Levetiracetam

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Jul 07, 2023

Warnings

Levetiracetam (Keppra) Risks, Warnings, and Complications

Levetiracetam can cause or worsen health problems in some people. Talk to your doctor or pharmacist about other treatments for seizures if you are at an increased risk of adverse reactions or complications from this medication. Some of the risks of taking levetiracetam include:

SUICIDAL RISK: Patients receiving levetiracetam and other antiepileptic drugs can develop suicidal thoughts or behaviors. Call your doctor without delay if you notice any new or worsening depression or unusual mood changes. The increased risk of suicidal thoughts and behaviors can occur as early as one week after starting treatment with levetiracetam and continues to be present for the duration you are on this medicine. If you have thoughts of hurting yourself, call 911 or get immediate medical attention.
BEHAVIORAL ABNORMALITIES: Levetiracetam may cause abnormal thoughts, mood, or behavior, such as irritability, agitation, aggression, hostility, anxiety, apathy, nervousness, depression, emotional lability, and paranoia. Call your doctor immediately if you notice any such changes in thoughts, mood, or behavior while on this medication. The risk of behavioral abnormalities is higher in people with a history of mental health problems such as depression, bipolar disorder, and schizophrenia. These changes can occur in both adult and pediatric patients.
DROWSINESS AND TIREDNESS: Levetiracetam can cause drowsiness, dizziness, tiredness, and weakness. It can also cause problems with coordination and movement, especially in the first few weeks of treatment or after dose adjustments. Avoid driving a motor vehicle or doing other activities that require alertness until you know how levetiracetam affects you.
SERIOUS SKIN REACTIONS: Rarely, levetiracetam can cause a severe allergic reaction. Seek emergency medical attention if you develop a rash, itching, hives, blisters, swelling of the face or mouth, or difficulty breathing.
LOW BLOOD CELL COUNTS: Patients treated with levetiracetam may develop statistically significant decreases in blood cell counts, including low levels of white blood cells, which the body needs to fight off infections, and platelets which help the blood clot after injuries. Tell your healthcare provider if you develop signs of infection or easy bruising or bleeding.
USE DURING PREGNANCY: Tell your healthcare provider if you become pregnant or are planning a pregnancy during levetiracetam therapy. Your doctor will encourage you to enroll in the North American Antiepileptic Drug (NAAED) pregnancy registry if you become pregnant while taking levetiracetam. This registry collects information about the safety of antiepileptic drugs during pregnancy.

Precautions Before Starting Levetiracetam (Keppra)

Tell your doctor if you have ever had an allergic reaction to levetiracetam, any of the active or inactive ingredients in levetiracetam immediate release formulation, extended release tablet, oral solution, or intravenous formulation. Your pharmacy can give you a list of ingredients. Also, tell your doctor if you have an allergy to any other drugs.

Give your doctor and pharmacist a complete list of your medications, including prescription medications, over-the-counter medicines, vitamins, supplements, and herbal products. This can help avoid possible drug interactions between levetiracetam and your other medications.

Give your doctor a complete medical history. Levetiracetam may not be right for people with certain medical conditions. Tell your doctor if you have kidney disease or mental illness.

Tell your health care professional if you are pregnant, could be pregnant, plan to get pregnant, or are breastfeeding.

Precautions During Use of Levetiracetam (Keppra)

Keep all your healthcare appointments during levetiracetam treatment. Your doctor will likely start you on a lower dose of levetiracetam and gradually increase the dose. Follow your doctor’s instructions on dose adjustment carefully. Tell your doctor if your seizures are not well controlled. Do not perform a dosage adjustment yourself without your doctor’s approval.

Taking levetiracetam can make you drowsy and dizzy. Do not drive or do any activity that requires your full alertness until you know how this medicine affects you.

Call your doctor without delay if you develop any changes in mood or behavior, including suicidal thoughts and behaviors.

Tell your doctor if you become pregnant while on this medication.

Tell all your healthcare providers you are on levetiracetam, especially before any procedure, including dental procedures.

Levetiracetam (Keppra) Drug Interactions

Other drugs may affect how levetiracetam works. Possible interactions with other medicines can increase the risk of severe adverse effects.

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, nonprescription drugs, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

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