A commonly prescribed anticonvulsant: Levetiracetam
The bottom line
Levetiracetam is prescribed for seizures. The first brand name was Keppra®, but other products are now on the market. Common side effects are drowsiness, fatigue, dizziness and headaches. Mood instability, other neuropsychiatric symptoms, rashes, allergic reactions, and infections are possible. Avoid alcohol, drugs, and supplements with sedative effects while taking levetiracetam.
Prevention Tips
Keep levetiracetam up, away and out of reach of children.
Take as prescribed.
Do not take more than prescribed or more often than prescribed.
Do not break, crush or chew the tablet.
Store at room temperature, away from heat and moisture. Do not put in direct sunlight.
Do not stop this medication suddenly since this may cause your seizures to return.
This Really Happened
A 38-year-old woman with a history of bipolar disorder ingested 60 levetiracetam 500 mg tablets. At 4 hours after ingestion, she vomited and at 6 hours after ingestion she arrived at the emergency department. She was extremely drowsy with respiratory depression and decreased deep tendon reflexes. She was intubated for respiratory support. Serial serum levetiracetam levels were elevated 10-40 times higher than the therapeutic range. On the next hospital day, she was extubated and recovered fully.
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What is levetiracetam (Keppra®)?
Levetiracetam is prescribed for the treatment of epilepsy. The types of seizures it is used for includes generalized tonic-clonic seizures, myoclonic seizures, and partial-onset seizures.
The first brand name for levetiracetam was Keppra®, but other products are now on the market. It comes in modified-release formulations such as Keppra XR® (extended-release), Spritam® (fast-dissolving), Elepsia XR™ (extended release), Roweepra™ (immediate-release), Roweepra XR™ (extended release) and Desitrend® granules or solution. Generic levetiracetam is also available. In the US, Keppra® and Keppra XR® are the most commonly dispensed brand of levetiracetam.
How does Keppra® work?
When a seizure occurs, there are bursts of electrical activity in the brain. Keppra works by slowing these electrical signals.
What are the side effects of levetiracetam?
Drowsiness, fatigue, dizziness, and headaches are the most common side effects of levetiracetam. These may decrease over time. A stuffy nose or sore throat can also occur. Other side effects include agitation, irritability, anxiety, mood swings, depression, psychosis, nausea, vomiting, diarrhea, and decreased appetite. If irritability or anger is severe, it might be referred to as ‘Keppra rage.’ Rashes, allergic reactions [including anaphylaxis (sudden severe allergic reaction that may compromise breathing) or angioedema (swelling of face, lips, tongue, throat, eyes, hands, feet)], and serious skin reactions are possible. There is a small increased risk of infection, especially upper respiratory tract infections.
Is Keppra® a controlled substance?
No, levetiracetam is not a controlled substance. It is a prescription medication available as tablets, extended-release tablets, tablets for suspension, granules, and a solution.
What should I avoid while taking Keppra®?
You should avoid alcohol as well as other drugs and supplements that cause drowsiness. Do not drive or participate in dangerous or physical activities like sports until you know to what degree you are affected by levetiracetam’s side effects of drowsiness and dizziness.
What should I do if someone accidentally takes Keppra® or takes too much Keppra®?
There is an increased risk of drowsiness and dizziness if someone accidentally takes a dose of someone else’s levetiracetam or takes a double dose by mistake. Seek medical advice. Overdoses can result in more severe central nervous system effects and can also cause low blood pressure and slow heart rate. In this situation, immediate medical attention is necessary.
If someone swallows levetiracetam, or if you have a question about using levetiracetam safely, use the webPOISONCONTROL® online tool to get help, or call your poison center at 1-800-222-1222. Whether online or by phone, expert guidance is always free, confidential, and available 24 hours a day.
