Keppra (levetiracetam) is a brand-name drug that’s prescribed for certain types of seizures in adults and some children. Keppra comes as an oral tablet and oral solution that’s typically taken twice per day.
Keppra is approved by the Food and Drug Administration (FDA) to treat:
- focal onset 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 in certain adults and children ages 6 years and older
Keppra belongs to a drug class called anticonvulsants. Keppra is available in a generic version.
Keep reading for specific information about the dosage of Keppra, including its strengths and how to take the medication. For a comprehensive look at Keppra, see this article.
Note: This article describes typical dosages for Keppra provided by the drug’s manufacturer. When taking Keppra, always follow the dosage prescribed by your doctor.
Keppra and Keppra XR have the same active ingredient (levetiracetam) but different dosages. This is because Keppra is an immediate-release version and Keppra XR is an extended-release version.
With immediate release, the drug is released into your body immediately after you take a dose. With extended release, the drug is released slowly over time. Since Keppra XR releases slowly over time, it’s taken less often than Keppra.
The table below describes dosage differences between Keppra and Keppra XR. Doses are in milligrams (mg) and milligrams per milliliter (mg/mL).
| Keppra | Keppra XR | |
| Forms and strengths | oral tablet: • 250 mg • 500 mg • 750 mg • 1,000 mg oral solution: • 100 mg/mL | extended-release oral tablet: • 500 mg • 750 mg |
| Typical dosing schedule | twice per day | once per day |
Keep in mind that Keppra XR is approved only to treat focal onset seizures in adults and children ages 12 years and older. To learn more, see the Keppra XR prescribing information or talk with your doctor or pharmacist. For details about Keppra’s approved uses, see just above.
If you’d like more information about Keppra vs. Keppra XR for focal onset seizures, talk with your doctor.
Below is information about Keppra’s forms, strengths, and dosages.
Keppra forms
Keppra comes in two forms:
- an oral tablet
- an oral solution
Keppra strengths
Keppra tablets come in four strengths:
- 250 mg
- 500 mg
- 750 mg
- 1,000 mg
Keppra oral solution comes in one strength of 100 mg/mL.
Typical dosages
Typically, your doctor will start by prescribing a low dosage. They’ll adjust it over time until they reach the amount that’s right for you.
The following information describes dosages that are commonly prescribed or recommended in adults. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Dosage for certain types of seizures
Doctors prescribe Keppra to treat certain types of seizures:
- focal onset seizures
- myoclonic seizures* in people with idiopathic epilepsy
- generalized tonic-clonic seizures* in people with idiopathic epilepsy
The typical starting dose of Keppra for these seizures in adults is 500 mg. You’ll take this amount twice per day. After 2 weeks, your doctor may recommend increasing your dosage. They’ll likely increase your dose every 2 weeks until they reach the amount that’s right for you. The recommended dosage of Keppra is 1,500 mg twice per day.
For more information about your specific dosage, talk with your doctor.
* For these types of seizures, doctors may prescribe Keppra in combination with other medications.
Children’s dosages
Keppra is approved to treat certain types of seizures in children. The dosage in children is typically based on the child’s body weight in kilograms (kg).* The dosage per kg is measured in mg per kg of body weight (mg/kg) and is calculated by your child’s doctor. If they prescribe Keppra solution, they’ll tell you how much to give your child for each dose.
Doctors will typically start Keppra treatment by prescribing a low dosage. They’ll likely increase the dosage every 2 weeks until they reach the recommended dosage.
The following information describes Keppra dosages that are commonly prescribed or recommended in children.
* One 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. Your child’s doctor will determine the dosage that’s right for your child. The table below lists typical dosages.
| Age | Body weight | Keppra form | Starting dose, given twice per day | Recommended dose, given twice per day |
|---|---|---|---|---|
| 1 month to less than 6 months | doesn’t apply | solution | 7 mg/kg | 21 mg/kg |
| 6 months to less than 4 years | doesn’t apply | solution | 10 mg/kg | 25 mg/kg |
| 4 years to less than 16 years | less than 20 kg (about 44 lb) | solution | 10 mg/kg | 30 mg/kg |
| 4 years to less than 16 years | 20–40 kg (about 44–88 lb) | tablet | 250 mg | 750 mg |
| 4 years to less than 16 years | more than 40 kg (about 88 lb) | tablet | 500 mg | 1,500 mg |
| 16–18 years | doesn’t apply | tablet | 500 mg | 1,500 mg |
Talk with your child’s doctor if you have questions about the dosage they prescribe.
Children’s dosage for myoclonic seizures
Keppra is approved to treat myoclonic seizures in children ages 12 years and older who have idiopathic epilepsy. Keppra may be prescribed in combination with other medications.
Typically, the starting dose in children is 500 mg. Your child will take this dose twice per day. After 2 weeks, your child’s doctor may recommend increasing the dosage. They’ll likely increase the dosage every 2 weeks until they reach the recommended dosage of 1,500 mg twice per day.
If you have any questions about your child’s prescribed dosage, talk with their doctor.
Children’s dosage for generalized tonic-clonic seizures
Keppra is approved to treat generalized tonic-clonic seizures in children ages 6 years and older who have idiopathic epilepsy. Keppra may be prescribed in combination with other medications.
