Skip to main content

Two medicines, side by side

Lamotrigine vs levetiracetam

Lamotrigine and levetiracetam are both labeled for seizures and epilepsy. Drugs@FDA records approvals of lamotrigine since 1994 and of levetiracetam since 1999. Pharmacies paid $0.0268 per lamotrigine 25 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. Lamotrigine's other strengths are brand-only: $2.86 per mL (Subvenite 10 mg/mL suspension). Only the lamotrigine label carries a boxed warning.

Check it at the source: the lamotrigine FDA label on DailyMed (effective October 10, 2025); the levetiracetam FDA label on DailyMed (effective January 28, 2026).

Highlights of the lamotrigine record

Lamotrigine (Lamictal) · label of October 10, 2025

Boxed warning

SERIOUS SKIN RASHES LAMICTAL can cause serious rashes requiring hospitalization and discontinuation of treatment. The incidence of these rashes, which have included Stevens-Johnson syndrome, is approximately 0.3% to 0.8% in pediatric patients (aged 2 to 17 years) and 0.08% to 0.3% in adults receiving LAMICTAL. One rash-related death was reported in a prospectively followed cohort of 1,983 pediatric patients (aged 2 to 16 years) with epilepsy taking LAMICTAL as adjunctive therapy.

Used for

From the label: indications

LAMICTAL is indicated for: Epilepsy–adjunctive therapy in patients aged 2 years and older: • partial-onset seizures. • primary generalized tonic-clonic (PGTC) seizures. • generalized seizures of Lennox-Gastaut syndrome. […]

On the market

Earliest approval on file
December 27, 1994
Generic labelers
49 labelers
Pharmacy cost
$0.0268 per tablet

Supply and safety

Shortage
A presentation being discontinued
Recalls
10

Highlights of the levetiracetam record

Levetiracetam (Keppra) · label of January 28, 2026

Used for

From the label: indications

KEPPRA 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 (Lamotrigine label of October 10, 2025, Levetiracetam label of January 28, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)

How do lamotrigine and levetiracetam differ on the record?

Only the lamotrigine label carries a boxed warning.

How each works, in its label's words: Lamotrigine, “The precise mechanism(s) by which lamotrigine exerts its anticonvulsant action are unknown.”; Levetiracetam, “A saturable and stereoselective neuronal binding site in rat brain tissue has been described for levetiracetam.”

Generics: lamotrigine since 2006; levetiracetam since 2008 (Drugs@FDA).

LamotrigineLevetiracetam
Labeled forSeizures and epilepsy, Bipolar disorderSeizures and epilepsy
Pharmacologic classAnti-epileptic Agent, Mood Stabilizern/a
How it works (label)The precise mechanism(s) by which lamotrigine exerts its anticonvulsant action are unknown.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)n/aFollowing 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)December 27, 1994November 30, 1999
First generic approvedJune 21, 2006November 4, 2008
Generic labelers (NDC)49 labelers84 labelers
Pharmacy cost (NADAC, each one's most listed form; strengths differ)$0.0268 per tablet (Lamotrigine 25 mg tablet)$0.0736 per tablet (Levetiracetam 500 mg tablet)
12-month price change-12%-5%
Boxed warningYesNo
Shortage nowA presentation being discontinuedNo current entry
Recalls recorded1015
FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used)130,994132,823
DEA schedulenonenone

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 lamotrigine
every medicine labeled for the same conditions