Add Zonisamide or increase Keppra dose?

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bethad5
Posts: 14
Joined: Fri Jul 08, 2016 4:49 pm
Location: Des Moines, IA

Add Zonisamide or increase Keppra dose?

Post by bethad5 » Wed Aug 03, 2016 4:34 am

Hi all,

My dog, Archer, is a 3.5 year old Lab/Akita mix. He had his first seizure in July 2015, followed by another six weeks later in August, followed by another 3 weeks later in September. He was started on phenobarbital at that time (only a half tab twice a day rather than the 'typical' full tab 2x/day for his weight (60 pounds) due to side effects) as well as a supplement, Cholodin. This was relatively successful and he didn't have another seizure until the end of November, at which time we upped his phenobarbital dose. He was then seizure free until March 2016, but beginning in January got really ill- had ringworm, then just was overall sick- turns out he had a severe reaction to the phenobarbital - neutropenia - which wiped out his immune system and he ended up septic. In March, he was running a fever around 102 the night of his seizure; when I took him to the vet in the morning his temperature was 105. He spent a weekend in the vet hospital, they ran all sorts of tests, and their initial diagnosis was "presumable lymphoma" because an ultrasound showed an enlarged liver and spleen. However, the specialist we saw told us that "documented in a textbook somewhere, but very rare, is a neutropenic reaction due to phenobarb" so we began weaning the phenobarb and started Keppra (500mg 3x/day). We weaned the phenobarb over a month's time. Once he was off the phenobarb, his white blood cell count was back in normal limits (we had weekly lab draws for about two months to monitor his counts. We were dangerously close to doing a bone marrow aspirate, which I am so grateful I held off on.)

After all that (it was a bad late winter/spring for Archer!), he made it until May 23 and had two seizures, ten hours apart - he had never had more than one seizure a day before, so this was new. We upped his keppra then to 750mg 3x/day and added Cholodin back in (when Archer went to the vet hospital, the specialist hadn't heard of Cholodin and recommended we stop using it. Since he made it so long on the pb/Cholodin combo, I figured it wouldn't hurt to add it back in). He made it until July 8, where he had two more grand mal seizures, this time 5 hours apart - went to the vet and they upped his Keppra to 1000mg 3x/day, and recommended we start 2 more supplements, GABA and taurine. He then had a focal seizure that afternoon (his first).

Yesterday he had a focal seizure around 2:10pm; my boyfriend luckily was home at the time, and gave him his 1000mg dose of keppra (due at 3pm). At 2:15pm he had a grand mal seizure. The Vet recommended giving him 500mg keppra between doses; gave him 500mg at 7:00pm and he had another grand mal seizure at 7:45pm. We gave him another 500mg around 8:15pm, then his regular 1000mg at 11:00pm.

When I spoke to my vet yesterday, he thinks it is time to add Zonisamide to Archer's med regimen, and wants to start him on 150mg 2x/day, which he tells me is 6 capsules total per day. He said he'd rather add Zonisamide than increase the Keppra since we're already at 3000mg daily. I am supposed to pick up the Zonisamide this afternoon.

Anyone have experience with Keppra and Zonisamide together?

As you all know, it is just so heartbreaking to watch your animal go through something like this, and trying to find a pattern when there isn't necessarily anything to make a pattern of is so frustrating. I think yesterday's seizures really got to me because I was so hopeful when we started the supplements, especially taurine, based on all the great things I've read about it; for him to have a seizure 3 weeks later was so disappointing.

Sorry for the wordy post.... look forward to hearing any advice you may have.
Archer, Lab/Akita mix

First seizure: July 6, 2015
Last seizure: March 25, 2017

Current meds:
Potassium Bromide 1000mg 1x/day (started 3/28/17)
Keppra 1000mg 3x/day
Zonisamide 150mg 2x/day
Cholodin 1 tablet 2x/day
GABA 500mg 2x/day
Taurine 500mg 2x/day

Gentle Jacob's mom
Posts: 925
Joined: Thu Mar 04, 2010 10:52 am

Re: Add Zonisamide or increase Keppra dose?

