Levetiracetam | Side Effects, Dosage, Uses & More
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Generic Name:

levetiracetam, Oral tablet

All Brands

  • Keppra
SECTION 1 of 5

Highlights for levetiracetam

Oral tablet
1

Levetiracetam is used to treat different types of seizures in people with epilepsy. These include partial-onset seizures, myoclonic seizures, and primary generalized tonic-clonic seizures. Levetiracetam is used in combination with other antiepileptic drugs.

2

This drug comes in three forms that are taken by mouth. It comes as an immediate-release tablet, an extended-release tablet, and a liquid solution. It also comes as an injectable solution. This form can only be given by your healthcare provider.

3

Levetiracetam is available as brand-name drugs called Keppra, Keppra XR (extended release), Spritam, and Elepsia XR. It’s also available as a generic drug.

4

The more common side effects of this drug include sleepiness, weakness, dizziness, and an increase in infections. Younger children may have additional side effects. These include overactive behavior that leads to an accidental head injury, and acting cranky and hostile.

5

Don’t stop taking this drug without talking to your doctor first. Stopping this drug suddenly can cause a medical emergency called status epilepticus.

IMPORTANT INFORMATION

Suicidal thoughts and actions

This drug may increase your risk of thinking about or trying to hurt or kill yourself (suicide). Call your doctor if you notice any unusual changes in your mood or behavior, or if you have thoughts of hurting yourself.

Stopping this drug

Don’t stop taking this drug without talking to your doctor first. Stopping this drug suddenly can cause a medical emergency called status epilepticus. This is when short or long seizures occur for 30 minutes or more.

Driving or other activities that require alertness

This drug may make you feel dizzy or sleepy. Don’t drive, use heavy machinery, or do other dangerous activities until you know how this drug affects you.

What is levetiracetam?

This drug is a prescription drug. It comes in three forms to be taken by mouth (orally). These forms include an immediate-release tablet, an extended-release tablet, and a liquid solution. This drug also comes as an injectable solution. This form can only be given by your healthcare provider.

This drug is used as part of a combination therapy. You’ll take it along with other antiepileptic drugs.

This drug is available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version. Talk to your healthcare provider to see if the generic version will work for you.

Why it's used

The immediate-release tablets and oral solution are used in combination with other antiepileptic drugs to treat three types of seizures.

More Details

How it works

This drug belongs to a class of drugs called anticonvulsants or antiepileptic drugs. A class of drugs is a group of medications that work in a similar way.

More Details

Why it's used

The immediate-release tablets and oral solution are used in combination with other antiepileptic drugs to treat three types of seizures. These are:

  • Partial-onset seizures
  • Myoclonic seizures in people 12 years of age and older with juvenile myoclonic epilepsy
  • Primary generalized tonic-clonic seizures in people 6 years of age and older with certain types of generalized epilepsy

The extended-release oral tablets are used in combination with other antiepileptic drugs to treat:

  • Partial-onset seizures

How it works

This drug belongs to a class of drugs called anticonvulsants or antiepileptic drugs. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

This drug may help slow or prevent certain messages from being sent between the neurons in your brain. This may help reduce the number of seizures that occur. 

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SECTION 2 of 5

levetiracetam Side Effects

Oral tablet

More Common Side Effects

These are some of the more common side effects that occur with use of levetiracetam.

  • Adult side effects can include:

    • sleepiness
    • weakness
    • dizziness
    • increase in infections
  • Children who are taking the immediate-release oral tablets or oral solution may also have additional side effects. These can include:

    • overactive behavior that leads to an accidental head injury
    • acting irritable
    • acting hostile 

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Changes in mood or behavior. Symptoms can include:

    • thoughts about dying or killing yourself (suicide)
    • attempts to harm yourself or commit suicide
    • depression that’s new or gets worse
    • anxiety that’s new or gets worse
    • feeling restless
    • panic attacks
    • trouble sleeping
    • moodiness that’s new or gets worse
    • feeling angry
    • acting in an aggressive or violent way
    • acting based on dangerous thoughts
    • extreme increase in activity and talking
    • hallucinations (seeing or hearing things that aren’t there)
    • delusions (false or strange thoughts or beliefs)
  • Extreme tiredness. Symptoms can include:

