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When using Levetiracetam (Keppra), it is crucial to be aware of several safety considerations to ensure its safe and effective use. Below are key warnings and precautions associated with this medication:

• Mood and Behavior Changes: Levetiracetam (Keppra) may lead to mood alterations, including irritability, aggression, anxiety, paranoia, depression, or withdrawal. If you or your child experience any changes in mood or behavior, consult your healthcare provider immediately. Those with a history of mental health conditions, such as depression, schizophrenia, or bipolar disorder, should be particularly cautious.

• Suicidal Thoughts and Behavior: This medication can increase the risk of suicidal thoughts or behaviors, possibly emerging as soon as one week after starting treatment. If you or those around you notice suicidal ideation or unusual behavior (such as anxiety, panic attacks, or restlessness), seek medical attention promptly. This risk is heightened for individuals taking other anti-seizure medications.

• Cognitive and Motor Impairments: Levetiracetam (Keppra) may cause concentration difficulties, speech and language problems, and motor coordination issues, along with dizziness and drowsiness. These effects can be more pronounced in those taking high doses, immediate-release forms, or other medications that induce sleepiness or dizziness, such as benzodiazepines or muscle relaxants.

• Serious Allergic Reactions: Severe allergic responses, including potentially fatal reactions like facial swelling and anaphylaxis, are possible. Levetiracetam (Keppra) can also lead to serious skin reactions, such as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN).

• Withdrawal Seizures: Discontinuing Levetiracetam (Keppra) suddenly can provoke seizures. It is essential to consult your healthcare provider before stopping the medication, as they will guide you on safely tapering the dose.

• Low Blood Cell Counts: Rarely, Levetiracetam (Keppra) may reduce blood cell counts, increasing the risk of anemia, infection, and bleeding. Your healthcare provider might conduct a complete blood count (CBC) before and during treatment. Contact your provider if you experience symptoms like fever, chills, unusual bruising, or bleeding.

• Increased Blood Pressure in Young Children: Children under 4 years may experience elevated blood pressure while on Levetiracetam (Keppra). Regular blood pressure monitoring at healthcare visits and possibly at home is recommended. Notify your provider if your child’s blood pressure is unusually high.

• Seizures During Pregnancy: Levetiracetam (Keppra) levels may decrease during pregnancy, particularly in the third trimester, potentially reducing seizure control. Pregnant individuals should have frequent follow-ups for seizure management and may require dosage adjustments.

By keeping these warnings in mind and maintaining communication with your healthcare provider, you can help ensure the safe use of Levetiracetam (Keppra).

Common side effects:

• weakness
• sleepiness
• headache
• infection
• dizziness
• common cold symptoms
• vomiting
• tiredness
• stuffy nose
• lowered appetite
• irritability

Less common but important to monitor:

• loss of coordination
• changes in mood or behavior (irritability, aggression, or anxiety)
• signs of anemia (persistent unusual tiredness, pale skin, rapid heart rate)
• mental health issues (depression or suicidal thoughts)

Serious side effects:

• rash
• very serious allergic reaction (fever, swollen lymph nodes, intense rash, itching or swelling especially of the face, tongue, or throat, severe dizziness, difficulty breathing)

Levetiracetam, commonly prescribed for seizure management, generally has a low potential for drug interactions. However, it's important to be aware of certain considerations:

Central Nervous System (CNS) Depressants: Levetiracetam may enhance the sedative effects of other CNS depressants, including alcohol, opioids, and benzodiazepines. Combining these substances can lead to increased drowsiness, dizziness, and impaired coordination. Therefore, it's advisable to avoid or limit the use of alcohol and consult your healthcare provider before using other CNS depressants alongside levetiracetam.

Other Antiepileptic Drugs (AEDs): When taken with enzyme-inducing AEDs like Phenytoin or Carbamazepine, levetiracetam's clearance from the body may increase by 9% to 22%, potentially reducing its effectiveness. Conversely, co-administration with enzyme-inhibiting drugs such as valproate can decrease levetiracetam clearance by approximately 19%, possibly leading to higher drug levels. While these changes are generally modest, your doctor may monitor drug levels and adjust dosages as needed.

Non-Vitamin K Antagonist Oral Anticoagulants (NOACs): Concerns have been raised about potential interactions between levetiracetam and NOACs due to possible effects on drug transport proteins. However, clinical studies have not demonstrated significant interactions, suggesting that levetiracetam does not notably affect the pharmacokinetics of NOACs.

Oral Contraceptives, Digoxin, and Warfarin: Levetiracetam does not appear to influence the effectiveness of oral contraceptives, digoxin, or warfarin, nor do these medications affect levetiracetam's pharmacokinetics. This indicates that levetiracetam can be co-administered with these drugs without significant interaction concerns.

Alcohol Consumption: While specific data on the interaction between levetiracetam and alcohol are limited, combining the two may increase the risk of side effects such as drowsiness and dizziness. It's advisable to avoid or limit alcohol intake while taking levetiracetam.

Always inform your healthcare provider about all medications and supplements you are taking to ensure safe and effective use of levetiracetam.