Jeffrey Panko NP Psychiatry · Patient education
Levetiracetam
Keppra / Keppra XR / Spritam / Generic formulations
A guide for adults taking levetiracetam.
Follow the directions on your prescription and your provider's recommendations.
Formulations: Immediate-release and extended-release tablets, oral solution, and dissolving formulations have different schedules and instructions. Kidney function affects dosing.
What it is used for
Levetiracetam treats certain seizure disorders. It is not an established treatment for bipolar disorder, and psychiatric use should have a clearly explained rationale.
How it works
It binds to SV2A, a protein involved in release of nerve-cell messengers, helping reduce seizure activity.
What to expect over time
The dose is often increased gradually to balance benefit and side effects. Track the condition being treated and report changes after each adjustment.
Taking your medication
- Follow the schedule for the exact formulation.
- Swallow XR tablets whole. Measure solution with a dosing device and follow dissolving-tablet instructions.
- If you miss a dose, take it when you remember unless it is almost time for the next dose. Then skip it. Do not double a dose.
- Consult with your provider before stopping; abrupt withdrawal can increase seizures.
When to get help
Emergency symptoms. Get emergency care for a severe allergic reaction, a blistering rash, or a seizure that is prolonged or repeated.
Prompt medical advice. Contact your provider promptly for severe irritability, aggression, depression, hallucinations, or a new rash. Fever with swelling or organ symptoms also needs urgent assessment.
If you feel unsafe or have thoughts of self-harm, call 911 or go to an emergency department.
Possible side effects
- Sleepiness, fatigue, or dizziness
- Irritability, anger, anxiety, or mood changes
- Problems with coordination
Keeping track of treatment
Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.
Report changes in mood, behavior, concentration, or suicidal thoughts. Antiseizure medicines carry a warning about suicidal thoughts and behavior.
Keep follow-up appointments. Your provider may adjust treatment based on symptoms, kidney or liver function, other medicines, and any recommended laboratory tests.
Behavioral changes can be significant. Ask a trusted person to mention new irritability, aggression, depression, or unusual behavior when helpful.
If you take too much
For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.
Before you start
Discuss kidney or liver disease, previous medication rashes, depression, and the reason for treatment.
Discuss pregnancy, pregnancy plans, and breastfeeding with your provider. Treatment decisions should consider both the medication and the condition being treated.
Medicines and interactions
Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.
Alcohol and other sedatives can worsen drowsiness, balance, and driving ability. Check new medications and supplements with your provider.
Everyday tips
Use reminders and arrange refills before you run out.
Avoid driving until you know how treatment affects you; seizure-related driving restrictions may also apply.
Your questions answered
Can I stop if I feel well?
Consult with your provider before stopping. Abrupt withdrawal can cause seizures or a return of the condition being treated.
Does use for seizures mean I have epilepsy?
Not necessarily. Some antiseizure medicines have other approved or off-label uses. Confirm the specific goal of your prescription.
Storage and safety
Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.
Sources
About this information
Educational handout; does not replace your prescription or provider's recommendations.
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.