Keppra

Keppra Overview

Keppra (generic: levetiracetam ) is a prescription medication used to treat certain seizures in children and adults with epilepsy. Keppra belongs to a group of drugs called anticonvulsants, which may work by decreasing abnormal excitement in the brain.

This medication comes in tablet and liquid forms, and is taken twice daily, with or without food. Swallow Keppra tablets whole.

Common side effects of Keppra include drowsiness, weakness, and dizziness. Do not drive or operate heavy machinery until you know how Keppra affects you.

Uses of Keppra

Keppra is a prescription medicine taken by mouth that is used with other medicines to treat:

  • partial onset seizures in people 4 years of age and older with epilepsy
  • 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.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Side Effects of Keppra

Keppra can cause serious side effects.

Call your healthcare provider right away if you have any of these symptoms:

  • mood and behavior changes such as aggression, agitation, anger, anxiety, apathy, mood swings, depression, hostility, and irritability. A few people may get psychotic symptoms such as hallucinations (seeing or hearing things that are really not there), delusions (false or strange thoughts or beliefs) and unusual behavior.
  • extreme sleepiness, tiredness, and weakness
  • problems with muscle coordination (problems walking and moving)

The most common side effects seen in people who take Keppra include:

  • sleepiness
  • weakness
  • dizziness
  • infection

The most common side effects seen in children who take Keppra include, in addition to those listed above:

  • accidental injury
  • irritability
  • hostility

These side effects can happen at any time but happen more often within the first 4 weeks of treatment except for infection.

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

Keppra Interactions

Keppra is unlikely to interact with other medicines, but it is important to tell your doctor about the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Keppra Precautions

Like other antiepileptic drugs, Keppra may cause suicidal thoughts or actions in a very small number of people, about 1 in 500 people taking it.

Call your doctor right away if you have any of these symptoms, especially if they are new, worse, or worry you:

  • thoughts about suicide or dying
  • attempts to commit suicide
  • new or worse depression
  • new or worse anxiety
  • feeling agitated or restless
  • panic attacks
  • trouble sleeping (insomnia)
  • new or worse irritability
  • acting aggressive, being angry, or violent
  • acting on dangerous impulses
  • an extreme increase in activity and talking (mania)
  • other unusual changes in behavior or mood

Do not stop Keppra without first talking to your doctor.

  • Stopping Keppra suddenly can cause serious problems. Stopping a seizure medicine suddenly can cause seizures that will not stop (status epilepticus).
  • Suicidal thoughts or actions can be caused by things other than medicines. If you have suicidal thoughts or actions, your healthcare provider may check for other causes.

How can I watch for early symptoms of suicidal thoughts and actions?

  • Pay attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings.
  • Keep all follow-up visits with your healthcare provider as scheduled.
  • Call your doctor between visits as needed, especially if you are worried about symptoms.

Tell your doctor if you have kidney, liver or heart problems.

Tell your doctor if you are pregnant or breastfeeding.

Keppra may make you drowsy or dizzy. Do not drive a car or operate machinery until you know how Keppra will affect you.

 

Keppra Food Interactions

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Keppra there are no specific foods that you must exclude from your diet when receiving Keppra.

Inform MD

Before taking Keppra, tell your doctor about all of your medical conditions, including if you:

  • have or have had depression, mood problems or suicidal thoughts or behavior
  • have kidney problems
  • are pregnant or planning to become pregnant. It is not known if Keppra will harm your unborn baby. 
  • are breastfeeding. Keppra can pass into your milk and may harm your baby. 

Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. Do not start a new medicine without first talking with your doctor.

Know the medicines you take. Keep a list of them to show your doctor and pharmacist each time you get a new medicine.

Keppra and Pregnancy

Tell your doctor if you are pregnant or planning to become pregnant. 

It is not known if Keppra will harm your unborn baby. You and your doctor will have to decide if you should take Keppra while you are pregnant. If you become pregnant while taking Keppra, talk to your doctor about registering with the North American Antiepileptic Drug Pregnancy Registry. You can enroll in this registry by calling 1-888-233-2334. You can also enroll in the UCB AED Pregnancy Registry by calling 1-888-537-7734. The purpose of these registries is to collect information about the safety of Keppra and other antiepileptic medicine during pregnancy.

