This medication binds to a protein in the brain called the synaptic vesicle protein SV2A. This protein is thought to be involved in regulating the release of certain neurotransmitters in the brain. It is not fully known how this action plays a role in seizure prevention.
Levetiracetam is available as a standard tablet, extended-release tablet, and as a solution for injection. It is also available as an orally disintegrating tablet (ODT) under the brand name Spritam.
What Is Keppra Used For?
The Food and Drug Administration (FDA) approved Keppra to prevent several different types of seizures.
Brand Name(s): Keppra, Keppra XR, Elepsia XR, Spritam, Roweepra
Administration Route(s): Oral
Drug Availability: Prescription
Therapeutic Classification: Anticonvulsant
Available Generically: Yes
Controlled Substance: N/A
Active Ingredient: Levetiracetam
Dosage Form(s): Tablet, extended-release tablet, tablet for suspension, solution
Keppra is used to prevent:
Partial-onset seizures for adults and children who are 1 month or older. Partial onset seizures begin with abnormal nerve activity in a small area of the brain. They may remain focal in a localized area of the brain, often with limited symptoms (such as one limb jerking or stiffening), or they can involve both sides of the brain, sometimes with extensive effects, such as loss of consciousness and uncontrolled movements of the body. Adjunctive (add-on) therapy for preventing seizures in juvenile myoclonic epilepsy (JME) for adults and children aged 12 years and older. JME is an epilepsy syndrome that begins during childhood or adolescence, causing several types of seizures. Adjunctive therapy for preventing idiopathic primary generalized tonic-clonic seizures for adults and children aged 6 years or older. Idiopathic primary generalized tonic-clonic seizures occur without a known cause and begin on both sides of the brain, causing jerking and stiffening of the body.
Adjunctive seizure medication is recommended for use with another AED because it isn’t expected to prevent seizures when used alone.
How to Take Keppra
You can take Keppra tablets or oral solution with or without food. This medication is usually taken twice per day. Your healthcare provider will let you know how much to take and when to take it.
If you or your child cannot swallow tablets, ask your healthcare provider for the oral solution.
For the ODT, allow the tablet to dissolve on your tongue completely before swallowing. On average, it will take the tablet 11 seconds to dissolve. For regular immediate-release tablets, you can dissolve it in water and swallow the content if needed.
Storage
You should keep Keppra in its original container and away from the reach of children or pets. This medication should be stored at a temperature of 77 degrees Fahrenheit (F). It can be briefly taken in temperatures between 59 degrees F and 86 degrees F.
Off-Label Uses
Healthcare providers sometimes prescribe Keppra off-label for treating medical issues that are not FDA-approved. In these situations, your dose may differ from the standard dose. When taking Keppra off-label, make sure you monitor the symptoms and let your healthcare provider know if you are improving with Keppra.
Off-label uses of Keppra include:
Use for seizure prevention in babies younger than 1 month of age Prevention of neuropathic pain Migraine prevention Prevention of psychiatric symptoms including depression, body dysmorphia, bipolar disorder symptoms Acute repetitive seizures and status epilepticus
If you are prescribed Keppra to treat an off-label indication, you can experience similar side effects to when taking Keppra for an indicated condition.
What Are the Side Effects of Keppra?
The common side effects of Keppra can be mild. However, Keppra can cause significant side effects that may interfere with your quality of life.
This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.
Common Side Effects
The most common side effects of Keppra differ slightly based on age.
The most common side effects in adults include:
Severe tirednessWeakness and lack of energyInfectionsDizziness
The most common side effects in children include:
FatigueAggressionNasal congestionDecreased appetiteIrritability
Make sure to tell your healthcare provider if you or your child experiences side effects of Keppra.
Severe Side Effects
Keppra can cause serious and potentially life-threatening side effects that should be treated promptly.
Severe side effects of Keppra can include:
Low blood pressure Mood changes Psychotic symptoms Suicidal thoughts or behavior Irritability Aggression Severe skin reactions Balance and coordination problems Trouble waking
Get medical attention right away if you experience any of these symptoms.
Long-Term Side Effects
Keppra is a relatively quick-acting medication with short-acting effects. You should not have long-term side effects after you stop taking Keppra.
Dosage: How Much Keppra Should I Take?
Modifications
In some cases, your healthcare provider may modify your treatment with Keppra by changing your dose or switching your medication altogether.
If you experience a serious side effect, you or your healthcare provider may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting Program or by phone (1-800-332-1088).
