Keppra is a brand-name drug prescribed for certain types of seizures. The medication is available in the following forms: oral tablet, oral solution, and intravenous (IV) injection. Keppra belongs to the antiepileptic drug class.
Specifically, Keppra is approved by the Food and Drug Administration (FDA) for treating the following:
- focal onset seizures (also known as partial seizures) in adults and children ages 1 month and older
- myoclonic seizures in certain adults and children ages 12 years and older*
- generalized tonic-clonic seizures (also known as grand mal seizures) in certain adults and children ages 6 years and older*
* For these conditions, doctors prescribe Keppra along with other medications. For details, see the “Keppra uses” section below.
Drug details
You’ll find key information about Keppra below.
- Drug forms: oral tablet, oral solution, and IV injection
- Generic available? yes
- Prescription required? yes
- Controlled substance? no
- Year of FDA approval: 1999
Keppra and Keppra XR are two different versions of Keppra. Both contain the same active ingredient (levetiracetam). However, Keppra XR contains an extended-release form of it. Extended release means the drug releases slowly into your body over a period of time.
This article focuses on Keppra, but some key differences between Keppra and Keppra XR are noted below:
| Keppra | Keppra XR | |
| Summary of approved uses* | • focal onset seizures in adults and children ages 1 month and older • myoclonic seizures in certain adults and children ages 12 years and older, along with other medications • generalized tonic-clonic seizures in certain adults and children ages 6 years and older, along with other medications | focal onset seizures in adults and children ages 12 years and older |
| Forms and strengths | oral tablet: • 250 milligrams (mg) • 500 mg • 750 mg • 1,000 mg oral solution: • 100 mg per milliliter (mg/mL) vial of solution for intravenous (IV) injection: • 500 mg/5 mL | extended-release oral tablet: • 500 mg • 750 mg |
| Typical dosing schedule | twice per day | once per day |
* For more details about Keppra’s uses, see the “Keppra uses” section below. To learn more about Keppra XR’s uses, see the drug’s prescribing information or talk with your doctor or pharmacist.
Keppra is a brand-name drug that contains the active ingredient levetiracetam. This active ingredient is also available as a generic medication. A generic drug is an exact copy of the active drug in a brand-name medication.
The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.
If you’re interested in the generic form of Keppra, talk with your doctor. They can tell you whether it comes in forms and strengths that can be prescribed for your condition.
Keppra can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Keppra. These lists do not include all possible side effects.
For more information about the possible side effects of Keppra, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.
Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Keppra, you can do so through MedWatch.
Mild side effects
Below is a partial list of mild side effects of Keppra. To learn about other mild side effects, talk with your doctor or pharmacist or view the prescribing information for the oral forms and the injection of Keppra.
Mild side effects of Keppra can include:
- feeling sleepy
- weakness
- dizziness
- infection, such as the common cold
- headache
- mild allergic reaction*
Most of these side effects may go away within a few days to a couple of weeks. However, if they become more severe or don’t go away, talk with your doctor or pharmacist.
* For more information about allergic reaction and Keppra, see “Allergic reaction” below.
Serious side effects
Serious side effects from Keppra aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.
Serious side effects and their symptoms can include:
- Difficulty with balance and coordination. Symptoms can include:
- problems with walking
- falling, which may cause injuries
- difficulty with activities that require coordination, such as driving or operating machinery
- Suicidal thoughts or behaviors. Symptoms can include:
- new or worsening depression
- unusual changes in mood
- Unusual behavior, such as:
- aggression
- psychosis
- depersonalization (a feeling of being detached from yourself)
- Serious skin reactions. Symptoms can include:
- rash
- blisters
- peeling
- Changes in blood cells, including low level of granulocytes (a type of white blood cell).
- Severe allergic reaction.*
* For details about allergic reaction and Keppra, see “Allergic reaction” below.
Side effects in children
In general, the side effects of Keppra in children are similar to those seen in adults, with a few differences. In clinical trials of oral and injectable forms of Keppra, the following side effects were more commonly reported in children:
- fatigue
- reduced appetite
- stuffy nose
- changes in mood or behavior, such as irritability or aggressiveness
- increases in blood pressure
If you have questions about Keppra side effects in children, talk with your doctor for more information.
Suicide prevention
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
Allergic reaction
As with most drugs, some people can have an allergic reaction after taking Keppra. This side effect wasn’t reported in clinical trials of this drug but has occurred since the drug was approved. To learn more, you can view the prescribing information for Keppra oral forms and injection.
Symptoms of a mild allergic reaction can include:
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:
- swelling under your skin, typically in your eyelids, lips, hands, or feet
- swelling of your tongue, mouth, or throat
- difficulty breathing
Call your doctor right away if you have an allergic reaction to Keppra, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.
