Key takeaways

  • Keppra can cause mild side effects like sleepiness, dizziness, and weakness. These often improve (become less bothersome) as your body adjusts to the medication.
  • Possible serious side effects of Keppra include abnormal behaviors such as aggression or irritability, suicidal thoughts, and severe skin reactions. These require immediate medical attention.
  • Children taking Keppra may experience different side effects than adults, including increased aggression, hostility, and behavioral changes that should be reported to their doctor right away.

Keppra (levetiracetam) is a prescription drug used to treat certain types of seizures. It can cause side effects that range from mild to serious.

This article helps you understand and manage potential side effects of the oral (tablets and liquid solution) forms of Keppra. This drug is also available in a solution for intravenous (IV) infusion by a healthcare professional, but side effects of that form are not discussed here. Talk with your doctor about possible side effects of Keppra infusions.

Some people may experience mild to serious side effects during Keppra treatment. Below are just a few of the more common side effects reported by people taking the drug in studies. Side effects can vary depending on what condition the drug is being used to treat.

More common side effects of Keppra in clinical studies of the drug included:

These side effects are usually mild and become less bothersome as your body adjusts to the medications. But if they persist for more than a couple weeks or become more bothersome, talk with your doctor.

Keppra vs Keppra XR side effects

There are two types of Keppra oral tablets: standard-release Keppra and extended-release tablets (Keppra XR). Side effects may vary on the type of tablet prescribed and the condition being treated.

For example, in clinical trials for the treatment of focal onset seizures, side effects of weakness and infections were more common with standard-release Keppra tablets and irritability was more common with Keppra XR.

For more details about the more common side effects of Keppra, including side effect differences between standard-release Keppra and Keppra XR and depending of the specific type of seizures being treated, see the prescribing information for Keppra and Keppra XR.

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Other mild side effects that have been reported with Keppra include:

  • inability to coordinate muscle movement
  • depression
  • nervousness
  • flu
  • vertigo
  • mood swings
  • irritability
  • common cold
  • sore throat
  • neck pain

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. And do not stop taking Keppra unless your doctor recommends it.

Keppra may cause mild side effects other than those listed above. For more details, see the prescribing information for Keppra and Keppra XR.

Serious side effects that have been reported with Keppra include:

  • drowsiness that can impair driving and operating machinery
  • withdrawal seizure
  • abnormal behaviors
  • suicidal thoughts or behavior
  • blood cell problems
  • inability to coordinate muscle movements
  • increased blood pressure in people ages 1 month to less than 4 years
  • loss of seizure control in pregnancy
  • serious skin reactions

For more details about some of these serious side effects and how to handle them, see the “How to manage Keppra side effects” section.

If you develop serious side effects while taking Keppra, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

The following side effects of Keppra were more among children than in adults in the drug’s studies:

For more information about potential side effects of Keppra in children, see the prescribing information for Keppra and Keppra XR or talk with your child’s doctor or a pharmacist.

Here are some tips on how to manage some of the side effects reported with Keppra:

Abnormal behaviors

Symptoms of abnormal behaviors that could occur as a side effect of Keppra include:

  • agitation
  • anxiety
  • irritability
  • lack of interest or energy
  • psychosis (loss of contact with reality)
  • depersonalization (a feeling like you’re living in a movie or dream)
  • mood swings
  • nervousness
  • obsessive worrying or actions
  • excessive restlessness
  • hostility
  • anger
  • aggression
  • depression
  • personality disorders

Factors that can increase the risk of abnormal behaviors when taking Keppra include:

  • kidney problems (may cause higher Keppra levels in your blood)
  • young age
  • history of abnormal behavior or mental health conditions

What might help

If you have abnormal behavior during Keppra treatment, talk with your doctor right away. They may decide to change your dose of Keppra or switch you to a different medication. Do not stop Keppra without checking with your doctor first. Suddenly stopping this drug may cause withdrawal seizures.

Blood cell problems

Taking Keppra can increase risk of certain blood cell problems in some people. These problems may cause symptoms such as:

  • fatigue
  • weakness
  • infections

Factors that can increase the risk of blood cell problems when taking Keppra include:

  • a history of blood cell problems
  • use of other medications that can cause blood cell problems

What might help

Eat a diet rich in lean meats, whole grains, fruits, and vegetables. Report any symptoms of fatigue, weakness, or frequent infections to your doctor right away. Your doctor will monitor your blood tests and adjust your Keppra dose as needed.