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For oral dosage form (extended-release tablets): For treatment of partial-onset seizures: Adults and children 12 years of age and older and weighing 50 kilograms (kg) or more—At first, 1000 milligrams (mg) once a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 3000 mg per day. Children younger than 12 years of age—Use and dose must be determined by your doctor. For oral dosage form (Keppra® solution or tablets): For partial onset seizures: Adults and children 16 years of age and older—At first, 500 milligrams (mg) 2 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 3000 mg per day. Children 4 to 15 years of age—Dose is based on body weight and must be determined by your doctor. The usual starting dose is 10 milligrams (mg) per kilogram (kg) of body weight 2 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 60 mg per kg of body weight per day. Children 6 months to 3 years of age—Dose is based on body weight and must be determined by your doctor. The usual starting dose is 10 mg per kg of body weight 2 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 50 mg per kg of body weight per day. Children 1 to 5 months of age—Dose is based on body weight and must be determined by your doctor. The usual starting dose is 7 mg per kg of body weight 2 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 42 mg per kg of body weight per day. Children younger than 1 month of age—Use and dose must be determined by your doctor. For juvenile myoclonic seizures: Children 12 years of age and older—At first, 500 milligrams (mg) 2 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 3000 mg per day. Children younger than 12 years of age—Use and dose must be determined by your doctor. For primary generalized tonic-clonic seizures: Adults and children 16 years of age and older—At first, 500 milligrams (mg) 2 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 3000 mg per day. Children 6 to 15 years of age—Dose is based on body weight and must be determined by your doctor. The usual starting dose is 10 milligrams (mg) per kilogram (kg) of body weight 2 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 60 mg per kg of body weight per day. Children younger than 6 years of age—Use and dose must be determined by your doctor. For oral dosage forms (Spritam® tablets, Spritam® tablets for suspension): For partial onset seizures: Adults and children 4 years of age and older weighing over 40 kilograms (kg)—Dose is based on body weight and must be determined by your doctor. The usual starting dose is 500 milligrams (mg) 2 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 3000 mg per day. Children 4 years of age and older weighing 20 to 40 kg—Dose is based on body weight and must be determined by your doctor. The usual starting dose is 250 mg 2 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 1500 mg per day. Children younger than 4 years of age and weighing less than 20 kg—Use is not recommended. For juvenile myoclonic seizures: Children 12 years of age and older—At first, 500 milligrams (mg) 2 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 3000 mg per day. Children younger than 12 years of age—Use and dose must be determined by your doctor. For primary generalized tonic-clonic seizures: Adults and children 6 years of age and older weighing over 40 kilograms (kg)—Dose is based on body weight and must be determined by your doctor. The usual starting dose is 500 milligrams (mg) 2 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 3000 mg per day. Children 6 years of age and older weighing 20 to 40 kg—Dose is based on body weight and must be determined by your doctor. The usual starting dose is 250 mg 2 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 1500 mg per day. Children younger than 6 years of age and weighing less than 20 kg—Use is not recommended.
Pregnancy
The physiological changes that occur when pregnant may affect the levels of Keppra in your body, especially during the third trimester. Your healthcare provider may adjust your dose of Keppra and monitor for any negative effects. If your dose is changed during pregnancy, close monitoring is also recommended through the postpartum period. Of note, there are no adequate and well-controlled studies of levetiracetam in people who are pregnant. Therefore, the potential risk should always be compared to the benefit of staying on the medication while pregnant.
Breastfeeding
Keppra can pass through human breast milk. Although there are no data on the effects of this medication on a breastfed infant or milk production, it is recommended to consider any side effects that might occur. Talk with your healthcare provider about your options.
Kidney Problems
People with kidney impairment may require a dose adjustment. Supplemental doses should be given after dialysis.
Missed Dose
If you miss a dose of Keppra, take the missed dose as soon as possible. If it is almost time for your next dose, skip the missed dose. Go back to your regular dosing schedule. Do not double up on doses.
Overdose: What Happens If I Take Too Much Keppra?
Taking too much Keppra can increase the risk of side effects, including severe problems with balance and/or blood pressure changes.
Tell your healthcare provider if you have taken too much Keppra. Seek emergency medical attention if you begin to experience symptoms of an overdose. You would need to be monitored and may receive treatment for symptoms of an overdose. Treatment can include medically-induced vomiting or a procedure to directly remove the drug from the stomach.
Precautions
What Are Reasons I Shouldn’t Take Keppra?
Do not take Keppra if you have a known allergy to levetiracetam or any of its ingredients. An allergic reaction can cause angioedema and anaphylaxis.
If someone collapses or isn’t breathing after taking Keppra, call 911 immediately.
It is important to tell your doctor if you become pregnant while using this medicine. Your doctor may want you to join a pregnancy registry for patients taking a seizure medicine.
Levetiracetam may cause changes in mood or behavior, problems with coordination, or unusual tiredness or weakness. Tell your doctor right away if you or your child start to feel depressed, anxious, angry, getting upset easily, restless, or have thoughts about hurting yourself. Report any unusual thoughts or behavior that trouble you, especially if they are new or getting worse quickly.
This medicine may cause some people to become dizzy, drowsy, tired, or less alert than they are normally. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
This medicine may cause serious allergic reactions, including anaphylaxis or angioedema, which can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, itching, large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs, trouble breathing or swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.
Serious skin reactions (eg, Stevens-Johnson syndrome, toxic epidermal necrolysis) can occur with this medicine. Check with your doctor right away if you or your child have blistering, peeling, or loosening of the skin, chills, cough, diarrhea, itching, joint or muscle pain, red irritated eyes, red skin lesions, sore throat, sores, ulcers, or white spots in the mouth or on the lips, or unusual tiredness or weakness while you are using this medicine.
Do not stop using levetiracetam without first checking with your doctor. Stopping the medicine suddenly may cause your seizures to return or to occur more often. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely.
Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.
What Other Medications Interact With Keppra?
Keppra does not usually cause harmful drug interactions. It is frequently taken with other AEDs for seizure prevention.
What Medications Are Similar?
Keppra is one of many AEDs used for preventing seizures.
Similar antiseizure medications include:
Briviact (brivaracetam) Lamictal (lamotrigine) Phenobarbitol Valproate and divalproex sodium
How to Stay Healthy While Taking Keppra
If you are taking Keppra, it is important that you monitor your symptoms and side effects and talk to your healthcare team about whether the medication is working.
Tips to stay healthy while taking Keppra include:
Avoid seizure triggers, including alcohol, sleep deprivation, flashing lights, skipping meals, and fevers. Take your medication as prescribed. Do not skip doses or take extra doses of Keppra. Have a plan in place for managing seizures if you have any. Have a plan to get medical attention if you have a severe seizure. Talk to your healthcare provider about whether you have permission to drive or operate potentially dangerous machinery.
