1. About levetiracetam
Levetiracetam is a medicine used to treat epilepsy.
Levetiracetam is available on prescription.
It comes as tablets, a liquid and granules. These can be swallowed directly from the packet or mixed with water to make a drink.
2. Key facts
- You'll usually start taking levetiracetam once a day and increase to twice a day. You can take it with or without food.
- The most common side effects of levetiracetam are headaches, feeling sleepy and a blocked nose or itchy throat.
- It can take a few weeks for levetiracetam to work. You may still have seizures during this time.
3. Who can and cannot take levetiracetam
Levetiracetam can be taken by adults and children aged 1 month and over.
Levetiracetam is not suitable for some people.
To make sure levetiracetam is safe for you, tell your doctor if you:
- have ever had an allergic reaction to levetiracetam or other medicines in the past
- have kidney problems
- have had a low mood (depression) or thoughts of harming or killing yourself in the past
- are pregnant, or planning to become pregnant
- have an intolerance to some sugars – some brands of levetiracetam liquid contain maltitol
- have ever had an allergic reaction to preservatives and artificial food colourings like sunset yellow (E110) – some brands of levetiracetam contain these
4. How and when to take levetiracetam
Levetiracetam is a prescription medicine. It's important to take it as advised by your doctor.
The usual dose of levetiracetam to treat epilepsy in:
- adults and older children (aged 12 years and over) – 250mg to 3,000mg a day, taken as 1 or 2 doses, but the exact dose may depend on your weight.
- children (aged 1 month to 12 years) – varies depending on their weight
How to take it
You can take levetiracetam with or without food.
If you take it twice a day, try to space your doses evenly through the day – for example, first thing in the morning and in the evening.
Tablets – swallow whole with a drink of water, milk or juice. Do not chew them.
Liquid – can be swallowed whole or mixed into a glass of water, milk or juice. This comes with a syringe to help you measure it. If you do not have a syringe, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not give you the right amount.
Granules – can be swallowed straight from the packet or mixed with food or water. Do not chew them. Drink some water after you have swallowed them.
Will my dose go up or down?
To prevent side effects, your doctor will prescribe a low dose to start with and then increase it over a few weeks.
Once you find a dose that suits you, it'll usually stay the same.
What if I forget to take it?
If you take levetiracetam and miss a dose:
- once a day – take the missed dose as soon as you remember. If it's less than 12 hours before the next dose is due, leave out the missed dose and take your next dose as normal.
- twice a day – take the missed dose as soon as you remember. If it's less than 8 hours before the next dose is due, leave out the missed dose and take your next dose as normal.
Do not take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.
It's important to take this medicine regularly. Missing doses may trigger a seizure.
If you forget doses often, it may help to set an alarm to remind you.
You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
What if I take too much?
Taking too much levetiracetam can cause serious side effects.
Urgent advice: Call your doctor or go to A&E if:
You take too much levetiracetam and:
- feel sleepy or less alert
- feel agitated or aggressive
- have problems breathing
- pass out
If you need to go to an A&E, do not drive yourself. Get someone else to drive you or call for an ambulance.
Take the levetiracetam packet or the leaflet inside it, plus any remaining medicine, with you.
5. Side effects
Like all medicines, levetiracetam can cause side effects, although not everyone gets them.
Common side effects
These common side effects may happen in more than 1 in 100 people. They're usually mild and go away by themselves.
Keep taking the medicine, but talk to your pharmacist or doctor if these side effects bother you or do not go away:
- a blocked nose or itchy throat
- feeling drowsy, sleepy or dizzy
- aggression, or feeling irritable or agitated
- feeling or being sick (nausea or vomiting)
Serious side effects
Very few people taking levetiracetam have serious problems.
Tell a doctor straight away if you have a serious side effect, including:
- flu-like symptoms and a rash on the face, or a rash that spreads or forms blisters – these can be signs of a rare serious skin condition called Stevens-Johnson syndrome
- seizures getting worse
- passing very little pee, feeling tired or confused, or having swollen legs, ankles or feet – these could be signs of kidney problems
- signs of serious mental changes, or someone around you notices signs of confusion, sleepiness, loss of memory, forgetfulness, abnormal behaviour or uncontrolled movements
- thoughts of harming or killing yourself – a small number of people taking levetiracetam have had suicidal thoughts
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to levetiracetam.
