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Keppra Disease Interactions

There are 4 disease interactions with Keppra (levetiracetam).


Antiepileptics (applies to Keppra) suicidal tendency

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Depression, Psychosis

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs across multiple indications in either monotherapy or adjunctive therapy for a median treatment duration of 12 weeks (up to a maximum of 24 weeks) showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. The estimated rate of suicidal behavior or ideation among 27,863 AED-treated patients was 0.43%, compared to 0.24% for 16,029 placebo-treated patients, representing an increase of approximately 1 case for every 530 patients treated. There were 4 suicides in AED-treated patients and none in placebo-treated patients, although the number is too small to establish any causal relationship. The increased risk of suicidal thoughts or behavior was observed as early as 1 week after starting AEDs and persisted for the duration of treatment assessed. The risk did not vary substantially by age (5 to 100 years) in the clinical trials analyzed. Therapy with AEDs should be administered cautiously in patients with depression or other psychiatric disorders. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. For clinically significant or persistent symptoms, a dosage reduction or treatment withdrawal should be considered. If patients have symptoms of suicidal ideation or behavior, treatment should be discontinued.


  1. "Product Information. Tegretol (carbamazepine)." Novartis Pharmaceuticals (2002):
  2. "Product Information. Klonopin (clonazepam)." Roche Laboratories (2001):
  3. "Product Information. Dilantin (phenytoin)." Parke-Davis (2001):
  4. "Product Information. Cerebyx (fosphenytoin)." Parke-Davis (2001):
  5. "Product Information. Mysoline (primidone)." Elan Pharmaceuticals (2001):
  6. "Product Information. Lyrica (pregabalin)." Pfizer U.S. Pharmaceuticals Group (2005):
  7. "Product Information. Sabril (vigabatrin)." Lundbeck Inc (2009):
  8. "Product Information. Potiga (ezogabine)." GlaxoSmithKline (2011):
  9. "Product Information. Qsymia (phentermine-topiramate)." Vivus Inc (2012):
  10. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  11. "Product Information. Briviact (brivaracetam)." UCB Pharma Inc (2016):
  12. "Product Information. Diacomit (stiripentol)." Biocodex USA (2018):
  13. "Product Information. Epidiolex (cannabidiol)." Greenwich Biosciences LLC (2018):
  14. "Product Information. Fintepla (fenfluramine)." Zogenix, Inc (2020):
  15. "Product Information. Ztalmy (ganaxolone)." Marinus Pharmaceuticals, Inc (2022):
View all 15 references

Levetiracetam (applies to Keppra) hemodialysis

Moderate Potential Hazard, High plausibility.

Levetiracetam is removed by hemodialysis. Approximately 50% of the pool of levetiracetam in the body is removed during a standard 4-hour hemodialysis session. The manufacturer recommends a 250 to 500 mg supplemental dose following dialysis.


  1. "Product Information. Keppra (levetiracetam)." UCB Pharma Inc (2001):

Levetiracetam (applies to Keppra) renal dysfunction

Moderate Potential Hazard, High plausibility.

Levetiracetam is primarily eliminated unchanged by the kidney. The clearance of levetiracetam is decreased in patients with renal impairment and is correlated with creatinine clearance. In study subjects with varying degrees of renal impairment, total body clearance of levetiracetam was reduced by 40% in the mild group (CrCl = 50 to 80 mL/min), 50% in the moderate group (CrCl = 30 to 50 mL/min), 60% in the severe group (CrCl < 30 mL/min), and 70% in anuric patients (end-stage renal disease) compared to patients with normal renal function (CrCl > 80 mL/min). Therapy with levetiracetam should be administered cautiously at reduced dosages in patients with impaired renal function. Dosage adjustments should be based on the degree of renal impairment (i.e. estimated creatinine clearance) in accordance with the product package labeling.


  1. "Product Information. Keppra (levetiracetam)." UCB Pharma Inc (2001):

Levetiracetam (applies to Keppra) hematologic abnormalities

Minor Potential Hazard, Moderate plausibility. Applicable conditions: Neutropenia, Anemia

The use of levetiracetam may be associated with minor decreases in total red blood cell count, hemoglobin, and hematocrit. Possibly significant decreases in white blood cell and neutrophil counts may also occur infrequently, although these changes may return to normal despite continued treatment. Therapy with levetiracetam should be administered cautiously in patients with or predisposed to anemia or neutropenia.


  1. "Product Information. Keppra (levetiracetam)." UCB Pharma Inc (2001):

Keppra drug interactions

There are 233 drug interactions with Keppra (levetiracetam).

Keppra alcohol/food interactions

There is 1 alcohol/food interaction with Keppra (levetiracetam).

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.