Post by Gentle Jacob's mom » Wed Aug 03, 2016 6:06 am

I'm so sorry for the way this has turned out after such an encouraging start. You've really been through it. This stupid disease can change at any time. Has you vet mentioned having Peak and Trough tests done to see how Archer is metabolizing Keppra? Jake was tested about 8 years ago and we found out that he was metabolizing it way too fast. We increased his dosing and really didn't see much improvement. Then someone here posted about dosing 4x a day instead of three, and we finally got our first real improvement since he'd started seizing. The seizures dropped from 1.5-2 minutes to 10-20 seconds and his post ictal pacing and blindness went away. Jake's refractory, so we've never gotten control, and he seizes about every 2-3 weeks, with an occasional 10 days just to scare the heck out of us. He's also prone to clusters. Has your vet suggested rectal Valium, Clorazepate or extra Keppra after a seizure to control the clusters? If not I would definitely ask about that to see if you can get control of them.
Jake's been taking Cholodin for 10 years and while I really don't know if it has helped keep his seizures from getting worse, it has helped with his overall well being. He's 12 and we've been in this for 10 years. Cholodin along with his extreme stubbornness have probably contributed a great deal to that.
I'm not a vet by a long shot, but I've really wondered about the connection between how dogs metabolize these drugs and how well they work. I've asked but the only drug they give answers for is Keppra. Maybe because it's the only one that they can test for, I don't know. I also think inflammation contributes on some level.
As far as anyone can tell Keppra is very safe at high doses. Jake overdosed on it back in June of 2013. I posted about how it happened. Let's just say I trusted someone I shouldn't have. Anyway, he had many thousands of mgs in his system for several days, had an enlarged spleen, and completely recovered with no long term problems at all. We do give him an extra 350 mgs of Keppra for 5 days after he seizes and so far it helps.
Jake's not on Zonisamide so maybe someone else can comment on that. But there are several dogs here that it has helped.
No matter how long you're in this this disease gets to you. You'd have to be made of cement for it not to. I recently melted down for the first time in years. Not because of anything all that big, but just because. 10 years ago I'd hoped we'd get Jake's seizures under control. Of course 10 years ago I didn't think there was any way he would still be with us. And he is and he's a happy dog. So don't give up.
As you can see long posts are more than okay. Please keep us posted. We're here when you need us.
Take Care,
Lynne

MK's mom
Posts: 1708
Joined: Wed Mar 01, 2006 9:48 am
Location: Michigan

Re: Add Zonisamide or increase Keppra dose?

Post by MK's mom » Wed Aug 03, 2016 6:43 am

My boy is on Pb and zonisamide. He started seizing in July of 2013, clustered thru March of 2014 and suddenly stopped with no seizures since then. The Pb was causing (we think) gingival hyperplasia where the gums enlarge and cover the teeth, which he's had two surgeries for thus far, so we started reducing the Pb back in November and I hope to get him off of it completely. All that said, I can't say if the zonisamide, Pb or both has helped his seizures, but we had a hard time stopping them until they came to an abrupt stop altogether and reducing meds hasn't caused anymore seizures yet. This disease is so unpredictable and every dog is different in what they'll respond to, so I say try the zonisamide, but only make one medicinal change at a time so you'll know for sure what is working and what isn't.
Nathan
3.5 yo Irish Setter boy
First seizure 7/26/2013
Last seizure 3/24/2014
__________________________________
MK
5 yo Irish Setter boy
First seizure 1/25/06
Last seizure 9/4/2009

Aug 17, 2004- Sept. 22, 2009
May the shamrocks fall softly sweetpea

bethad5
Posts: 14
Joined: Fri Jul 08, 2016 4:49 pm
Location: Des Moines, IA

Re: Add Zonisamide or increase Keppra dose?