    • unusual sleepiness
    • unusual weakness
  • Problems with muscle coordination. Symptoms can include:

    • trouble walking or moving
    • slurred speech
  • Skin rash. Symptoms can include:

    • blistering or peeling of your skin
    • hives
    • painful sores in your mouth or around your eyes
    • rash
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug may cause dizziness and sleepiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

levetiracetam May Interact with Other Medications

Oral tablet

Levetiracetam can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Drug interaction studies have been performed with levetiracetam and several other medications (including other antiepileptic drugs), but no clinically significant interactions have been found. However, taking levetiracetam with certain other drugs may cause more side effects.

Alcohol interaction

Levetiracetam may make you dizzy or sleepy. Taking this drug with drinks that contain alcohol may make your dizziness or sleepiness worse.

Don’t have alcoholic drinks while taking this drug until you talk to your doctor about the risks.

Medications that might interact with this drug

Anxiety drugs

Levetiracetam can cause drowsiness and dizziness. Some anxiety drugs can also cause drowsiness and dizziness. Taking these drugs together increases your chance of having these side effects. Examples of these drugs include:

  • lorazepam
  • alprazolam
  • clonazepam

Pain drugs

Levetiracetam can cause drowsiness and dizziness. Some pain medications can also cause drowsiness and dizziness.  Taking these drugs together increases your chance of having these side effects. Examples of these drugs include:

  • morphine
  • hydrocodone
  • oxycodone
  • hydromorphone
  • tramadol

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
kidney problems
People with kidney problems

This drug is removed from your body by your kidneys. If your kidneys aren’t working well, more of the drug may stay in your body for a longer time. This puts you at risk for increased side effects. If you have kidney disease or are on dialysis, your doctor will decrease your dose of this drug.

depression
People with depression or other mood problems

This drug may worsen your depression, mood problems, or suicidal thoughts or behavior. Talk to your doctor about whether this drug is safe for you to take.

Pregnant women
Pregnant women

This drug is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus.

If you become pregnant while taking this drug, talk to your doctor about registering with the North American Antiepileptic Drug Pregnancy Registry and the UCB AED Pregnancy Registry. The purpose of these registries is to collect information about the safety of using this drug and other antiepileptic medications during pregnancy.

breast-feeding
Women who are breast-feeding

This drug may pass into breast milk and may cause side effects in a child who is breast-fed. 

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

children
For children

Immediate-release oral tablets: It hasn’t been confirmed that this form of this drug is safe and effective for use in children younger than 4 years.

Extended-release tablets: It hasn’t been confirmed that this form of this drug is safe and effective for use in children younger than 12 years.

call the doctor
When to call the doctor

Call your doctor if you notice an increase in the number or severity of seizures you have, or if you have a different type of seizure. Your doctor will decide if the dose of your medication needs to be increased or changed.

Allergies

This drug can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives
  • rash 

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

SECTION 4 of 5

How to Take levetiracetam (Dosage)

Oral tablet

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Partial onset seizures

Brand: Keppra

Form: Oral tablet
Strengths: 250 mg, 500 mg, 750 mg, 1000 mg
Form: Oral solution
Strengths: 100 mg/mL

Brand: Spritam

Form: Oral tablet
Strengths: 250 mg, 500 mg, 750 mg, 1000 mg

Generic: levetiracetam

Form: Oral tablet
Strengths: 250 mg, 500 mg, 750 mg, 1000 mg
Form: Oral solution
Strengths: 100 mg/mL

