tonic-clonic seizures in patients 4 years of age and older. […]
On the market
- Earliest approval on file
- October 28, 2008
- Generic labelers
- 57 labelers
- Pharmacy cost
- $0.174 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 8
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 (Lacosamide label of May 12, 2026, Levetiracetam label of January 28, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do lacosamide and levetiracetam differ on the record?
How each works, in its label's words: Lacosamide, “The precise mechanism by which VIMPAT exerts its antiepileptic effects in humans remains to be fully elucidated.”; Levetiracetam, “A saturable and stereoselective neuronal binding site in rat brain tissue has been described for levetiracetam.”
Half-life, in each label's words: Lacosamide, “The maximum lacosamide plasma concentrations occur approximately 1-to-4-hour post-dose after oral dosing, and …”; Levetiracetam, “Following oral administration of twice-daily dosing for 10 days, total body clearance decreased by 38% and the …”
Generics: lacosamide since 2022; levetiracetam since 2008 (Drugs@FDA).
DEA schedule: lacosamide CV; levetiracetam none.
| Lacosamide | Levetiracetam | |
|---|---|---|
| Labeled for | Seizures and epilepsy | Seizures and epilepsy |
| Pharmacologic class | n/a | n/a |
| How it works (label) | The precise mechanism by which VIMPAT exerts its antiepileptic effects in humans remains to be fully elucidated. | 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) | The maximum lacosamide plasma concentrations occur approximately 1-to-4-hour post-dose after oral dosing, and elimination half-life is approximately 13 hours. | 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) | October 28, 2008 | November 30, 1999 |
| First generic approved | March 17, 2022 | November 4, 2008 |
| Generic labelers (NDC) | 57 labelers | 84 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.174 per tablet (Lacosamide 100 mg tablet) | $0.0736 per tablet (Levetiracetam 500 mg tablet) |
| 12-month price change | -15% | -5% |
| Boxed warning | No | No |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 8 | 15 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 36,995 | 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 next?
- Alternatives to lacosamide
- every medicine labeled for the same conditions