Immediate action required: Call 999 or go to A&E if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of levetiracetam. For a full list, see the leaflet inside your medicines packet.
If you have other possible side effects, you can report them using the Yellow Card safety scheme.
7. How to cope with side effects of levetiracetam
What to do about:
- a blocked nose or itchy throat – if it's bothering you, ask your pharmacist for something to help your symptoms. If they do not wear off, tell your doctor
- feeling drowsy, sleepy or dizzy – as your body gets used to levetiracetam, these side effects should wear off. Do not drive, ride a bike, or operate machinery until you feel more alert. If they do not wear off within 1 or 2 weeks, your doctor may reduce your dose or increase it more slowly. If that does not work, you may need to switch to a different medicine
- headaches – make sure you rest and drink plenty of fluids. Do not drink too much alcohol. If it's a problem, ask your pharmacist to recommend a painkiller. Talk to your doctor if your headaches last longer than a week or are severe.
- aggression, or feeling irritable or agitated – talk to your doctor if you have any of these side effects.
- feeling or being sick – stick to simple meals and do not eat rich or spicy food. It might help to take your levetiracetam after a meal or snack. If you're being sick, take small, frequent sips of water to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any medicines to treat vomiting without speaking to a pharmacist or doctor. Speak to a doctor if your symptoms get worse or last longer than a week.
8. Pregnancy and breastfeeding
Levetiracetam and pregnancy
There's no firm evidence that levetiracetam is harmful to an unborn baby.
But for safety, your doctor will only advise you to take it in pregnancy if the benefits of the medicine outweigh the risks.
It's very important that your epilepsy is treated during pregnancy as seizures can harm you and your unborn baby.
If you become pregnant while taking levetiracetam, tell your doctor or nurse straight away.
Do not stop the medicine without talking to your doctor first.
If you're pregnant, or trying to get pregnant, and taking levetiracetam, you're recommended to take a higher dose of folic acid, a vitamin that helps your baby grow normally.
Your doctor might prescribe a high dose of 5mg a day for you to take when you're trying to get pregnant, and during the first 12 weeks of pregnancy.
Levetiracetam and breastfeeding
If your doctor or health visitor says your baby is healthy, levetiracetam can be taken while you're breastfeeding.
Levetiracetam passes into breast milk in small amounts.
There have been some reports of side effects in breastfed babies, including not feeding well. But in most cases babies do not get any side effects.
If your baby's not feeding as well as usual, seems unusually sleepy, or you have any other concerns about them, talk to your pharmacist, health visitor or doctor as soon as possible.
Non-urgent advice: Talk to your doctor if you're:
- trying to get pregnant
For more information about how levetiracetam can affect you and your baby during pregnancy, read this leaflet on the Best Use of Medicines in Pregnancy (BUMPs) website.
10. Cautions with other medicines
Some medicines and levetiracetam interfere with each other and increase your side effects.
Your doctor may need to change your dose of levetiracetam if you're taking any of these medicines.
Tell your pharmacist or doctor if you're taking:
- macrogol, a laxative
- other epilepsy medicines, such as carbamazepine, lamotrigine, oxcarbazepine, phenobarbital and phenytoin
- methotrexate, a medicine that can be used to treat arthritis and other conditions
Mixing levetiracetam with herbal remedies and supplements
There might be a problem taking some herbal remedies and supplements alongside levetiracetam, especially ones that cause sleepiness or dizziness.
Ask your pharmacist for advice.
Tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.
11. Common questions about levetiracetam
How does levetiracetam work?
How long does it take to work?
How long will I take it for?
Are there similar medicines?
Is it safe to take levetiracetam for a long time?
Are there similar medicines?
How does it compare with other medicines?
Can I switch to a different medicine?
Can I come off levetiracetam?
What is 'Keppra rage' and how may this affect my mood?
Do I need to take vitamin B alongside my levetiracetam?
Will it affect my contraception?
Will it affect my fertility?
Does levetiracetam cause weight loss?
Can I get epilepsy medicines for free?
Can I drink alcohol with it?
Is there any food or drink I need to avoid?
Can I drive or ride a bike with it?
Page last reviewed: 25/02/2019
Next review due: 25/02/2022