Your child’s doctor will determine the dosage that’s right for your child. The table below lists typical dosages.
| Age | Body weight | Keppra form | Starting dose, given twice per day | Recommended dose, given twice per day |
|---|---|---|---|---|
| 6 years to less than 16 years | 20–40 kg (about 44–88 lb) | solution | 10 mg/kg | 30 mg/kg |
| 6 years to less than 16 years | more than 40 kg (about 88 lb) | solution or tablet | 10 mg/kg | 30 mg/kg |
| 16–18 years | doesn’t apply | tablet | 500 mg | 1,500 mg |
Talk with your child’s doctor if you have questions about their dosage.
Long-term treatment
Keppra is meant to be a long-term treatment. If you and your doctor determine that Keppra is safe and effective for you, you’ll likely take it long term.
If you have questions about what to expect with Keppra treatment, talk with your doctor for more information.
The Keppra dosage your doctor prescribes will depend on several factors. These include:
- your age
- body weight (for some children)
- the type and severity of the condition Keppra is being used to treat
- the form of Keppra that’s prescribed
- your kidney function
Dosage adjustments
Your doctor may need to adjust your dosage if you have kidney disease.
Be sure to tell your doctor about any health conditions you may have.
Keppra comes as an oral tablet or oral solution you swallow. You may take your dose with or without food. Do not crush, chew, or place the tablet in water.
If your child’s doctor prescribes the solution, it will come with a marked measuring spoon, dropper, oral syringe, or medicine cup. Do not use a household teaspoon or tablespoon because it may not hold the right amount of solution. If you have questions about measuring your child’s dosage, ask your doctor or pharmacist.
You should take Keppra around the same time each day. This helps maintain a steady level of the drug in your body so Keppra can work effectively.
If you have trouble swallowing tablets, see this article for tips on how to take this form of medication. You can also talk with your doctor or pharmacist.
ACCESSIBLE DRUG LABELS AND CONTAINERSSome pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.
If you’re having trouble opening medication bottles, ask your pharmacist about putting Keppra in an easy-open container. They also may recommend tools that can make it easier to open bottles.
If you miss a dose of Keppra, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and take your next scheduled dose. Do not take two doses to make up for the missed one. If you’re not sure whether to take a missed dose or skip it, talk with your doctor or pharmacist.
To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or putting a note where you’ll see it, such as on your bathroom mirror or bedside table. You could also download a reminder app on your phone.
It’s important that you do not take more Keppra than your doctor prescribes. For some medications, taking more than the recommended amount may lead to harmful effects or overdose.
Symptoms of an overdose
Overdose symptoms of Keppra can include:
- agitation
- drowsiness
- difficulty breathing
- behavior changes, such as aggressiveness
- coma
If you take more than the recommended amount of Keppra
Call your doctor right away if you believe you’ve taken too much Keppra. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.
Withdrawal seizures are a known risk of stopping anticonvulsant medications, including Keppra. These seizures may occur more often than the seizures you’re taking the drug to treat. There’s also an increased risk of status epilepticus, which requires immediate medical attention. Due to this risk, it’s recommended that Keppra’s dose be gradually decreased over time.
If you and your doctor decide to stop Keppra treatment, your doctor will slowly lower your dose. Do not stop taking Keppra unless your doctor specifically tells you to do so. If you have questions about your seizure treatment, talk with your doctor.
Below are some frequently asked questions about Keppra.
What is the recommended maximum dosage of Keppra?
The recommended maximum dosage of Keppra is 1,500 mg taken twice per day. Doctors typically prescribe a low dosage to start. Your doctor will likely increase your dose until they reach the amount that’s right for you. For details about Keppra dosages, see the “Keppra dosage” section above.
If you have questions or concerns about your dosage of Keppra, talk with your doctor or pharmacist. If it seems like you need a higher dosage, ask your doctor whether a dosage increase is right for you. Do not increase your dosage unless your doctor recommends doing so.
What is considered a high dose of Keppra?
The highest dose of Keppra recommended per day is 3,000 mg. Doses of up to 4,000 mg per day have been studied for safety and effectiveness. Another study from the year 2000 suggests that a dosage of 4,000 mg per day is well tolerated and effective in managing seizures. In both studies, side effects such as drowsiness and physical weakness occurred more often in people taking 4,000 mg per day than in those taking lower dosages.
In clinical trials of Keppra, dosages as high as 6,000 mg per day were evaluated. In these trials, there were no reports of overdose symptoms other than drowsiness. However, there have been reports of overdose since the drug became available. To learn more about the possible symptoms of overdose, see “Keppra and overdose” above.
Talk with your doctor if you have questions about the dosage of Keppra they prescribe for your condition. Do not increase your dosage unless your doctor recommends doing so. They’ll prescribe the dosage that’s right for you.
How long does it take for Keppra to start working?
Keppra starts to work after your first dose. Because of how the drug works, you likely won’t feel the drug working in your body. But your doctor will monitor you during treatment to check whether the drug is working to treat your condition.
You may want to keep a diary of your seizures to share with your doctor. This may help determine whether Keppra is working for you.
Talk with your doctor if you have questions about what to expect with Keppra treatment.
The dosages in this article are typical dosages provided by the drug’s manufacturer. If your doctor recommends Keppra for you, they’ll prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes.
As with any drug, never change your dosage of Keppra without your doctor’s recommendation. If you have questions about the dosage of Keppra that’s best for you, talk with your doctor.
Besides learning about dosage, you may want other information about Keppra. These additional articles might be helpful:
- More about Keppra: For information about other aspects of Keppra, refer to this article.
- Side effects: To learn about side effects of Keppra, see this article. You can also look at the Keppra prescribing information.
- Cost: If you’d like to learn about Keppra and cost, see this article.
- Details about seizures: For details about seizures, see this article and our epilepsy and seizures hub.
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.