Levetiracetam (Keppra): Practical Guide for People with Seizures
Levetiracetam—often called Keppra—is a widely used antiepileptic that helps reduce different types of seizures. It works differently than older drugs and has fewer drug interactions, which makes it a go-to choice for many people. This quick guide gives straight answers: how to take it, what to watch for, and easy tips to stay safe.
What it treats and how to start
Doctors prescribe levetiracetam for focal (partial) seizures, generalized tonic-clonic seizures, and some myoclonic seizures. For adults, a common start is 500 mg twice daily. Your provider may raise this every 2 weeks to 1,000 mg twice daily (2,000 mg/day) or up to 1,500 mg twice daily (3,000 mg/day) if needed. Kids get weight-based dosing—follow the pediatric plan closely. There’s also an IV form when oral pills can’t be taken.
Take it with or without food. If you miss a dose, take it as soon as you remember unless it's almost time for the next dose—don’t double up. Never stop levetiracetam suddenly; stopping abruptly can trigger seizures. Your doctor will taper the dose down slowly when it’s time to stop.
Side effects, safety, and monitoring
Common side effects: sleepiness, dizziness, irritability, mood swings, and headache. Many people find these ease after a few weeks. Less commonly, levetiracetam can cause more severe mood changes—depression, aggression, or suicidal thoughts. If you notice new or worsening mood symptoms, tell your doctor right away.
Levetiracetam is cleared mainly by the kidneys, so kidney function matters. People with reduced kidney function need lower doses and sometimes dosing after dialysis. Routine check-ups usually include kidney tests and a conversation about mood and sleep. Keep a seizure diary so your care team can see how well the medicine is working.
Drug interactions are relatively rare because levetiracetam doesn’t heavily involve liver enzymes. Still, combining it with other sedatives (benzodiazepines, opioids, alcohol) increases drowsiness and fall risk. Pregnant people should talk to their neurologist—seizure control is critical in pregnancy, and levetiracetam is often considered because it has reasonable safety data compared with some older drugs. It does pass into breast milk, so discuss feeding plans with your provider.
Practical tips: set phone reminders to keep doses steady, store pills in a dry place, and bring a current medication list to every visit. If cost is a worry, ask about the generic version—levetiracetam generics are widely available and usually much cheaper.
Questions to ask your doctor right now: What dose should I expect? How will we know it’s working? How long before I call about mood changes? With clear communication and simple safety steps, levetiracetam can control seizures while fitting into everyday life.