Brand: Keppra XR

Form: Oral extended-release tablet
Strengths: 500 mg, 750 mg

Brand: Elepsia XR

Form: Oral extended-release tablet
Strengths: 1000 mg, 1500 mg

Generic: levetiracetam ER

Form: Oral extended-release tablet
Strengths: 500 mg, 750 mg
Adult dosage (ages 18–64 years)
  • Immediate-release oral tablets and oral solution:
    • The starting dose is 500 mg taken twice per day.
    • The maximum recommended total dose is 3,000 mg per day.
  • Extended-release oral tablets:
    • The starting dose is 1,000 mg taken once per day.
    • The maximum recommended daily dose is 3,000 mg per day.
Child dosage (ages 0–17 years)
  • Immediate-release oral tablets and oral solution:
    • (age less than 1 month)
      • This medication hasn’t been studied in newborns less than 1 month old.
    • (ages 1–5 months)
      • The starting dose is 7 mg per kilogram of body weight taken twice per day.
      • Your doctor will increase your dose slowly to the recommended dose of 21 mg per kilogram of body weight taken twice per day.
    • (ages 6 months to 3 years)
      • The starting dose is 10 mg per kilogram of body weight taken twice per day.
      • Your doctor will increase your dose slowly to the recommended dose of 25 mg per kilogram of body weight taken twice per day.
    • (ages 4–15 years)
      • The starting dose is 10 mg per kilogram of body weight taken twice per day.
      • Your doctor will increase the dose slowly to the recommended daily dose of 60 mg per kilogram of body weight.
    • (ages 16–17 years)
      • The starting dose is 500 mg taken twice per day.
      • The highest recommended total dose is 3,000 mg per day.
  • Spritam brand immediate-release oral tablets:
    • (ages 4–17, weighing 89 pounds or more)
      • The starting dose is 500 mg taken twice per day.
      • Your doctor will increase your dose as needed to control your seizures.
      • The highest recommended total dose is 3,000 mg per day.
    • (ages 4–17, weighing 44–88 pounds)
      • The starting dose is 250 mg taken twice per day.
      • Your doctor will increase your dose as needed to control your seizures.
      • The highest recommended total dose is 1,500 mg per day.
  • Extended-release oral tablets:
    • (ages 0–11 years)
      • This medication hasn’t been studied in children. It shouldn’t be used in people younger than 12 years.
    • (ages 12–17 years)
      • The starting dose is 1,000 mg taken once per day.
      • The highest recommended daily dose is 3,000 mg per day.
Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Special considerations

Kidney disease: Levetiracetam is removed from your body by your kidneys. If your kidneys aren’t working well, more of the drug may stay in your body for a longer time. This increases your risk of side effects. If you have kidney disease or are on dialysis, your doctor will decrease your dose of this drug.

Myoclonic seizures

Brand: Keppra

Form: Oral tablet
Strengths: 250 mg, 500 mg, 750 mg, 1000 mg
Form: Oral solution
Strengths: 100 mg/mL

Brand: Spritam

Form: Oral tablet
Strengths: 250 mg, 500 mg, 750 mg, 1000 mg

Generic: levetiracetam

Form: Oral tablet
Strengths: 250 mg, 500 mg, 750 mg, 1000 mg
Form: Oral solution
Strengths: 100 mg/mL
Adult dosage (ages 18–64 years)
  • Immediate release oral tablets and oral solution only):
    • The starting dose is 500 mg taken twice per day.
    • Your doctor will increase your dose slowly to the recommended total dose of 3,000 mg per day.
Child dosage (ages 0–17 years)
  • Immediate-release oral tablets and oral solution only:
    • (ages 0–11 years)
      • No dosing recommendations provided.
    • (ages 12–17 years)
      • The starting dose is 500 mg taken twice per day.
      • Your doctor will increase the dose slowly to the recommended daily dose of 3,000 mg per day.
Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Special considerations

Kidney disease: Levetiracetam is removed from your body by your kidneys. If your kidneys aren’t working well, more of the drug may stay in your body for a longer time. This increases your risk of side effects. If you have kidney disease or are on dialysis, your doctor will decrease your dose of this drug.