The Keppra dosage your doctor prescribes will depend on several factors. These include:
- the type and severity of the condition Keppra is treating
- your age
- the form of Keppra you’re prescribed
- other medical conditions you may have, such as kidney problems
- body weight (for children)
The following information describes dosages that are commonly prescribed or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Drug forms and strengths
Keppra is available in several forms and strengths, including:
- oral tablet, which comes in four strengths:
- 250 milligrams (mg)
- 500 mg
- 750 mg
- 1,000 mg
- oral solution, which comes in one strength of 100 mg per milliliter (mg/mL)
- vial of solution given by a healthcare professional as an intravenous (IV) injection, which comes in one strength of 500 mg/5 mL
Note: Keppra IV injection is only prescribed short term when oral medications can’t be taken, such as before surgery. If your doctor prescribes this form of the drug, they’ll determine the dosage that’s right for you.
Dosage for certain types of seizures
Keppra is prescribed for treating certain types of seizures. These include focal onset seizures, myoclonic seizures,* and generalized tonic-clonic seizures.*
The typical starting dose of Keppra in most adults and children ages 16 years and older is 500 mg. You’ll take this dose twice daily.
Your doctor will likely increase your dose every 2 weeks until they reach the amount that’s right for you. The recommended maximum dosage of Keppra is 1,500 mg twice daily.
If you have kidney problems, your doctor may prescribe a lower dosage.
If you have questions about your dosage, talk with your doctor or pharmacist.
* For these types of seizures, doctors prescribe Keppra along with other medications. For details about this, see the “Keppra uses” section below.
Children’s dosage
Keppra is approved to treat the following types of seizures:
- focal onset seizures in children ages 1 month and older
- myoclonic seizures in certain children ages 12 years and older*
- generalized tonic-clonic seizures in certain children ages 6 years and older*
Keppra dosages for children can depend on several factors. These include the type of seizure, and the child’s age and body weight in kilograms (kg).† In this case, the dosage is measured in mg per kg (mg/kg) of body weight, which your child’s doctor will calculate.
The dosage also depends on the form of Keppra prescribed. Doctors typically prescribe Keppra oral solution for children who weigh 20 kg (about 44 lb) or less. They prescribe either Keppra oral tablet or oral solution for children who weigh more than 20 kg.
Typically, doctors prescribe a low dosage of Keppra to start. Then, they’ll likely increase the dosage every 2 weeks until they reach the recommended maintenance dosage. This is the dosage that helps manage your child’s seizure activity.
* For these types of seizures, doctors prescribe Keppra along with other medications. For details, see the “Keppra uses” section below.
† For reference, 1 kg equals about 2.2 pounds (lb).
Children’s dosage for focal onset seizures
Keppra is approved to treat focal onset seizures in children ages 1 month and older. The table below shows typical dosages based on the child’s age and body weight and the drug form prescribed:
| Age and body weight | Drug form | Starting dosage | Maintenance dosage |
| 1 month to less than 6 months | oral solution | 7 mg/kg of body weight, given twice daily | 21 mg/kg, given twice daily |
| 6 months to less than 4 years | oral solution | 10 mg/kg of body weight, given twice daily | 25 mg/kg, given twice daily |
| 4 years to less than 16 years and: • weighing less than 20 kg (less than about 44 lb) | oral solution | 10 mg/kg of body weight, given twice daily | 30 mg/kg, given twice daily |
| 4 years to less than 16 years and: • weighing 20–40 kg (about 44–88 lb) | oral tablet | 250 mg, given twice daily | 750 mg, given twice daily |
| 4 years to less than 16 years and: • weighing more than 40 kg (more than about 88 lb) | oral tablet | 500 mg, given twice daily | 1,500 mg, given twice daily |
| 16–18 years | oral tablet | 500 mg, given twice daily | 1,500 mg, given twice daily |
Your child’s doctor will calculate the correct dosage. For example, if your child is 4 months old and weighs 7.1 kg (about 15.6 lb), their starting dosage will likely be 50 mg twice daily. Then, their doctor will likely increase it every 2 weeks to reach the typical maintenance dosage. Your child’s doctor will tell you how much Keppra oral solution to give for each dose.
If you have questions about your child’s dosage, talk with their doctor for more information.
Children’s dosage for myoclonic seizures
Keppra is approved to treat myoclonic seizures in certain children ages 12 years and older. The typical starting dose is 500 mg. This dose is given twice daily.
Your child’s doctor will likely increase the dose every 2 weeks until they reach the amount that’s right for your child. The recommended dosage of Keppra is 1,500 mg twice daily.
Talk with your child’s doctor if you have questions about the dosage they prescribe.
