Uses

What is levetiracetam used for?

Levetiracetam is commonly used to control certain types of seizures.

Levetiracetam may also be used for other conditions as determined by your healthcare provider.

How does levetiracetam work (mechanism of action)?

A seizure happens when neurons in the brain, which are responsible for communicating chemical and electrical signals, suddenly fire too much. Levetiracetam binds to a protein in the brain called SV2A, which may help calm brain activity to reduce seizures. 

How is levetiracetam supplied (dosage forms)?

Brands and other names

  • Keppra
  • Keppra XR 
  • Spritam

Dosage forms and strengths 

  • 500 mg, 750 mg extended-release oral tablets
  • 100 mg/mL oral solution
  • 250 mg, 500 mg, 750 mg, 1000 mg oral tablets
  • 250 mg, 500 mg, 750 mg, 1000 mg tablets for oral solution

Levetiracetam is also available in injectable forms.

How should I store levetiracetam?

Levetiracetam should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of levetiracetam?

The most common side effects of levetiracetam are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Drowsiness
  • Irritability
  • Feeling unusually weak or tired
  • Infection 
  • Dizziness 
  • Aggression (Children)
  • Nasal congestion (Children)
  • Lack of appetite (Children)

There may be other side effects of levetiracetam that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of levetiracetam?

While less common, the most serious side effects of levetiracetam are described below, along with what to do if they happen.

Severe Allergic Reactions. Levetiracetam can cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for Drug Reaction with Eosinophilia and Systemic Symptoms. It is also sometimes called multiorgan hypersensitivity. This is a reaction that can affect multiple parts of the body, including your liver, kidneys, and heart. Stop taking the medicine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat (angioedema)
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Dark colored urine
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Severe Skin Reactions. Levetiracetam can cause severe skin reactions, called Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), that can lead to death if not treated. If you develop a rash, stop levetiracetam and call your healthcare provider right away. Get emergency help if you have any of the following symptoms of SJS or TEN.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes

Mood and Behavior Changes. Levetiracetam can cause changes in mood and behavior such as aggression, agitation, anger, anxiety, lack of interest, mood swings, depression, hostility, and irritability. Levetiracetam may also cause hallucinations or psychotic-like behaviors. Tell your healthcare provider right away if you have any unusual changes in mood or behavior, have the following symptoms, or if you have been told by others you have these symptoms.

  • Hearing, seeing, smelling, tasting, or otherwise perceiving things that others do not
  • Delusional thoughts, such as false beliefs that you are being controlled
  • Disorganized thoughts, such as jumping between topics or having a hard time focusing
  • Sudden decline in self-care, such as personal hygiene or academic/work performance
  • Aggressive behavior

Suicidal Thoughts and Actions. Levetiracetam may cause suicidal thoughts or actions in a small number of people. If you are about to harm yourself, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your healthcare provider right away if you have any of the following symptoms.

  • New or increased thoughts of suicide or death
  • Suicide attempt
  • New or increased feelings of anxiety, depression, aggression, or other unusual changes in mood or behavior
  • Trouble sleeping

Decreased Alertness or Coordination. Leveteracetam can cause you to feel drowsy and tired which can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how levetiracetam affects you.

Blood Disorders. Levetiracetam can cause blood disorders, such as low white blood cell levels (leukopenia), low neutrophil levels (neutropenia), low red blood cell levels (anemia), and high eosinophil levels (eosinophilia). Keep all appointments with your healthcare provider to have your blood checked. Stop taking levetiracetam and get help right away if you have any of the following symptoms of blood disorders.

  • Fever
  • Shortness of breath
  • Pale or yellowish skin
  • Easy bruising or bleeding
  • Frequent infection
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat

Warnings & Precautions

Who should not use levetiracetam?

Allergies to Ingredients. People who are allergic to any of the following should not take levetiracetam.

  • Levetiracetam
  • Spritam
  • Keppra
  • Keppra XR
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific levetiracetam products they stock.

What should I know about levetiracetam before using it?

Keep all appointments with your healthcare provider while taking levetiracetam.

Do not stop taking levetiracetam without talking to your healthcare provider. Stopping levetiracetam suddenly could lead to increased seizures and increase your risk of having status epilepticus, which is a seizure that lasts more than 5 minutes. If you need to stop taking levetiracetam, your healthcare provider will give you instructions on how to stop the medicine.

Use an accurate measuring device to measure your dose of levetiracetam oral liquid. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device.

Do not chew or crush levetiracetam tablets or extended-release tablets. Swallow whole 

Levetiracetam is also available as an orally disintegrating tablet (ODT). You can take it with a sip of water and let the tablet disintegrate in your mouth or it can be mixed with a small amount of water in a cup (enough to cover the tablet) with the mixture being swallowed after the tablet disintegrates.

Levetiracetam extended-release tablets may not completely dissolve in the body. There is no need for concern if you notice something in your poop that looks like a swollen piece of tablet.

Do not take levetiracetam unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share levetiracetam with other people, even if they have the same condition as you. It may harm them.

Keep levetiracetam out of the reach of children.

What should I tell my healthcare provider before using levetiracetam?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if levetiracetam is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Depression, mood problems, suicidal thoughts or behavior, or a history of these conditions
  • Kidney problems

Pregnancy. It is not known if or how levetiracetam could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take levetiracetam while you are pregnant or trying to get pregnant. If you become pregnant while taking levetiracetam, you can register for the North American Antiepileptic Drug Pregnancy Registry by calling 888-233-2334 or at www.aedpregnancyregistry.org. This registry collects safety information about the use of antiepileptic medicines during pregnancy. Make sure that your healthcare provider knows if you become pregnant, as you may need to have the dose of levetiracetam changed.

Breastfeeding. Levetiracetam passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take levetiracetam while breastfeeding.

Interactions

Does levetiracetam interact with foods or drinks?

There are no known interactions between levetiracetam and foods or drinks.

It is unknown if drinking alcohol will affect levetiracetam. The risk of drowsiness and dizziness may be increased if you drink alcohol while taking levetiracetam.

Does levetiracetam interact with other medicines (drug interactions)?

There are no known interactions between levetiracetam and other medicines. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

Does Levetiracetam (Keppra, Spritam) interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much levetiracetam?

If you or someone else has used too much levetiracetam, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of levetiracetam?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses. 

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