Post by bethad5 » Thu Aug 04, 2016 2:58 pm

Gentle Jacob's mom wrote:I'm so sorry for the way this has turned out after such an encouraging start. You've really been through it. This stupid disease can change at any time. Has you vet mentioned having Peak and Trough tests done to see how Archer is metabolizing Keppra? Jake was tested about 8 years ago and we found out that he was metabolizing it way too fast. We increased his dosing and really didn't see much improvement. Then someone here posted about dosing 4x a day instead of three, and we finally got our first real improvement since he'd started seizing. The seizures dropped from 1.5-2 minutes to 10-20 seconds and his post ictal pacing and blindness went away. Jake's refractory, so we've never gotten control, and he seizes about every 2-3 weeks, with an occasional 10 days just to scare the heck out of us. He's also prone to clusters. Has your vet suggested rectal Valium, Clorazepate or extra Keppra after a seizure to control the clusters? If not I would definitely ask about that to see if you can get control of them.
Jake's been taking Cholodin for 10 years and while I really don't know if it has helped keep his seizures from getting worse, it has helped with his overall well being. He's 12 and we've been in this for 10 years. Cholodin along with his extreme stubbornness have probably contributed a great deal to that.
I'm not a vet by a long shot, but I've really wondered about the connection between how dogs metabolize these drugs and how well they work. I've asked but the only drug they give answers for is Keppra. Maybe because it's the only one that they can test for, I don't know. I also think inflammation contributes on some level.
As far as anyone can tell Keppra is very safe at high doses. Jake overdosed on it back in June of 2013. I posted about how it happened. Let's just say I trusted someone I shouldn't have. Anyway, he had many thousands of mgs in his system for several days, had an enlarged spleen, and completely recovered with no long term problems at all. We do give him an extra 350 mgs of Keppra for 5 days after he seizes and so far it helps.
Jake's not on Zonisamide so maybe someone else can comment on that. But there are several dogs here that it has helped.
No matter how long you're in this this disease gets to you. You'd have to be made of cement for it not to. I recently melted down for the first time in years. Not because of anything all that big, but just because. 10 years ago I'd hoped we'd get Jake's seizures under control. Of course 10 years ago I didn't think there was any way he would still be with us. And he is and he's a happy dog. So don't give up.
As you can see long posts are more than okay. Please keep us posted. We're here when you need us.
Take Care,
Lynne
I asked my vet about doing blood tests for the Keppra but he said there weren't any. He has recommended an extra dose of keppra after a seizure to try to prevent clustering- not sure how well that is working; Tuesday he had a focal seizure at 2:10, he got his keppra dose, then had a grand mal at 2:15... the vet recommended only giving 500-750mg of keppra instead of the full 1000mg after that so we gave him 500mg around 7pm, then he seized again at 7:45pm, so he got another 500mg, then his regular 1000mg at 11:00pm. We were hesitant to give him a full 1000mg after his grand mal seizure since he had just gotten his full dose. His second/final seizure was the one at 7:45pm, so maybe the keppra is what stopped more from happening. I wish we would have given another full dose of keppra between seizures instead of 500mg, but it's impossible to know if that would have mattered or not.
Archer, Lab/Akita mix

First seizure: July 6, 2015
Last seizure: March 25, 2017

Current meds:
Potassium Bromide 1000mg 1x/day (started 3/28/17)
Keppra 1000mg 3x/day
Zonisamide 150mg 2x/day
Cholodin 1 tablet 2x/day
GABA 500mg 2x/day
Taurine 500mg 2x/day

bethad5
Posts: 14
Joined: Fri Jul 08, 2016 4:49 pm
Location: Des Moines, IA

Re: Add Zonisamide or increase Keppra dose?

Post by bethad5 » Thu Aug 04, 2016 3:03 pm

MK's mom wrote:My boy is on Pb and zonisamide. He started seizing in July of 2013, clustered thru March of 2014 and suddenly stopped with no seizures since then. The Pb was causing (we think) gingival hyperplasia where the gums enlarge and cover the teeth, which he's had two surgeries for thus far, so we started reducing the Pb back in November and I hope to get him off of it completely. All that said, I can't say if the zonisamide, Pb or both has helped his seizures, but we had a hard time stopping them until they came to an abrupt stop altogether and reducing meds hasn't caused anymore seizures yet. This disease is so unpredictable and every dog is different in what they'll respond to, so I say try the zonisamide, but only make one medicinal change at a time so you'll know for sure what is working and what isn't.
Started the zonisamide last night- it seemed to knock him out completely but maybe that was coincidence since it didn't seem to do that to him this morning. Do you remember if/when any side effects of zonisamide appeared and how long it took? Trying to prepare myself for ataxia, etc.; glad that the weekend is coming up so I'll be able to keep a better, more consistent eye on him. The vet started him on 150mg 2x/day- so three 50mg capsules each time. He said if that seems to be working he'll order a 100mg bottle and a 50mg bottle next time to hopefully cut costs. I got a 100ct bottle of 50mg capsules yesterday for $22, which I thought was a great deal, until I did the math and realized that's only 16 days worth of pills. Do you mind my asking what you pay? When he was on phenobarb I went through CVS, but I've gotten the Cholodin, keppra, and now zonisamide through the vet's office because the prices seem reasonable enough. Wondering if I should consider my options??

