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Two medicines, side by side

Zonisamide vs levetiracetam

Zonisamide and levetiracetam are both labeled for seizures and epilepsy. Drugs@FDA records approvals of zonisamide since 2000 and of levetiracetam since 1999. Pharmacies paid $0.106 per zonisamide 100 mg capsule and $0.0736 per levetiracetam 500 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Zonisamide's other strengths are brand-only: $2.75 per mL (Zonisade 100 mg/5 mL oral suspension).

Check it at the source: the zonisamide FDA label on DailyMed (effective June 4, 2026); the levetiracetam FDA label on DailyMed (effective January 28, 2026).

Highlights of the zonisamide record

Zonisamide (Zonegran) · label of June 4, 2026

Used for

From the label: indications

Zonisamide is indicated as adjunctive therapy in the treatment of partial seizures in adults with epilepsy.

On the market

Earliest approval on file
March 27, 2000
Generic labelers
20 labelers
Pharmacy cost
$0.106 per capsule

Supply and safety

Shortage
No current entry
Recalls
11

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 (Zonisamide label of June 4, 2026, Levetiracetam label of January 28, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)

How do zonisamide and levetiracetam differ on the record?

Half-life, in each label's words: Zonisamide, “The elimination half-life of zonisamide in plasma is approximately 63 hours.”; Levetiracetam, “Following oral administration of twice-daily dosing for 10 days, total body clearance decreased by 38% and the …”

Generics: zonisamide since 2005; levetiracetam since 2008 (Drugs@FDA).

ZonisamideLevetiracetam
Labeled forSeizures and epilepsySeizures and epilepsy
Pharmacologic classAnti-epileptic Agentn/a
How it works (label)n/aThe 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 elimination half-life of zonisamide in plasma is approximately 63 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)March 27, 2000November 30, 1999
First generic approvedDecember 22, 2005November 4, 2008
Generic labelers (NDC)20 labelers84 labelers
Pharmacy cost (NADAC, each one's most listed form; strengths differ)$0.106 per capsule (Zonisamide 100 mg capsule)$0.0736 per tablet (Levetiracetam 500 mg tablet)
12-month price change-1%-5%
Boxed warningNoNo
Shortage nowNo current entryNo current entry
Recalls recorded1115
FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used)10,560132,823
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 zonisamide
every medicine labeled for the same conditions