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This medication, levetiracetam (Keppra), comes with important safety information that should be carefully reviewed. Contact your healthcare provider if you have any concerns.

• Mood and Behavioral Changes: Levetiracetam may cause changes in mood or behavior, such as irritability, aggression, anxiety, paranoia, depression, or withdrawal. Those with a history of mental health issues, including children, are at greater risk. Inform your provider of any such changes.

• Suicidal Thoughts or Behaviors: There is an increased risk of suicidal thoughts or self-harm, potentially beginning within the first week of treatment. If you or someone around you notices symptoms like anxiety, panic attacks, or irritability, seek immediate medical assistance, especially if you are also taking other anti-seizure medications.

• Cognitive and Motor Impairment: The medication can cause difficulty with concentration, speech, and coordination, as well as dizziness and sleepiness. Your risk is higher with high doses, immediate-release forms, or when combined with other medications causing drowsiness. Exercise caution if experiencing these side effects.

• Severe Allergic Reactions: Serious allergic reactions, including facial swelling and anaphylaxis, are possible, as well as severe skin reactions such as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN).

• Withdrawal Seizures: Do not discontinue levetiracetam suddenly without consulting your provider, as it may lead to withdrawal seizures. If stopping the medication is necessary, your provider will guide you on tapering the dose safely.

• Low Blood Cell Counts: Rarely, the medication can reduce blood cell counts, increasing risks for anemia, infection, and bleeding. Your provider may conduct blood tests to monitor your blood cell counts. Report symptoms like fever, unusual bruising, or bleeding to your provider.

• Increased Blood Pressure in Young Children: Levetiracetam has been associated with increased blood pressure in children under four. Regular monitoring by your healthcare provider and at home is advised. Report any significant changes to your provider.

• Pregnancy Considerations: During pregnancy, particularly the third trimester, levetiracetam levels may decrease, potentially reducing seizure control. Pregnant individuals should have regular follow-ups for dose adjustments to manage seizures effectively.

Consult your healthcare provider for personalized advice and before making any changes to your medication regimen.

Common side effects:

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

Serious side effects:

• loss of coordination
• mental or mood changes
• signs of anemia
• easy bruising or bleeding
• depression
• suicidal thoughts
• severe rash
• serious allergic reactions

Levetiracetam extended-release (ER) is an antiepileptic medication used to manage seizures. While it generally has a low potential for drug interactions, it's important to be aware of certain considerations:

Central Nervous System (CNS) Depressants: Combining levetiracetam ER with other CNS depressants—such as opioids, benzodiazepines, or alcohol—can enhance sedative effects. This may lead to increased drowsiness, dizziness, and impaired coordination. Caution is advised when using these substances together, and activities requiring alertness, like driving, should be avoided until individual responses are known.

Enzyme-Inducing Antiepileptic Drugs (EIAEDs): Medications like Carbamazepine, Phenytoin, and Phenobarbital can increase the clearance of levetiracetam, potentially reducing its effectiveness. Although this interaction is relatively modest, monitoring is recommended to ensure optimal seizure control.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) and Caffeine: In animal studies, levetiracetam has shown synergistic effects with NSAIDs (e.g., Ibuprofen, Celecoxib) and caffeine, enhancing pain relief. While these findings are promising, further research is needed to confirm their relevance in humans.

Anticoagulants: Concerns have been raised about potential interactions between levetiracetam and non-vitamin K antagonist oral anticoagulants (NOACs). However, clinical data suggest that levetiracetam does not significantly affect the pharmacokinetics of these anticoagulants, indicating a low risk of interaction.

Oral Contraceptives: Levetiracetam does not appear to influence the effectiveness of hormonal contraceptives. Studies have shown no significant impact on the pharmacokinetics of oral contraceptives or hormone levels, suggesting that contraceptive efficacy remains intact.

Digoxin and Warfarin: Co-administration of levetiracetam with digoxin or warfarin does not significantly alter the pharmacokinetics or pharmacodynamics of these medications, indicating minimal interaction risk.

It's essential to inform your healthcare provider about all medications, supplements, and substances you are using to ensure safe and effective treatment with levetiracetam ER.