I'm hoping zonisamide is the "answer" we're looking for - I do feel better about seizure meds now being given 4x/day to hopefully spread the meds out enough to present seizures. It's so hard to do 3x/day keppra consistently with a 9-5 workday!
Archer, Lab/Akita mix

First seizure: July 6, 2015
Last seizure: March 25, 2017

Current meds:
Potassium Bromide 1000mg 1x/day (started 3/28/17)
Keppra 1000mg 3x/day
Zonisamide 150mg 2x/day
Cholodin 1 tablet 2x/day
GABA 500mg 2x/day
Taurine 500mg 2x/day

Gentle Jacob's mom
Posts: 925
Joined: Thu Mar 04, 2010 10:52 am

Re: Add Zonisamide or increase Keppra dose?

Post by Gentle Jacob's mom » Thu Aug 04, 2016 5:49 pm

I hate to get into who is right and wrong here, but there is a Peak and Trough test for Keppra. There is also a Keppra level test, but they really don't know what to do with the results yet. If your vet has any question about this have him call NC State and speak to Dr Munana.
You can go to Recut.com and Goodrx.com for coupons for Keppra and Zonisamide. Hopefully they will help with the cost.
Take Care,
Lynne

Gentle Jacob's mom
Posts: 925
Joined: Thu Mar 04, 2010 10:52 am

Re: Add Zonisamide or increase Keppra dose?

Post by Gentle Jacob's mom » Thu Aug 04, 2016 6:55 pm

I'm sorry that's Rxcut.com. My spell check changed it. Did your vet weigh in on Clorazepate for clusters?

Lynne

bethad5
Posts: 14
Joined: Fri Jul 08, 2016 4:49 pm
Location: Des Moines, IA

Re: Add Zonisamide or increase Keppra dose?

Post by bethad5 » Thu Aug 04, 2016 8:04 pm

Gentle Jacob's mom wrote:I hate to get into who is right and wrong here, but there is a Peak and Trough test for Keppra. There is also a Keppra level test, but they really don't know what to do with the results yet. If your vet has any question about this have him call NC State and speak to Dr Munana.
You can go to Recut.com and Goodrx.com for coupons for Keppra and Zonisamide. Hopefully they will help with the cost.
Take Care,
Lynne
I thought I had read posts here about people having their dog's keppra levels tested, so I asked my vet about it but he was pretty clear there wasn't any way to check levels. Any advice on how to advocate for my dog but not offend my vet? Seems like a fine line. I will keep note of Dr Munana/NC state though.

Thanks for the website info- will definitely check it out!

Thank you so much for your support, Lynne. Jake gives me hope that although seizures are awful to witness, they aren't a death sentence, and Archer has every opportunity to live a long and happy life. However, I think I'm going to hit submit now so I don't start crying again ;)
Archer, Lab/Akita mix

First seizure: July 6, 2015
Last seizure: March 25, 2017

Current meds:
Potassium Bromide 1000mg 1x/day (started 3/28/17)
Keppra 1000mg 3x/day
Zonisamide 150mg 2x/day
Cholodin 1 tablet 2x/day
GABA 500mg 2x/day
Taurine 500mg 2x/day

Gentle Jacob's mom
Posts: 925
Joined: Thu Mar 04, 2010 10:52 am

Re: Add Zonisamide or increase Keppra dose?

Post by Gentle Jacob's mom » Fri Aug 05, 2016 10:19 am

Maybe this will help clarify it for him.
http://www.vetmed.auburn.edu/wp-content ... M-2016.pdf

Also, he shouldn't have a problem with you getting a second opinion or you suggesting things you've heard about. I would maybe talk to a neurologist if you can. I do understand not wanting to offend your vet, but he shouldn't be offended by you being proactive and asking questions. You're trying to find the best combination for Archer and he should be open to listening. If he isn't then I think I'd look for another vet. I know it's a fine line, but this isn't about hurting feelings, it's about helping Archer.
I hope Zonisamide gets good results for you.
Take Care,
Lynne

MK's mom
Posts: 1708
Joined: Wed Mar 01, 2006 9:48 am
Location: Michigan

Re: Add Zonisamide or increase Keppra dose?