Children’s dosage for generalized tonic-clonic seizures
Keppra is approved to treat generalized tonic-clonic seizures in certain children ages 6 years and older.
For children ages 6 years to less than 16 years who weigh 20–40 kg (about 44–88 lb), the typical starting dose of Keppra oral solution is 10 mg/kg of body weight. This dose is given twice daily. Your child’s doctor will likely increase the dose every 2 weeks until they reach the maintenance dosage of 30 mg/kg twice daily.
For children in this age range who weigh more than 40 kg (more than about 88 lb), either the oral tablet or oral solution may be prescribed.
For treating this type of seizure in children 16 years and older, doctors prescribe the adult dosage of Keppra. You can find these details in the section just above, “Dosage for certain types of seizures.”
For more information about your child’s dosage, talk with their doctor.
How to use
You take Keppra oral tablet and oral solution by swallowing them.
Keppra IV injection is only prescribed short term when you can’t take an oral medication, such as before surgery. A healthcare professional will prepare and administer this form of the drug to you in a hospital or clinic.
About taking Keppra
Below you’ll find information about key dosage issues.
- When to take: You should take Keppra twice per day. This is typically one dose in the morning and one dose in the evening. Taking the medication around the same times each day helps keep a steady level of the drug in your body. This helps Keppra work effectively.
- If you miss a dose: If you miss a dose of Keppra, take it as soon as possible. Or check with your doctor or pharmacist for guidance. It’s important not to miss doses of this medication. Doing so can increase the risk of seizures.
- Food: You can take Keppra with or without food. The timing of meals doesn’t affect this medication.
- Crushing, splitting, or chewing Keppra: You should swallow Keppra tablets whole. Do not crush, cut, or chew them. If you have difficulty swallowing Keppra tablets, your doctor may prescribe Keppra solution instead.
- Length of time to work: Keppra starts working after your first dose, but it may be several weeks before there’s a significant change in seizure activity. For details, see the question, “How does Keppra work? And, how long does it take to start working?” in “Common questions about Keppra” below.
Overdose
Taking more than the recommended dosage of Keppra can lead to serious side effects. Do not take more Keppra than your doctor recommends.
Overdose symptoms
Symptoms of an overdose may include:
- drowsiness
- agitation
- changes in behavior, such as aggression or rage
- respiratory depression (slowed, shallow breathing)
- coma
What to do in case of overdose
If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number or go to the nearest emergency room right away.
The Food and Drug Administration (FDA) approves prescription drugs such as Keppra to treat certain conditions. Keppra may also be prescribed off-label for other conditions. Off-label drug use is when an FDA-approved drug is prescribed for a purpose other than what it’s approved for.
Keppra for focal onset seizures
Keppra is approved to treat focal onset seizures (also known as partial seizures) in adults and children ages 1 month and older.
The brain works by sending and receiving electrical signals between cells. A seizure occurs due to a sudden, irregular surge in electrical activity in the brain. A focal onset seizure is when a seizure affects one area of the brain.
Symptoms can vary with this type of seizure, but may include muscle contractions or repetitive movements on one side of your body.
Keppra for myoclonic seizures
Keppra is approved to treat myoclonic seizures in people with juvenile myoclonic epilepsy. The drug is approved for this use in adults and children ages 12 years and older.
Juvenile myoclonic epilepsy is a seizure disorder that begins in adolescence or early adulthood. People with this type of epilepsy may experience different types of seizures. With a myoclonic seizure, brief episodes of muscle jerking or twitching occur. This most commonly involves the upper body, including the neck, shoulders, and upper arms.
For this purpose, Keppra is prescribed with other drugs for seizures. Examples of other seizure medications that may be prescribed with Keppra include carbamazepine (Tegretol), valproate, and phenytoin (Dilantin).
Keppra for generalized tonic-clonic seizures
Keppra is also approved to treat generalized tonic-clonic seizures in adults and children ages 6 years and older with idiopathic generalized epilepsy. (Idiopathic means that the condition doesn’t have a known cause.) Generalized tonic-clonic seizures are also known as grand mal seizures.
With a generalized tonic-clonic seizure, an irregular surge in electrical activity affects both sides of the brain. Symptoms typically include rapid convulsing or jerking movements along with loss of consciousness. This may involve the torso, arms, and legs on both sides of the body.
For this purpose, Keppra is prescribed with other seizure drugs. Examples of other seizure medications that may be prescribed with Keppra include carbamazepine (Tegretol), valproate, and topiramate (Topamax).
