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Old 12-02-2018, 01:39 AM
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When am I “in the clear” of breakthrough seizure risk after forgetting a dose?


I’ve been seizure free for 5 years taking 2500mg of keppra, after having a bunch of auras and two grand mals. I take 1000mg in the morning and 1500 in the afternoon. For the first time ever, I forgot the morning dose. I took the PM dose on time and took the AM with it because my doctor told me I could take it daily if I wanted. Since this is my first time, I’m worried about the risk of a breakthrough seizure. I have taken the dose late before with no symptoms, but never missed one. I’m trying to figure out when my risk is over. I’d assume that after 24 hours of missing the dose and being caught up I should be ok, but I don’t know if it’s something to worry about for multiple days or not.
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Old 12-02-2018, 08:16 AM
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Hi Mike --

Everyone us different -- individual metabolism, responsiveness to medication, therapeutic blood serum level, current stressors, health and age variations, etc. -- so unfortunately there's no way to predict for sure when you will be "in the clear." As with a lot of stuff about epilepsy, this kind of thing can be unpredictable and idiosyncratic.

Generally speaking, it bodes well that you have been seizure-free for five years, and also that you haven't had any problems when you've been late with a dose. Keppra has a short half life, so it's likely -- but not a given -- that if you were to experience a reaction it would occur within two or three days. However, it's still a good idea to pay attention to how you are feeling over the next few days. Be alert for auras or anything that feels unusual. Take care to avoid stressors, get plenty of sleep, etc. and avoid driving if at all possible.

Good luck!
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Old 12-02-2018, 09:31 AM
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Hi Mike,

Nakamova gave you some great advice. I've forgotten to take my meds in the past and there have been times when I have had seizures and other times there's been no problems a lot of it has to do with my drug level along with hormones changing. If you have any vitamin B12 take one of those it helps calm the nerves down. I wish you the best of luck and May God Bless You!

Sue
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Old 12-03-2018, 07:31 AM
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Five years seizure free is awesome! Have you ever discussed with your doctor if you could test the waters with weaning off the medication? Two years seizure free was the threshold/guideline last I checked where doctors consider it worth testing:

https://www.coping-with-epilepsy.com...ed-years-1458/
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Old 12-03-2018, 11:43 PM
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i can skip days and be free. but as for thinking i am free, not at all.
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Old 12-04-2018, 08:27 PM
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Five years seizure free is great. I can barely go a month without a seizure--simple or complex partial.
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Old 12-04-2018, 09:11 PM
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ditto
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Old 12-04-2018, 10:55 PM
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Originally Posted by Sabbo View Post:
Five years seizure free is great. I can barely go a month without a seizure--simple or complex partial.
Im the same, in my adult life I'm just happy to take each day as it comes. The fact I've only had 3 seizures in 4 months in amazing for me 😊
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Old 12-09-2018, 09:44 PM
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I take my meds 3 time a day - 7am, 1pm and 7pm. I have missed a dose before, only one dose during the day not a whole day. Depending on how long it was after I missed the dose, maybe an hour or two, I'll take it but if it's any later than that I'll just leave that dose alone and take next one on time. I don't think I've ever had any problems. I've never doubled doses when I take the next dose.
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Old 12-10-2018, 07:16 AM
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To really determine you would have to have been taking blood samples to measure the medication levels.
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