Levetiracetam

Levetiracetam is a prescription medication used to help control several types of seizures. It is widely used in both adults and children. This guide explains what it is, how it works, possible side effects, and what to discuss with your neurologist or other licensed medical specialist. It is meant to support, not replace, the advice of your care team.

What is Levetiracetam?

Levetiracetam is an anti-seizure medication (also called an antiepileptic drug or anticonvulsant). It is sold under brand names such as Keppra, Keppra XR, Spritam, and Elepsia XR, as well as generic products. Its chemical structure is different from most older seizure medicines.

Approved uses: In the United States, levetiracetam is approved by the FDA as treatment for:

• Partial-onset (focal) seizures, in adults and in children, with age ranges that depend on the product
• Myoclonic seizures (sudden muscle jerks) in adolescents and adults with juvenile myoclonic epilepsy
• Primary generalized tonic-clonic seizures in adults and children of certain ages with generalized epilepsy

Depending on the product and the seizure type, it may be used as add-on (adjunctive) therapy. The injectable form may be used in hospitals for people who cannot take medicine by mouth temporarily.

Available forms and strengths (may vary by brand, manufacturer, and country):

• Immediate-release tablets: commonly 250 mg, 500 mg, 750 mg, and 1,000 mg
• Extended-release tablets: commonly 500 mg, 750 mg, and 1,000 mg or 1,500 mg, depending on the product
• Oral solution (liquid): commonly 100 mg per mL
• Tablets for oral suspension (dispersible): commonly 250 mg to 1,000 mg
• Injection (intravenous): for use only in hospitals or medical settings

Individual strength pages provide more detailed questions and answers.

What is the Recommended Dosage of Levetiracetam?

There is no single dose that fits everyone. Your specialist chooses a dose based on:

• The condition being treated and how well seizures are controlled
• Age (infants, children, and older adults are dosed differently)
• Body weight, especially for children
• Kidney function, since the body clears levetiracetam mainly through the kidneys and doses are often lowered when kidney function is reduced
• Other medications and whether the person is pregnant or on dialysis

Treatment often starts with a lower dose that is increased gradually. Immediate-release forms are usually taken twice daily. Extended-release forms are usually taken once daily and must be swallowed whole, not crushed or chewed. Levetiracetam can be taken with or without food. Use the measuring device provided with the liquid, not a household spoon.

Always follow your prescription label. Do not change your dose, and do not stop levetiracetam suddenly, because abrupt withdrawal can trigger seizures. Any change should be directed by your specialist.

How Levetiracetam Works

Seizures occur when nerve cells in the brain send bursts of abnormal electrical signals. Levetiracetam is thought to work by binding to a protein in nerve endings called SV2A. This appears to help regulate how nerve cells release chemical messengers, which may reduce abnormal, overactive signaling.

Levetiracetam helps manage seizures. It does not cure epilepsy, and its benefit depends on taking it consistently as prescribed. Response varies from person to person.

Is a Prescription Required to Buy Levetiracetam Online?

Yes. Levetiracetam is a prescription-only medication. It should be started and monitored by a licensed medical specialist, most often a neurologist or epileptologist, or by another licensed prescriber familiar with seizure care.

If you use an online pharmacy:

• Use only licensed pharmacies that require a valid prescription.
• Be cautious of websites that sell prescription medicines without a prescription, since these products may be counterfeit, expired, or incorrectly labeled.
• Confirm that the medication name, form, and strength match what your prescriber ordered.
• Ask your pharmacist if a product looks different from your usual supply.

Side Effects of Levetiracetam

Everyone reacts differently. Many side effects are mild and improve as the body adjusts, but you should report any bothersome or unusual symptoms to your prescriber.

Common Side Effects

• Drowsiness or tiredness
• Weakness or low energy
• Dizziness
• Headache
• Irritability, nervousness, or mood changes
• Cold-like symptoms or infections, such as a stuffy nose or sore throat
• Trouble with coordination or balance
• In children, behavior changes, hyperactivity, or aggression

Serious Side Effects

Serious reactions are uncommon, but they need prompt attention. Seek emergency medical care or contact your specialist right away if you notice:

• Mood or behavior changes: new or worsening depression, anxiety, anger, aggression, unusual thoughts, hallucinations, or any thoughts of self-harm. Anti-seizure medicines as a group carry a warning about suicidal thoughts. If you or someone you care for has these thoughts, contact a healthcare professional or local emergency services immediately.
• Severe skin reactions: a rash, blistering, peeling skin, or sores in the mouth or eyes, especially with fever
• Signs of a serious allergic reaction: swelling of the face, lips, tongue, or throat, or trouble breathing
• Signs of multi-organ reaction: fever, swollen glands, rash, or signs of liver or blood problems
• Signs of blood problems: unexplained fever, sore throat, easy bruising or bleeding, or unusual tiredness
• Severe sleepiness or loss of coordination that affects walking or daily activities
• Unexplained muscle pain, weakness, or dark urine
• Worsening seizures or an increase in seizure frequency

In young children (age 1 month to under 4 years), blood pressure may rise. Pediatric specialists may monitor this.