Primary generalized tonic-clonic seizures

Brand: Keppra

Form: Oral tablet
Strengths: 250 mg, 500 mg, 750 mg, 1000 mg
Form: Oral solution
Strengths: 100 mg/mL

Brand: Spritam

Form: Oral tablet
Strengths: 250 mg, 500 mg, 750 mg, 1000 mg

Generic: levetiracetam

Form: Oral tablet
Strengths: 250 mg, 500 mg, 750 mg, 1000 mg
Form: Oral solution
Strengths: 100 mg/mL
Adult dosage (ages 18–64 years)
  • Immediate release oral tablets and oral solution only:
    • The starting dose is 500 mg taken twice per day.
    • Your doctor will increase your dose slowly to the recommended total dose of 3,000 mg per day.
Child dosage (ages 0–17 years)
  • Immediate-release oral tablets and oral solution only:
    • (ages 0–5 years)
      • No dosing recommendations provided.
    • (ages 6–15 years)
      • The starting dose is 10 mg per kilogram of body weight taken twice per day.
      • Your doctor will increase the dose slowly to the recommended daily dose of 60 mg per kilogram of body weight.
    • (ages 16–17 years)
      • The starting dose is 500 mg taken twice per day.
      • Your doctor will increase your dose slowly to the recommended total dose of 3,000 mg per day.
  • Spritam brand immediate-release oral tablets:
    • (ages 0–5 years)
      • No dosing recommendations provided.
    • (ages 6–17 years, weighing 89 pounds or more)
      • The starting dose is 500 mg taken twice per day.
      • Your doctor will increase your dose as needed to control your seizures.
      • The highest recommended total dose is 3,000 mg per day.
    •  (ages 6–17 years, weighing 4488 pounds)
      • The starting dose is 250 mg taken twice per day.
      • Your doctor will increase your dose as needed to control your seizures.
      • The highest recommended total dose is 1,500 mg per day.
Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Special considerations

Kidney disease: Levetiracetam is removed from your body by your kidneys. If your kidneys aren’t working well, more of the drug may stay in your body for a longer time. This increases your risk of side effects. If you have kidney disease or are on dialysis, your doctor will decrease your dose of this drug.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug or don’t take it at all

If you stop taking this drug suddenly, you’re at risk for more frequent or severe seizures, or a seizure that won’t stop.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. In order for this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • sleepiness
  • feeling agitated or aggressive
  • breathing that slows down or stops
  • drowsiness
  • coma (being unconscious for a long time)

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away.

What to do if you miss a dose

Take it as soon as you remember. But if you remember just a few hours before the time for your next dose, only take one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

You should have fewer seizures and your seizures may be less severe.

This drug is used for long-term treatment.

Swallow the tablets whole. Don’t chew, break, or crush the tablets

If you can’t swallow tablets, talk to your doctor about whether the oral solution is a better choice for you.

Store this drug carefully

  • Store this drug at room temperature between 59°F and 86°F (15°C and 30°C).
  • Keep it away from high temperatures. Don’t freeze it.
  • Keep this drug away from light.
  • Don’t store this drug in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt your medication.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.
  • Be sure to bring enough of this drug to last your entire trip. You don’t want to run out of this medication while you’re away from home.
  • You may need to show airport staff the pharmacy label for your medication. Be sure to carry with you the prescription-labeled box your medication came in.

Clinical monitoring

Your and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include:

  • Kidney function. Blood tests can check how well your kidneys are working. If your kidneys aren’t working well, your doctor may decide to lower your dose of this drug.
  • Mental health and behavioral problems. You and your doctor should watch for any unusual changes in your behavior and mood. This drug can cause new mental health and behavioral problems, or worsen problems you already have.
  • Seizures. You and your doctor should track how often you have seizures. This can help you make sure that this drug is working for you.

Not every pharmacy stocks every form of this drug

When filling your prescription, be sure to call ahead.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription. 

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

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How Much Does levetiracetam Cost?

Oral tablet

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on October 9, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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