Post by MK's mom » Fri Aug 05, 2016 10:42 am

I haven't noticed any side effects with the zonisamide, but every dog is different. Pb and KBr are the two that are known for hind end weakness and increased thirst and hunger, I didn't see anything like that when using Keppra or when we started the dogs on zonisamide. (I have dealt with two epi boys)
Nathan
3.5 yo Irish Setter boy
First seizure 7/26/2013
Last seizure 3/24/2014
__________________________________
MK
5 yo Irish Setter boy
First seizure 1/25/06
Last seizure 9/4/2009

Aug 17, 2004- Sept. 22, 2009
May the shamrocks fall softly sweetpea

Gentle Jacob's mom
Posts: 925
Joined: Thu Mar 04, 2010 10:52 am

Re: Add Zonisamide or increase Keppra dose?

Post by Gentle Jacob's mom » Fri Aug 05, 2016 11:54 am

I forgot to add that you're not alone. We've all shed a lot of tears here. Many happy tears when our dogs make it through tests and trying times and when they seem to defy the worst and come out swinging.
Then unfortunately there are far too many times we lose.
I know it's easy to get caught up and forget, but take care of yourself too. The stress of this can take it's toll so take deep breaths often and when you need to, make some water balloons and throw them around. It helps :)
We'll be here when you need us.
Lynne

Lovelight
Posts: 64
Joined: Sun Mar 13, 2016 11:46 pm

Re: Add Zonisamide or increase Keppra dose?

Post by Lovelight » Tue Aug 23, 2016 4:23 pm

Hello,

My dog, Buttercup, just had the Zonisamide added yesterday due to her recent clusters. Butter's only had two doses of the Zonisamide, and the only side effects seen in her is sedative and being hungry. She had two extra doses of pheno and she's only mildly more hungry. I was expecting her to be wobbly, or some other pheno side effect, but so far, just increased appetite, and she is completely normalized. Butter's vet also said that research is showing Zonisamide is an effective medicine, like I said though, we'll see what happens. The vet said Zonisamide is effective in treating focal/partial seizures and literature indicates it is a good add on with phenobarbital. The vet couldn't increase pheno with Butter without a current level check, and we couldn't do a level because Butter had extra doses of pheno due to recent clusters, so the reading wouldn't be accurate. Additionally, she said Butter was on a 'good dose' of pheno (64.8mg per DAY), and said that increasing pheno might not be a good idea considering other side effects in higher doses. I have no experience with Keppra or Potassium Bromide, though the vet and I discussed them before deciding on Zonisamide.

I hope your Archer improves in condition. Perhaps Archer can obtain decent control again, so keep up hope. We know, each time our babies go through changes, episodes, etc, it is difficult to endure, especially when after doing well. We've all cried and dropped to our knees, I am certain. You are not alone, and we too share in your hope for the right combination for your Archer.

Thank you for sharing Archer's story and change in condition, details and things. The information is good to know for all on phenobarbital. I agree with others too in taking care of you too. You and her vets are doing the best possible for Archer. I hope Archer is better soon.

Good luck,
Light

bethad5
Posts: 14
Joined: Fri Jul 08, 2016 4:49 pm
Location: Des Moines, IA

Re: Add Zonisamide or increase Keppra dose?

Post by bethad5 » Mon Mar 06, 2017 10:00 am

Well - to update, adding zonisamide last August did wonderful, wonderful things. We made it 7 months and 4 days seizure-free - until this morning at 2:00am. Since then, he has had 3 grand mal seizures and 2 focal seizures. These took place over a 6 hour time span.

My vet is now talking possible brain lesion, and saying Archer may need a CT scan. Archer turned four in January. The vet is very concerned about such a long break from the seizures to now having so many so close together. He asked if I gave Archer any different types of treats or introduced anything new to him recently. The only thing I can think of is a new flavor of Pupperoni yesterday (I rip a pupperoni up into small pieces when I kennel him to leave. We were gone about 3 hours yesterday. He had pupperoni at noon, and seized at 2:00am). Not sure if a food allergy would cause a seizure 14 hours later, but it's enough to make me never give him this flavor again.

Also wondering if it may be a change in generic Keppra manufacturers. He started a new bottle of Keppra Saturday morning. If this bottle isn't effective, meaning all of his 3x/day doses since Saturday haven't been doing anything, would it make sense for him to have started seizing this morning? Unfortunately I threw the old bottle away already so I can't compare manufacturers. My vet's office is going to try to see what manufacturer this bottle came from compared to bottles he's had in the past.

