Medically reviewed by Philip Thornton, DipPharm. Last updated on Jul 8, 2021.
Keppra Side Effects
Medically reviewed by Drugs.com. Last updated on Mar 22, 2023.
Note: This document contains side effect information about levetiracetam. Some dosage forms listed on this page may not apply to the brand name Keppra.
Summary
Common side effects of Keppra include: infection, neurosis, drowsiness, asthenia, headache, nasopharyngitis, nervousness, abnormal behavior, aggressive behavior, agitation, anxiety, apathy, depersonalization, depression, fatigue, hostility, hyperkinetic muscle activity, personality disorder, emotional lability, irritability, laceration, and mood changes. Other side effects include: tonic clonic epilepsy, dizziness, vertigo, decreased neutrophils, depressed mood, neck pain, and pain. Continue reading for a comprehensive list of adverse effects.
Applies to levetiracetam: oral solution, oral tablet, oral tablet for suspension, oral tablet extended release. Other dosage forms:
Serious side effects of Keppra
Along with its needed effects, levetiracetam (the active ingredient contained in Keppra) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking levetiracetam:
More common
- Aggressive or angry
- anxiety
- change in personality
- chills
- cough
- crying
- deep or fast breathing with dizziness
- delusions of persecution, mistrust, suspiciousness, or combativeness
- diarrhea
- dry mouth
- false or unusual sense of well-being
- feeling of unreality
- fever
- general feeling of discomfort or illness
- headache
- hoarseness
- irregular heartbeat
- irritability
- joint pain
- loss of appetite
- lower back or side pain
- mental depression
- muscle aches and pains
- nausea
- numbness of the feet, hands, and around the mouth
- painful or difficult urination
- quick to react or overreact emotionally
- rapidly changing moods
- restlessness
- sense of detachment from self or body
- shaking
- shivering
- sleepiness or unusual drowsiness
- sore throat
- stuffy or runny nose
- sweating
- trouble sleeping
- unusual tiredness or weakness
- vomiting
Less common
- Bloody nose
- burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings
- clumsiness or unsteadiness
- discouragement
- dizziness or lightheadedness
- double vision
- earache
- feeling of constant movement of self or surroundings
- feeling sad or empty
- increase in body movements
- loss of bladder control
- loss of memory
- mood or mental changes
- outburst of anger
- pain or tenderness around the eyes and cheekbones
- problems with memory
- redness or swelling in the ear
- seizures
- sensation of spinning
- shakiness and unsteady walk
- shakiness in the legs, arms, hands, or feet
- tightness of the chest
- trembling or shaking of the hands or feet
- trouble concentrating
- unsteadiness, trembling, or other problems with muscle control or coordination
Incidence not known
- Attempts at killing oneself
- being forgetful
- bleeding gums
- blistering, peeling, or loosening of the skin
- bloating
- blood in the urine or stools
- bloody, black, or tarry stools
- blurred vision
- changes in vision
- chest pain
- coma
- confusion
- constipation
- dark urine
- difficulty with moving
- fast heartbeat
- fever with or without chills
- general feeling of tiredness or weakness
- high fever
- increased thirst
- indigestion
- itching
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- light-colored stools
- muscle pains or stiffness
- pains in the stomach, side, or abdomen, possibly radiating to the back
- pale skin
- pinpoint red spots on the skin
- red skin lesions, often with a purple center
- red, irritated eyes
- skin rash, encrusted, scaly, and oozing
- sores, ulcers, or white spots on the lips or in the mouth
- stomach pain, continuing
- swelling of the face, ankles, or hands
- swollen glands
- swollen joints
- thoughts or attempts at killing oneself
- trouble with balance
- twitching, twisting, or uncontrolled repetitive movements of the tongue, lips, face, arms, or legs
- uncontrolled jerking or twisting movements of the hands, arms, or legs
- uncontrolled movements of the lips, tongue, or cheeks
- unexplained bleeding or bruising
- unusual bleeding or bruising
- upper right abdominal or stomach pain
- weight loss
- yellow eyes or skin
Other side effects of Keppra
Some side effects of levetiracetam may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
- Loss of strength or energy
- muscle pain or weakness
- pain
- tender, swollen glands in the neck
- trouble swallowing
- unusual weak feeling
- voice changes
Less common
- Body aches or pain
- burning, dry, or itching eyes
- change in the color of the skin
- congestion
- cough increased
- sneezing
Incidence not known
- Hair loss or thinning of the hair
For Healthcare Professionals
Applies to levetiracetam: intravenous solution, oral solution, oral tablet, oral tablet dispersible, oral tablet extended release.
General
The more commonly reported adverse reactions in adults have included somnolence, asthenia, and dizziness; in children, fatigue, aggression, nasal congestion, decreased appetite, and irritability.
