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The following safety information outlines the potential risks and necessary precautions associated with the use of levetiracetam (Keppra). It is important that you review these details carefully and consult your healthcare provider if you have any concerns or questions.

• Mood and Behavioral Changes: Levetiracetam (Keppra) may cause changes in mood or behavior, including irritability, aggression, anxiety, paranoia, depression, or withdrawal. Report any significant mood or behavioral changes to your provider. This is particularly important for children and individuals with a history of mental health disorders such as depression, schizophrenia, or bipolar disorder.

• Suicidal Thoughts or Behaviors: There is an increased risk of suicidal thoughts or behaviors when taking levetiracetam (Keppra), which may emerge as soon as one week after starting the medication. Seek immediate medical attention if you or someone around you notices suicidal thoughts or behavior, anxiety, panic attacks, insomnia, anger, or restlessness. This risk is heightened when taking other anti-seizure medications.

• Cognitive and Motor Impairment: Levetiracetam (Keppra) can affect brain function, leading to difficulty with concentration, speech, and coordination. Dizziness and sleepiness are also possible, which can impair thinking and reaction times. The risk is greater with high doses, immediate-release formulations, or concurrent use of medications that cause drowsiness or dizziness, such as benzodiazepines, muscle relaxants, or sleep aids.

• Severe Allergic Reactions: Serious allergic reactions, including anaphylaxis and severe skin conditions like Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN), can occur. Seek emergency medical care if you experience facial swelling or any signs of a severe allergic reaction.

• Withdrawal Seizures: Do not abruptly discontinue levetiracetam (Keppra) without consulting your healthcare provider, as sudden cessation can result in withdrawal seizures. If discontinuation is necessary, your provider will guide you on gradually reducing the dosage.

• Blood Cell Count Reduction: Although rare, levetiracetam (Keppra) may lower blood cell counts, increasing the risk of anemia, infections, and bleeding. Your provider may conduct blood tests to monitor blood cell levels. Contact your provider if you experience symptoms such as fever, shortness of breath, chills, weakness, unusual bruising or bleeding, or blood in urine, stools, or gums.

• Increased Blood Pressure in Young Children: Levetiracetam (Keppra) can raise blood pressure in children under 4 years. Regular blood pressure monitoring may be necessary. Report any significant increases in blood pressure to your child's healthcare provider.

• Seizure Management During Pregnancy: The effectiveness of levetiracetam (Keppra) may decrease during pregnancy, particularly in the third trimester, due to lower medication levels in the body. Pregnant individuals should have regular consultations with their healthcare provider to manage seizure control and may require dosage adjustments.

Please note that there are no specific contraindications listed for levetiracetam (Keppra) in the provided data. Always consult your healthcare provider for personalized medical advice.

When taking Keppra (levetiracetam), it's important to be aware of potential interactions with other substances:

Central Nervous System (CNS) Depressants: Combining Keppra with medications that depress the CNS can enhance drowsiness and dizziness. Such medications include:

• Benzodiazepines: Drugs like Alprazolam, Diazepam, and Lorazepam.

• Opioids: Medications such as codeine, hydrocodone, and Oxycodone.

• Antihistamines: Sedating types like diphenhydramine and hydroxyzine.

• Antidepressants: Certain types, including Amitriptyline and Mirtazapine.

• Antipsychotics: Medications like Aripiprazole and Haloperidol.

Alcohol: Drinking alcohol while on Keppra may intensify side effects such as sleepiness, dizziness, and coordination problems. It's advisable to limit or avoid alcohol consumption during treatment.

Other Antiepileptic Drugs (AEDs): Keppra generally does not significantly interact with other AEDs like Carbamazepine, Gabapentin, Lamotrigine, Phenobarbital, Phenytoin, Primidone, and Valproic Acid. However, in pediatric patients, concurrent use with enzyme-inducing AEDs may increase Keppra's clearance by about 22%, though dosage adjustments are typically unnecessary.

Methotrexate: Using methotrexate alongside Keppra can reduce methotrexate clearance, potentially leading to toxic levels. Regular monitoring of blood levels for both drugs is recommended when used together.

Oral Contraceptives: Keppra does not affect the effectiveness of oral contraceptives containing Ethinyl Estradiol and levonorgestrel, nor does it alter hormone levels like luteinizing hormone and progesterone.

Probenecid: This medication can decrease the clearance of Keppra's primary metabolite, leading to higher metabolite levels. However, the unchanged drug's excretion remains unaffected.

Food: While food doesn't change the extent of Keppra absorption, it may slightly slow down the absorption rate.

Herbal Supplements: There are no specific reports of interactions between Keppra and herbal supplements. Nonetheless, it's prudent to consult your doctor or pharmacist before combining them.

Always inform your healthcare provider about all medications, supplements, and substances you're using to ensure safe and effective treatment with Keppra.