My vet is currently consulting with a specialist at the ER vet about next steps. He said to give an extra dose of zonisamide around noon today. He had two extra doses of keppra (after seizures 1 and 2) this morning, but now I'm wondering if that even mattered if it's a manufacturer issue. I'd much rather it be a medication issue than a brain lesion issue, though.

To make matters worse, we've had a rough year aside from seizures -- Archer was diagnosed with a mast cell tumor in January, and had to have it surgically removed. It came back as a grade II, low risk tumor so they said it's "most likely curative with complete excision." This dog does not appear to fit into the "most likely" category of anything - especially when I think about how being on phenobarb almost killed him around a year ago ("well, the chances of it being due to the phenobarb are 1 in a million, so it most likely isn't that" and it turned out to be exactly that.)

Waiting to hear back from the vet and will go from there. To go from 7 months and 4 days seizure free to having to start back at 0 is heartbreaking. :cry:
Archer, Lab/Akita mix

First seizure: July 6, 2015
Last seizure: March 25, 2017

Current meds:
Potassium Bromide 1000mg 1x/day (started 3/28/17)
Keppra 1000mg 3x/day
Zonisamide 150mg 2x/day
Cholodin 1 tablet 2x/day
GABA 500mg 2x/day
Taurine 500mg 2x/day

Gentle Jacob's mom
Posts: 925
Joined: Thu Mar 04, 2010 10:52 am

Re: Add Zonisamide or increase Keppra dose?

Post by Gentle Jacob's mom » Mon Mar 06, 2017 11:56 am

If the generic Keppra came from different pharmaceutical companies that could make a difference. The base drug, by law is supposed to be identical, but the fillers are different. I spent so much time looking into this four years ago because we had a huge problem with Jake's Keppra and had to change. I called several companies and they were surprising very open about where I could find the names of the fillers they use. I also checked with NC State and found out that fillers can affect how well each dog or person metabolizes or responds to the drug. Then I looked up what fillers non generic Keppra uses and almost none matched the generic forms. I whittled the generic down to two that had one or two fillers in common with the non generic Keppra and basically just picked one. We've bought exactly the same one since then. Jake's comes from Lupin Pharmaceuticals. I don't know if anything has changed since then, but given how iffy Jake's seizures are I thought it was one thing I could be sure of.
I've know of dogs that only seize a couple of times a year and there's no other problems. It's just when they seize. I can't speak for anyone else, but the longer Jake goes between seizures, when he does seize, it's always worse. He averages every 2-3 weeks, but when he makes it over a month, the threat of clusters come back.
I'm sorry the guessing game has started all over again for you. I hope Archer gets back on track again.
Take Care,
Lynne

bethad5
Posts: 14
Joined: Fri Jul 08, 2016 4:49 pm
Location: Des Moines, IA

Re: Add Zonisamide or increase Keppra dose?

Post by bethad5 » Tue Mar 07, 2017 12:20 pm

Lynne,
I called to my local CVS and Walgreens and both carry Lupin Pharmaceutical's generic Keppra. However the out of pocket cost is astronomical - even with Walgreens' prescription savings plan, a 30 day supply of Archer's Keppra would be $140 per month. Until Friday, I was paying $47 for a 40 day supply through my vet. This newest bottle I've gotten was only $41. I wonder if the cheaper cost is why the distributor sent it to my vet's office?

I've been perusing images of generic keppra pills trying to figure out which pills Archer has had and had success with. I wish I had paid more attention to what's written on Archer's pills - but he takes so many, they all run together. The picture of the pill manufactured by Lupin looks familiar, though. I think the other manufacturer we had success with (and that his 750mg pills are from, which I'm currently giving him 1.5 of those 3x/day rather than the newest 1000mg pills I've gotten) is Aurobindo. Both are from India. I compared the inactive ingredients list between the bottle I just opened Saturday (Solco Healthcare), the Aurobindo, and now Lupin, to the inactive ingredients in brand name Keppra. Lupin had the most matching ingredients (7); Aurobindo had 5; and Solco had 4.

Where do you get Lupin products from, Lynne? Do you order online or go to a pharmacy?

Thanks,
Beth
Archer, Lab/Akita mix

First seizure: July 6, 2015
Last seizure: March 25, 2017

Current meds:
Potassium Bromide 1000mg 1x/day (started 3/28/17)
Keppra 1000mg 3x/day
Zonisamide 150mg 2x/day
Cholodin 1 tablet 2x/day
GABA 500mg 2x/day
Taurine 500mg 2x/day

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