Levetiracetam Side Effects
Some side effects of levetiracetam may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
For the Consumer
Applies to levetiracetam: oral solution, oral tablet, oral tablet extended release
Other dosage forms:
Along with its needed effects, levetiracetam may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking levetiracetam:More common
- Aggressive or angry
- change in personality
- cough or hoarseness
- dry mouth
- general feeling of discomfort or illness
- irregular heartbeats
- joint pain
- loss of appetite
- lower back or side pain
- mental depression
- muscle aches and pains
- painful or difficult urination
- quick to react or overreact emotionally
- rapidly changing moods
- shortness of breath
- sleepiness or unusual drowsiness
- sore throat
- stuffy or runny nose
- trouble with sleeping
- unusual tiredness or weakness
- Bloody nose
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- clumsiness or unsteadiness
- dizziness or lightheadedness
- double vision
- fear or nervousness
- feeling of constant movement of self or surroundings
- feeling sad or empty
- increase in body movements
- loss of bladder control
- loss of memory
- mood or mental changes
- outburst of anger
- pain or tenderness around the eyes and cheekbones
- problems with memory
- redness or swelling in the ear
- sensation of spinning
- shakiness and unsteady walk
- shakiness in the legs, arms, hands, or feet
- tightness of the chest or wheezing
- trembling or shaking of the hands or feet
- trouble concentrating
- unsteadiness, trembling, or other problems with muscle control or coordination
- Attempts at killing oneself
- being forgetful
- bleeding gums
- blistering, peeling, or loosening of the skin
- blood in the urine or stools
- bloody, black, or tarry stools
- blurred vision
- changes in vision
- chest pain
- dark urine
- difficulty with moving
- fast heartbeat
- general feeling of tiredness or weakness
- high fever
- increase in body movements
- light-colored stools
- muscle pains or stiffness
- painful or difficult urination
- pains in the stomach, side, or abdomen, possibly radiating to the back
- pale skin
- pinpoint red spots on the skin
- red skin lesions, often with a purple center
- red, irritated eyes
- sores, ulcers, or white spots on the lips or in the mouth
- stomach pain, continuing
- swollen glands
- swollen joints
- thoughts or attempts at killing oneself
- trouble with balance
- twitching, twisting, or uncontrolled repetitive movements of the tongue, lips, face, arms, or legs
- uncontrolled jerking or twisting movements of the hands, arms, or legs
- uncontrolled movements of the lips, tongue, or cheeks
- unexplained bleeding or bruising
- unusual bleeding or bruising
- upper right abdominal or stomach pain
- weight loss
- yellow eyes or skin
Some side effects of levetiracetam may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
- Loss of strength or energy
- muscle pain or weakness
- tender, swollen glands in the neck
- trouble with swallowing
- unusual weak feeling
- voice changes
- Body aches or pain
- burning, dry, or itching eyes
- change in the color of the skin
- cough increased
- Hair loss or thinning of the hair
- skin rash, encrusted, scaly, and oozing
For Healthcare Professionals
Applies to levetiracetam: intravenous solution, oral solution, oral tablet, oral tablet extended release
Nervous system side effects have included somnolence (up to 15%), dizziness (9%), vertigo (up to 5%), depression (4%), nervousness (4%), ataxia (3%), amnesia (2%), anxiety (2%), emotional lability (2%), hostility (2%), and paresthesia (2%). A case of levetiracetam-induced parkinsonism has also been reported.
Somnolence (8%) and dizziness (5%) have been reported with extended release tablets.
Postmarketing reports: Choreoathetosis, dyskinesia
General side effects have included asthenia (15%), headache (14%), nasopharyngitis (14%), infection (13%), fatigue (10%), pain (7%), and influenza (5%). Several cases of considerable weight loss associated with levetiracetam use have also been reported. Levetiracetam has been associated with fatigue in pediatric patients.
Influenza (8%) has been reported with extended release tablets.
Respiratory side effects have included pharyngitis (up to 7%), rhinitis (4%), increased cough (2%), and sinusitis (2%).
Nasopharyngitis (7%) has been reported with extended release tablets.
Slower titration should be considered in patients at a higher risk of discontinuing levetiracetam for behavioral reasons.
Psychiatric side effects such as depression (up to 5.7%) including suicidal depression (up to 0.7%), irritability (6%), and mood swings (5%) have been reported.
In some patients experiencing primary generalized tonic-clonic seizures, levetiracetam caused behavioral abnormalities. Nonpsychotic mood disorders (reported as anger, apathy, depression, altered mood, mood swings, negativism, suicidal ideation, and tearfulness) occurred in 12.7% of levetiracetam-treated patients. One patient experienced suicidal ideation. Another patient experienced delusional behavior that required the lowering of the dose of levetiracetam.
Irritability (7%) has been reported with extended release tablets.
A multicenter, double-blind, placebo controlled trial (n=517) has reported that 10.1% of patients treated with levetiracetam had adverse psychiatric events. A significant association was reported with previous psychiatric history, history of febrile convulsions, and history of status epilepticus. Concomitant therapy with lamotrigine was reported to have had a protective effect. Psychiatric adverse events were not related to the titration schedule of levetiracetam. Certain patients seem to be more vulnerable biologically.
Gastrointestinal side effects have included anorexia (3%), pancreatitis, and diarrhea.
Nausea (5%) has been reported with extended release tablets.
Ocular side effects have included diplopia (2%).
One possibly significant decreased WBC count occurred in every 3.2% of treated patients. One possibly significant decreased neutrophil count occurred in every 2.4% of treated patients.
Hematologic side effects have included leukopenia, neutropenia, pancytopenia (with bone marrow suppression identified in some of these cases), and thrombocytopenia. Minor, but statistically significant decreases in total mean RBC count (0.03 x 1,000,000/mm2), mean hemoglobin (0.09 g/dL), and mean hematocrit (0.38%) have also been reported.
Recovery from alopecia was reported in the majority of the cases where levetiracetam was discontinued.
Dermatologic side effects have included Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in both children and adults and alopecia.
Hepatic side effects including abnormal liver function tests, hepatitis, and hepatic failure have been reported during postmarketing surveillance.
Musculoskeletal side effects including neck pain (8%) have been reported.
More levetiracetam resources
- levetiracetam MedFacts Consumer Leaflet (Wolters Kluwer)
- levetiracetam Advanced Consumer (Micromedex) - Includes Dosage Information
- Keppra Prescribing Information (FDA)
- Keppra Consumer Overview
- Keppra XR extended-release tablets MedFacts Consumer Leaflet (Wolters Kluwer)
- Levetiracetam Prescribing Information (FDA)
- Levetiracetam Monograph (AHFS DI)
- Levetiracetam Professional Patient Advice (Wolters Kluwer)
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