Nervous system
Very common (10% or more): Headache (14%), somnolence (14%)
Common (1% to 10%): Dizziness, ataxia, vertigo, paresthesia, coordination difficulties
Postmarketing reports: Choreoathetosis, dyskinesia [Ref]
Psychiatric
In studies, non-psychotic behavioral symptoms (reported as aggression, agitation, anger, anxiety, apathy, depersonalization, depression, emotional lability, hostility, hyperkinesias, irritability, nervousness, neurosis, and personality disorder) were reported in 13% of adults and 38% of pediatric patients aged 4 to 16 years compared to 6% and 19%, respectively in placebo patients. In patients less than 4 years old, irritability was reported in 12% compared to 0% in placebo patients. In adult patients, behavioral symptoms resulted in dose reduction or discontinuation 0.8% and 1.7% of patients, respectively. Dose reduction or discontinuation due to behavioral symptoms occurred in 11% of pediatric patients.
In studies, psychotic symptoms were reported in 1%, 2%, and 17% of patients receiving this drug aged adult, 4 to 16 years old, and less than 4 years compared to 0.2%, 2%, and 5% in placebo patients, respectively. [Ref]
Very Common (10% or more): Non-psychotic behavioral symptoms (up to 38%), psychotic symptoms (up to 17%)
Common (1% to 10%): Depression, nervousness, amnesia, anxiety, hostility, emotional lability, irritability, mood swings, hypersomnia, insomnia, apathy, tearfulness, negativism
Postmarketing reports: Panic attack [Ref]
Hematologic
In adults, 3.2% of patients receiving this drug had at least 1 WBC of 2.8 x 10(9)/L or lower and 2.4% had at least 1 neutrophil count of 1 x 10(9)/L or lower compared to 1.8% and 1.4% of placebo patients, respectively. Of those with a low neutrophil count, only 1 patient did not have resolution with continued treatment. No patient discontinued therapy due to a low neutrophil count. In pediatric patients 4 to 16 years old, mean decreases in WBC and neutrophils were 0.4 x 10(9)/L and 0.3 x 10(9)/L, respectively, compared to small increases in placebo patients. Mean relative lymphocyte counts increased by 1.7% in patients receiving this drug (placebo=decrease of 4%). [Ref]
Common (1% to 10%): Decreased white blood cell count (WBC), decreased neutrophil count, increased lymphocyte counts, higher eosinophil counts
Frequency not reported: Decreases in white blood cell, neutrophil, and red blood cell counts; decreased in hemoglobin and hematocrit; increases in eosinophil counts
Postmarketing reports: Pancytopenia (with bone marrow suppression reported in some cases), thrombocytopenia, agranulocytosis [Ref]
Hypersensitivity
Postmarketing reports: Anaphylaxis
Dermatologic
Alopecia reported with this drug resolved with discontinuation of therapy in most cases. [Ref]
Other
Very common (10% or more): Asthenia (15%), fatigue (10%)
Common (1% to 10%): Pain, vertigo [Ref]
Respiratory
Gastrointestinal
Common (1% to 10%): Diarrhea, gastroenteritis, constipation
Uncommon (0.1% to 1%): Nausea
Ocular
Common (1% to 10%): Diplopia [Ref]
Hepatic
Postmarketing reports: Abnormal liver function tests, hepatic failure, hepatitis [Ref]
Musculoskeletal
Common (1% to 10%): Neck pain
Postmarketing reports: Muscular weakness [Ref]
Immunologic
Very common (10% or more): Infection (13%)
Postmarketing reports: Drug reaction with eosinophilia and systemic symptoms (DRESS) [Ref]
Metabolic
Common (1% to 10%): Anorexia
Postmarketing reports: Weight loss, hyponatremia [Ref]
Cardiovascular
Very common (10% or more): Increased diastolic blood pressure (less than 4 years of age; 17%) [Ref]
In a clinical trial in patients 1 month to less than 4 years, 17% of patients had a significantly elevated diastolic blood pressure (placebo=2%). No overall difference in mean diastolic blood pressure was observed in treated patients compared with placebo nor was this effect observed in trials with older pediatric patients or adults. [Ref]
Renal
Postmarketing reports: Acute kidney injury
Frequently asked questions
- How long does it take to get Keppra out of your system?
- What is the difference between Briviact and Keppra?
- Aptiom vs Keppra, what is the difference?
More about Keppra (levetiracetam)
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Patient resources
- Drug Information
- Keppra (Advanced Reading)
- Keppra Intravenous (Advanced Reading)
- Keppra (Levetiracetam Injection)
- Keppra (Levetiracetam Oral Solution)
- Keppra (Levetiracetam Tablets)
Other brands
Professional resources
Other formulations
Related treatment guides
References
1. “Product Information. Keppra (levetiracetam).” UCB Pharma Inc (2001):
2. Cerner Multum, Inc. “UK Summary of Product Characteristics.” O 0
3. Pharmaceutical Society of Australia “APPGuide online. Australian prescription products guide online. http://www.appco.com.au/appguide/default.asp” (2006):
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Some side effects may not be reported. You may report them to the FDA.
Keppra
Medically reviewed by Philip Thornton, DipPharm. Last updated on Jul 8, 2021.
What is Keppra?
Keppra is an anti-epileptic drug, also called an anticonvulsant.
