Two medicines, side by side
Levetiracetam vs topiramate
Levetiracetam and topiramate are both labeled for seizures and epilepsy. Drugs@FDA records approvals of levetiracetam since 1999 and of topiramate since 1996. Pharmacies paid $0.0736 per levetiracetam 500 mg tablet and $0.0567 per topiramate 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 topiramate FDA label on DailyMed (effective June 1, 2026).
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 topiramate record
Topiramate (Topamax) · label of June 1, 2026
Used for
From the label: indicationsTopiramate is indicated for: Epilepsy: initial monotherapy for the treatment of partial-onset or primary generalized tonic-clonic seizures in patients 2 years of age and older (1.1); adjunctive therapy for the treatment of partial-onset seizures, primary generalized tonic-clonic seizures, or seizures associated with Lennox- Gastaut syndrome in patients 2 years of age and older (1.2) Preventive treatment of migraine […]
On the market
- Earliest approval on file
- December 24, 1996
- Generic labelers
- 47 labelers
- Pharmacy cost
- $0.0567 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 10
Source: FDA drug labels via openFDA (Levetiracetam label of January 28, 2026, Topiramate label of June 1, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do levetiracetam and topiramate 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.”; Topiramate, “The precise mechanisms by which topiramate exerts its anticonvulsant and preventive migraine effects are unknown; however, preclinical studies have revealed four properties that may contribute to …”
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 …”; Topiramate, “The mean plasma elimination half-life is 21 hours after single or multiple doses.”
Generics: levetiracetam since 2008; topiramate since 2003 (Drugs@FDA).
| Levetiracetam | Topiramate | |
|---|---|---|
| Labeled for | Seizures and epilepsy | Seizures and epilepsy, Migraine |
| Pharmacologic class | n/a | n/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. | The precise mechanisms by which topiramate exerts its anticonvulsant and preventive migraine effects are unknown; however, preclinical studies have revealed four properties that may contribute to topiramate's efficacy for epilepsy and the … |
| 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 mean plasma elimination half-life is 21 hours after single or multiple doses. |
| Earliest approval on file (Drugs@FDA) | November 30, 1999 | December 24, 1996 |
| First generic approved | November 4, 2008 | December 17, 2003 |
| Generic labelers (NDC) | 84 labelers | 47 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0736 per tablet (Levetiracetam 500 mg tablet) | $0.0567 per tablet (Topiramate 100 mg tablet) |
| 12-month price change | -5% | -10% |
| Boxed warning | No | No |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 15 | 10 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 132,823 | 91,067 |
| 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 do the labels say about using others of their kind?
Topiramate label, drug interactionsBecause of the potential of topiramate to cause CNS depression, as well as other cognitive and/or neuropsychiatric adverse reactions, topiramate should be used with extreme caution if used in combination with alcohol and other CNS depressants.
Source: FDA drug labels via openFDA
What next?
- Alternatives to levetiracetam
- every medicine labeled for the same conditions