Two medicines, side by side
Levetiracetam vs phenytoin
Levetiracetam and phenytoin are both labeled for seizures and epilepsy. Drugs@FDA records approvals of levetiracetam since 1999 and of phenytoin since 1953. Pharmacies paid $0.0736 per levetiracetam 500 mg tablet and $0.145 per phenytoin sod ext 100 mg capsule (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 phenytoin FDA label on DailyMed (effective October 15, 2024).
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
Highlights of the phenytoin record
Phenytoin (Dilantin) · label of October 15, 2024
Used for
From the label: indicationsPHENYTEK ® capsules (extended phenytoin sodium capsules) are indicated for the treatment of tonic-clonic (grand mal) and psychomotor (temporal lobe) seizures and prevention and treatment of seizures occurring during or following neurosurgery. […]
On the market
- Earliest approval on file
- January 6, 1953
- Generic labelers
- 29 labelers
- Pharmacy cost
- $0.145 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 11
Source: FDA drug labels via openFDA (Levetiracetam label of January 28, 2026, Phenytoin label of October 15, 2024); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do levetiracetam and phenytoin differ on the record?
How each works, in its label's words: Levetiracetam, “A saturable and stereoselective neuronal binding site in rat brain tissue has been described for levetiracetam.”; Phenytoin, “The precise mechanism by which phenytoin exerts its therapeutic effect has not been established but is thought to involve the voltage-dependent blockade of membrane sodium channels resulting in a …”
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 …”; Phenytoin, “Elimination The plasma half-life in man after oral administration of phenytoin averages 22 hours, with a range of 7 to …”
Generics: levetiracetam since 2008; phenytoin since 1975 (Drugs@FDA).
| Levetiracetam | Phenytoin | |
|---|---|---|
| Labeled for | Seizures and epilepsy | Seizures and epilepsy |
| Pharmacologic class | n/a | Anti-epileptic Agent |
| 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. | The precise mechanism by which phenytoin exerts its therapeutic effect has not been established but is thought to involve the voltage-dependent blockade of membrane sodium channels resulting in a reduction in sustained high-frequency … |
| 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. | Elimination The plasma half-life in man after oral administration of phenytoin averages 22 hours, with a range of 7 to 42 hours. |
| Earliest approval on file (Drugs@FDA) | November 30, 1999 | January 6, 1953 |
| First generic approved | November 4, 2008 | July 16, 1975 |
| Generic labelers (NDC) | 84 labelers | 29 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0736 per tablet (Levetiracetam 500 mg tablet) | $0.145 per capsule (Phenytoin sod ext 100 mg capsule) |
| 12-month price change | -5% | -5% |
| Boxed warning | No | No |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 15 | 11 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 132,823 | 40,278 |
| DEA schedule | none | 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 levetiracetam
- every medicine labeled for the same conditions