Keppra is a prescription medicine used to treat certain types of seizures in people with epilepsy, including partial onset seizures, myoclonic seizures, and tonic-clonic seizures.
When used for partial onset seizures:
- Keppra XR is for adults and children at least 12 years old.
- Keppra (immediate release tablets or oral solution) may be used in children as young as 1 month old.
Keppra is also used with other seizure medications to treat tonic-clonic seizures in people who are at least 6 years old, and myoclonic seizures in people at least 12 years old.
Keppra injection is used only as an alternative for patients when oral use is temporarily not possible.
Warnings
Do not stop using Keppra without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using this medicine suddenly. You may need to use less and less before you stop the medication completely.
Some people have thoughts about suicide when first taking this medicine. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.
Wear a medical alert tag or carry an ID card stating that you take Keppra. Any medical care provider who treats you should know that you take seizure medication.
Keppra may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Do not start or stop taking levetiracetam during pregnancy without your doctor’s advice. Having a seizure during pregnancy could harm both the mother and the baby. Seizure control is very important during pregnancy and the benefits of preventing seizures may outweigh any risks posed by using this medicine.
Related/similar drugs
Before taking this medicine
You should not use Keppra if you are allergic to levetiracetam.
To make sure Keppra is safe for you, tell your doctor if you have ever had:
- kidney disease (or if you are on dialysis);
- depression or other mood problems;
- mental illness or psychosis; or
- suicidal thoughts or actions.
Do not give this medicine to a child without medical advice. Different brands of levetiracetam are for use only in children of certain ages.
Some people have thoughts about suicide while taking Keppra. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.
Do not start or stop seizure medication during pregnancy without your doctor’s advice. Having a seizure during pregnancy could harm both mother and baby. Tell your doctor if you become pregnant. Your dose needs may be different during pregnancy.
If you are pregnant, your name may be listed on a pregnancy registry to track the effects of levetiracetam on the baby.
Ask a doctor if it is safe to breastfeed while using this medicine.
How should I take Keppra?
Take Keppra exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.
Keppra oral is taken by mouth at the same time each day, with or without food.
Keppra injection is given in a vein if you are unable to take the medicine by mouth.
Your dose needs may change if you switch to a different brand, strength, or form of levetiracetam. A child’s dose needs may change if the child gains or loses weight. Avoid medication errors by using only the brand, form, and strength your doctor prescribes.
Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.
Measure liquid medicine with the supplied syringe or a dose-measuring device (not a kitchen spoon).
Swallow the extended-release tablet whole and do not crush, chew, or break it.
Your kidney function may need to be tested.
Use all seizure medications as directed. Do not change your dose or stop using a medicine without your doctor’s advice.
Seizures may increase if you stop using Keppra suddenly.. Ask your doctor before stopping the medicine.
Wear a medical alert tag or carry an ID card to let others know you have seizures.
Store at room temperature away from moisture, heat, and light.
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
Get your prescription refilled before you run out of medicine completely.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include extreme drowsiness, agitation, aggression, shallow breathing, weakness, or fainting.
What should I avoid while taking Keppra?
Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.
Keppra side effects
Get emergency medical help if you have signs of an allergic reaction to Keppra (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, panic attacks, trouble sleeping, or if you feel agitated, hostile, irritable, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have:
- unusual changes in mood or behavior (unusual risk-taking behavior, being irritable or talkative);
- confusion, hallucinations, extreme drowsiness, feeling very weak or tired;
- loss of balance or coordination, problems with walking or movement;
- a skin rash, no matter how mild;
- easy bruising, unusual bleeding; or
- fever, chills, weakness, or other signs of infection.
Common Keppra side effects may include:
- dizziness, drowsiness, tiredness, weakness;
- feeling aggressive or irritable;
- loss of appetite;
- stuffy nose; or
- infection.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect Keppra?
Other drugs may interact with levetiracetam, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.
Popular FAQ
Aptiom (eslicarbazepine) is a once-daily oral seizure medicine (anticonvulsant) used alone or with other medicines to treat focal seizures (formerly called partial seizures). Keppra (levetiracetam) is an oral seizure medicine used to treat focal seizures, but is additionally approved to treat myoclonic seizures and tonic-clonic seizures. It is usually given twice a day. Both prescription treatments are used to treat adults and children of various ages with epilepsy. Continue reading
More FAQ
- How long does it take to get Keppra out of your system?
- What is the difference between Briviact and Keppra?
More about Keppra (levetiracetam)
- Check interactions
- Compare alternatives
- Pricing & coupons
- Reviews (295)
- Drug images
- Latest FDA alerts (5)
- Side effects
- Dosage information
- Patient tips
- During pregnancy
- Generic availability
- Support group
- Drug class: pyrrolidine anticonvulsants
- Breastfeeding
- En español
Patient resources
- Advanced Reading
- Keppra Intravenous (Advanced Reading)
- Keppra (Levetiracetam Injection)
- Keppra (Levetiracetam Oral Solution)
- Keppra (Levetiracetam Tablets)
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