Allergic reaction

Like most drugs, Keppra can cause an allergic reaction in some people. Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin (usually in your eyelids, lips, hands, or feet)
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an antihistamine you swallow, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Keppra, they’ll decide if you should continue taking it.

Warning: If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care. If your doctor confirms you’ve had a serious allergic reaction to Keppra, they may have you switch to a different treatment.

Keeping track of side effects

During your Keppra treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Keppra affects you. They can then use this information to adjust your treatment plan if needed.

Below is important information you should consider before starting Keppra.

Interactions

Keppra can sometimes cause harmful effects in people with certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Keppra is a good treatment option for you.

Talk with your doctor about your health history before taking Keppra. Be sure to tell them if any of the following factors apply to you:

  • kidney problems
  • history of depression, mood problems, or suicidal thoughts or behaviors
  • use of other prescription medications, over-the-counter drugs, supplements, herbs, or vitamins
  • previous allergic reaction to Keppra
  • pregnancy
  • breastfeeding

Alcohol and Keppra

There are no known interactions between alcohol and Keppra. But consuming alcohol may worsen side effects of Keppra, such as dizziness or sleepiness. And alcohol may increase the risk of seizure in people with epilepsy.

It’s best to avoid or limit alcohol consumption during Keppra treatment. If you have questions, talk with your doctor or pharmacist.

Pregnancy and breastfeeding with Keppra

There’s limited information about the safety of Keppra use during pregnancy or while breastfeeding.

Pregnancy

It’s not known whether it’s safe to take Keppra during pregnancy. If you and your doctor determine that Keppra is needed to treat your seizures during pregnancy, you’ll need more frequent monitoring during the last trimester. As changes happen in your body, you may need a higher dose of Keppra to maintain seizure control.

If you’re pregnant or planning to become pregnant, talk with your doctor before starting this medication.

If you’re able to become pregnant, your doctor may recommend using a form of birth control before and throughout your Keppra treatment.

Breastfeeding

It isn’t known whether Keppra is safe to take while breastfeeding. Keppra can pass into breast milk, and it’s not known whether the drug will harm a child who is breastfed. If you’re breastfeeding or planning to do so, talk with your doctor before starting this medication.

It’s possible. Long-term side effects include those that may start at any time you’re taking a drug, even if you’ve taken it for a long time. They also include side effects that may not go away, even after you stop taking the drug.

Examples of long-term side effects reported in Keppra’s studies include:

If you’re concerned about possible long-term side effects from Keppra, talk with your doctor or pharmacist.

Most mild side effects — such as sleepiness, weakness, dizziness, and cold or flu symptoms — may go away as you become used to Keppra. Your doctor will likely increase your dose slowly to minimize these side effects.

Other side effects, such as abnormal behaviors, suicidal thoughts or actions, skin reactions, and allergic reactions, may become more severe over time. If you experience these side effects, do not stop Keppra, but call your doctor right away. These types of side effects may require emergency medical attention.

If you still have bothersome side effects after a few weeks, check with your doctor. It’s likely they may be able to adjust your dose schedule or the amount you take to help you get the benefits of the drug with fewer side effects.

Keppra is not FDA approved for use in dogs, but your veterinarian may prescribe this drug for your dog, depending on the condition your dog has.

Side effects of Keppra in dogs may vary, so it’s best to discuss your dog’s specific risks with your veterinarian. Do not give Keppra or any other drug to your dog without first talking with your vet.

Keppra (levetiracetam) is an antiseizure medication that can cause a range of side effects from mild to severe. While many symptoms are temporary, monitoring your mood and physical health is essential for safe management.

  • Common Side Effects: Most people experience mild drowsiness, dizziness, infection, or weakness. These often improve as your body adjusts to the medicine.
  • Serious Risks: Seek medical help immediately for “Keppra rage” (extreme irritability), depression, suicidal thoughts, or severe skin rashes.
  • How to Manage: Keep a side effect log, maintain a healthy diet, and consult your doctor about adjusting your dosage of Keppra if symptoms interfere with your daily life.
  • Warning: Never stop taking Keppra suddenly, as this can trigger withdrawal seizures.

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Disclaimer: While MyistyClan strives for factual, comprehensive, and current information, this article is not a substitute for a licensed healthcare professional’s expertise. Always consult a doctor before taking or discontinuing any medication. Drug information is subject to change and may not cover all uses, directions, precautions, warnings, interactions, reactions, or adverse effects. The lack of a warning does not guarantee a drug’s safety, effectiveness, or appropriateness for all patients or specific uses. Learn more about our approach to content integrity.