Drug Interactions

Levetiracetam has fewer drug interactions than many other seizure medicines, but interactions can still happen. Tell your specialist and pharmacist about everything you take, including prescription drugs, over-the-counter (OTC) products, supplements, and herbal remedies. Major categories include:

• Other seizure medicines: Levetiracetam does not usually change levels of other seizure medicines, but combining seizure medicines can add to sleepiness, dizziness, and other side effects.
• Sedating medicines and alcohol: Opioids, sleep aids, anti-anxiety drugs, muscle relaxants, and alcohol can add to drowsiness and dizziness.
• Methotrexate: Levetiracetam may slow how quickly the body clears methotrexate. If you take it, your specialist may monitor closely.
• Probenecid: This medicine can affect how the body clears a byproduct of levetiracetam.
• OTC products: Antihistamines that cause sleepiness may add to drowsiness. Ask a pharmacist before combining products.
• Supplements and herbal products: Discuss any supplement, including sleep or mood products such as St. John’s wort, valerian, or kava, before starting it.

Bring a complete, up-to-date medication list to each appointment.

Safety & Important Considerations

• Kidney disease: Doses are usually lowered when kidney function is reduced, and adjusted for people on dialysis.
• Liver disease: Levetiracetam is not heavily processed by the liver, but talk to your specialist if you have liver problems.
• Pregnancy: Uncontrolled seizures can be dangerous during pregnancy, and treatment decisions should be made with your specialist. Blood levels of levetiracetam can fall during pregnancy, so monitoring or dose changes may be needed. Do not stop your medicine on your own. If you are pregnant, planning pregnancy, or become pregnant, contact your specialist promptly. Ask about pregnancy registries for anti-seizure medicines.
• Breastfeeding: Levetiracetam passes into breast milk. Discuss risks and benefits with your specialist, and watch the infant for sleepiness or poor feeding.
• Children: Behavior and mood changes may be more noticeable in children. Caregivers should report changes promptly.
• Older adults: Older adults may be more sensitive to sleepiness and dizziness, and are more likely to have reduced kidney function, which can affect dosing.
• Monitoring: Your specialist may check kidney function, blood counts, and mood and behavior, and ask about seizure frequency and side effects.
• Alcohol and driving: Avoid alcohol, and avoid driving or operating machinery until you know how levetiracetam affects you. Follow local laws about driving with seizures.
• Boxed warning status: Levetiracetam does not carry a boxed warning, but its labeling includes important warnings on behavior and mood changes, sleepiness, serious skin reactions, and withdrawal seizures.

Who This Medication Is For

Levetiracetam is intended for people diagnosed with partial-onset seizures, myoclonic seizures (in juvenile myoclonic epilepsy), or primary generalized tonic-clonic seizures, within the age ranges on each product’s label. Whether it is suitable depends on medical history, other treatments, and personal risk factors, which only a specialist can assess.

Who Should Not Take Levetiracetam

• People who are allergic to levetiracetam or any ingredient in the product

Use extra caution, and talk to your specialist first, if you have:

• Kidney disease or are on dialysis
• A history of depression, mood disorders, aggression, psychosis, or suicidal thoughts
• A history of allergic reaction or serious skin reaction to another seizure medicine
• Pregnancy, plans for pregnancy, or breastfeeding

What to Do If You Miss a Dose

• Take the missed dose as soon as you remember, unless it is almost time for the next dose.
• If it is almost time for the next dose, skip the missed one and return to your normal schedule.
• Do not take a double dose to make up for a missed one.
• If you miss more than one dose, or you are unsure what to do, contact your licensed medical specialist or pharmacist. Missing doses can raise the risk of breakthrough seizures.

Using a pill organizer, phone reminder, or caregiver check-in can help with consistency.

Related medications to Levetiracetam

Other anti-seizure medicines may be used for the same seizure types, depending on the person. Examples include brivaracetam (a related medicine), lamotrigine, lacosamide, topiramate, valproate, oxcarbazepine, and zonisamide. Each has its own benefits, risks, and interactions, and none is right for everyone. Non-drug options, such as epilepsy surgery, vagus nerve stimulation, or dietary therapy, may also be considered in some cases.

Do not switch or stop medications on your own. Any change in treatment requires consultation with your neurologist or other licensed medical specialist.

Storage Instructions

• Store at room temperature, generally 68°F to 77°F (20°C to 25°C), unless the label says otherwise.
• Keep tablets and liquid in the original tight container, away from moisture, heat, and light. Avoid storing in bathrooms.
• For the oral solution, follow the label for how long it can be kept after opening, and use the dosing device provided.
• Keep out of reach and sight of children and pets. Consider a locked storage spot.
• Do not use medication past its expiration date. Ask your pharmacist about safe disposal or take-back programs.

Disclaimer:

This page is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Patients must consult a licensed neurologist or other relevant medical specialist before starting, changing, or stopping treatment. Treatment decisions must be based on a full clinical evaluation by a qualified specialist. If you think you are having a medical emergency, contact your local emergency services immediately.