Keppra and Lactation

Tell your doctor if you are breastfeeding or planning to breastfeed. Keppra may be excreted in human breast milk. It may harm your nursing baby. You and your doctor should discuss whether you should take Keppra or breast feed; you should not do both.

Keppra Usage

Take Keppra exactly as prescribed.

  • Your doctor will tell you how much Keppra to take and when to take it. Keppra is usually taken twice a day. Take Keppra at the same times each day.
  • Your doctor may change your dose. Do not change your dose without talking to your doctor.
  • Take Keppra with or without food.
  • Swallow the tablets whole. Do not chew or crush tablets. Ask your doctor for Keppra oral solution if you cannot swallow tablets.
  • If your doctor has prescribed Keppra oral solution, be sure to ask your pharmacist for a medicine dropper or medicine cup to help you measure the correct amount of Keppra oral solution. Do not use a household teaspoon. Ask your pharmacist for instructions on how to use the measuring device the right way.
  • If you miss a dose of Keppra, take it as soon as you remember. If it is almost time for your next dose, just skip the missed dose. Take the next dose at your regular time. Do not take two doses at the same time.
  • If you take too much Keppra, call your local Poison Control Center or go to the nearest emergency room right away.

Keppra Dosage

Take Keppra exactly as prescribed by your doctor. Follow the directions on your prescription label carefully. Your doctor will determine the best dose for you.

For Partial Onset Seizures the recommended maximum total daily dosage in adults and children ages 16 and older is 3,000 mg. The initial (starting) dose will likely be 500 mg or 1000 mg taken twice daily.

For children younger than 16 years of age, the dosage is based on weight and type of seizure. For patients weighing 44 lb (20 kg) or less, the oral solution should be given. Always use the measuring device provided (not a household spoon) to measure your medicine.

For Myoclonic Seizures in Patients 12 years of age and older with Myoclonic Epilepsy - Treatment should be initiated with a dose of 1000 mg/day, given as twice-daily dosing (500 mg BID). Dosage should be increased by 1000 mg/day every 2 weeks to the recommended daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been studied.

Primary Generalized Tonic-Clonic Seizures 

Adults 16 Years And Older

Treatment should be initiated with a dose of 1000 mg/day, given as twice-daily dosing (500 mg BID). Dosage should be increased by 1000 mg/day every 2 weeks to the recommended daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been adequately studied.

Pediatric Patients Ages 6 To <16 Years

Treatment should be initiated with a daily dose of 20 mg/kg in 2 divided doses (10 mg/kg BID). The daily dose should be increased every 2 weeks by increments of 20 mg/kg to the recommended daily dose of 60 mg/kg (30 mg/kg BID). The effectiveness of doses lower than 60 mg/kg/day has not been adequately studied. Patients with body weight ≤ 20 kg should be dosed with oral solution. Patients with body weight above 20 kg can be dosed with either tablets or oral solution. See Table 14 for tablet dosing based on weight during titration to 60 mg/kg/day. Only whole tablets should be administered.

Keppra Overdose

If you take too much Keppra (more than the prescribed amount), call your local Poison Control Center or seek emergency medical attention right away.

Forms of Keppra

Keppra tablets are available in the following strengths: 250 mg, 500 mg, and 750 mg.

Keppra tablet active ingredient: levetiracetam

Inactive ingredients: colloidal silicon dioxide, croscarmellose sodium, magnesium stearate, polyethylene glycol 3350, polyethylene glycol 6000, polyvinyl alcohol, talc, titanium dioxide, and additional agents listed below:

250 mg tablets: FD&C Blue #2/indigo carmine aluminum lake

500 mg tablets: iron oxide yellow

750 mg tablets: FD&C yellow #6/sunset yellow FCF aluminum lake, iron oxide red

Keppra oral solution active ingredient: levetiracetam

Inactive ingredients: ammonium glycyrrhizinate, citric acid monohydrate, glycerin, maltitol solution, methylparaben, potassium acesulfame, propylparaben, purified water, sodium citrate dihydrate and natural and artificial flavor.

Keppra does not contain lactose or gluten. Keppra oral solution does contain carbohydrates. The liquid is dye-free.

 

Other Requirements

  • Store Keppra at room temperature, 59°F to 86°F (15°C to 30°C) away from heat and light.
  • Keep Keppra and all medicines out of the reach of children.

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Reviewed by: 
Beth Bolt, RPh
Last Updated:
February 15, 2013