Keppra and children
Keppra is approved for treating certain types of seizures in children, specifically:
- focal onset seizures in children ages 1 month and older
- myoclonic seizures in certain children ages 12 years and older with juvenile myoclonic epilepsy*
- generalized tonic-clonic seizures in children ages 6 years and older with idiopathic generalized epilepsy*
* For these types of seizures, doctors prescribe Keppra along with other medications. For details, see “Keppra uses” just above.
Keppra is not known to interact with other medications, herbs, supplements, foods, or alcohol. The manufacturer of Keppra did not report any significant interactions in the prescribing information for Keppra oral forms and injection.
However, this doesn’t mean that interactions won’t be recognized in the future. For example, new drugs could be approved that interact with Keppra.
Before starting Keppra treatment, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you take. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
Here are answers to some frequently asked questions about Keppra.
Does Keppra have a loading dose?
No, Keppra doesn’t require a loading dose. This is a higher dose of medication prescribed at the start of treatment to help the drug begin working faster.
Instead of a loading dose, doctors typically prescribe a lower dose of Keppra to start. Then they typically increase the dose every 2 weeks until they reach the amount that’s right for you.
Talk with your doctor or pharmacist if you have questions about Keppra dosing. You can also refer to the “Keppra dosage” section above.
How does Keppra work? And how long does it take to start working?
Researchers don’t know exactly how Keppra works for seizures. They know the brain works by sending and receiving electrical signals between cells. And they know that a sudden, irregular surge in electrical activity can cause a seizure.
Keppra may attach to a specific type of protein in the brain, which may result in decreased electrical activity. Dampening this activity could explain how Keppra reduces the number and severity of seizures. However, this is not confirmed.
Keppra starts working about 1 hour after you start treatment, but it may take several weeks for you to experience a reduction in seizures. This is because your doctor will likely need to increase your dose over time until they reach the dosage that’s recommended for you. For details about this, see the “Keppra dosage” section above.
Keppra has a half-life of 7 hours. This is the length of time it takes for half of a dose to be cleared from your body.
Talk with your doctor if you have questions about what to expect with Keppra.
Can Keppra cause weight gain?
No, Keppra treatment isn’t likely to cause weight gain. This side effect wasn’t reported in clinical trials of Keppra oral forms or injection. (To learn about side effects of Keppra, see “Keppra side effects” above.)
However, doctors sometimes prescribe Keppra along with other medications for seizures.* And some other seizure medications commonly cause weight gain as a side effect.
Talk with your doctor if you have questions about weight gain during treatment with Keppra.
* For details about this, see the “Keppra uses” section above.
This drug comes with several precautions.
Before taking Keppra, discuss your health history with your doctor. Keppra may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:
- kidney problems
- mental health conditions, such as depression
- suicidal thoughts or behaviors
- past allergic reaction to this or a similar drug
- pregnancy
- breastfeeding
Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Keppra, talk with your doctor. They can tell you about other medications that may work well for you.
The following are examples of medications that are similar to Keppra:
- brivaracetam (Briviact)
- carbamazepine (Tegretol)
- divalproex (Depakote)
- lamotrigine (Lamictal)
- lacosamide (Vimpat)
- phenytoin (Dilantin)
- topiramate (Topamax)
As with all medications, the cost of Keppra can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.
Drug coupons: You can visit Optum Perks for price estimates of Keppra. These estimates are based on the use of Optum Perks coupons. Note: Optum Perks coupons cannot be used with any insurance copays or benefits.
Financial and insurance assistance: If you need financial support to pay for Keppra, or if you need help understanding your insurance coverage, help is available.
To learn more about saving money on prescriptions, check out this article.
Generic version: Keppra is available in a generic form called levetiracetam. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. And generics tend to cost less than brand-name drugs. To find out how the cost of levetiracetam compares with the cost of Keppra, talk with your doctor or pharmacist.
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If you can become pregnant, consider the following information about pregnancy and breastfeeding.
Keppra and pregnancy
There are risks associated with Keppra treatment during pregnancy. But there are also risks associated with having unmanaged seizures during pregnancy. (Keppra is prescribed for treating certain types of seizures.)
If you’re planning a pregnancy or can become pregnant, talk with your doctor about potential treatments for seizures during pregnancy. Together, you can consider the risks and benefits of your treatment options and decide whether you should take Keppra while pregnant.
If you take Keppra during pregnancy, your doctor may encourage you to participate in a pregnancy registry. It’s a collection of information about the use of certain medications during pregnancy. The pregnancy registry for Keppra is called the North American Antiepileptic Drug Pregnancy Registry. To learn more, visit the registry website or call 888-233-2334.
Keppra and breastfeeding
It’s not known whether Keppra should be taken while breastfeeding. The drug passes into breast milk, but it’s not known whether this affects children who are breastfed.
If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication.
Note: For more information about the potential negative effects of Keppra, see the “Keppra side effects” section above.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.