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Two medicines, side by side

Levetiracetam vs phenobarbital

Levetiracetam and phenobarbital are both labeled for seizures and epilepsy. Drugs@FDA records approvals of levetiracetam since 1999 and of phenobarbital since 2022. Pharmacies paid $0.0736 per levetiracetam 500 mg tablet and $0.213 per phenobarbital 100 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like.

Check it at the source: the levetiracetam FDA label on DailyMed (effective January 28, 2026); the phenobarbital FDA label on DailyMed (effective August 27, 2026).

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

Highlights of the phenobarbital record

Phenobarbital (Sezaby) · label of August 27, 2026

Used for

From the label: indications

Sedative Anticonvulsant – For the treatment of generalized and partial seizures.

On the market

Earliest approval on file
November 17, 2022
Generic labelers
none listed
Pharmacy cost
$0.213 per tablet

Supply and safety

Shortage
A presentation being discontinued
Recalls
9

Source: FDA drug labels via openFDA (Levetiracetam label of January 28, 2026, Phenobarbital label of August 27, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)

How do levetiracetam and phenobarbital differ on the record?

Half-life, in each label's words: Levetiracetam, “Following oral administration of twice-daily dosing for 10 days, total body clearance decreased by 38% and the …”; Phenobarbital, “The plasma half-life for phenobarbital in adults ranges between 53 and 118 hours with a mean of 79 hours.”

Generics: levetiracetam since 2008; phenobarbital none approved (Drugs@FDA).

DEA schedule: levetiracetam none; phenobarbital CIV.

LevetiracetamPhenobarbital
Labeled forSeizures and epilepsySeizures and epilepsy
Pharmacologic classn/an/a
How it works (label)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.n/a
Half-life (label)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.The plasma half-life for phenobarbital in adults ranges between 53 and 118 hours with a mean of 79 hours.
Earliest approval on file (Drugs@FDA)November 30, 1999November 17, 2022
First generic approvedNovember 4, 2008none
Generic labelers (NDC)84 labelersnone listed
Pharmacy cost (NADAC, each one's most listed form; strengths differ)$0.0736 per tablet (Levetiracetam 500 mg tablet)$0.213 per tablet (Phenobarbital 100 mg tablet)
12-month price change-5%-18%
Boxed warningNoNo
Shortage nowNo current entryA presentation being discontinued
Recalls recorded159
FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used)132,823402
DEA schedulenoneCIV

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?

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