What are the most common side effects of Levetiracetam (Keppra)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: February 21, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

The most common side effects of levetiracetam include CNS depression, as noted in the most recent and highest quality study 1. When starting levetiracetam, it's essential to be aware of these potential effects and monitor for their occurrence.

  • Side effects often improve over time as the body adjusts to the medication.
  • If side effects persist or worsen, consult your healthcare provider. Levetiracetam works by binding to SV2 and influencing SV2-dependent neurotransmitter release in the brain, which can affect various neurological functions. This mechanism of action explains why CNS depression is common, as the medication influences brain activity. To minimize side effects, levetiracetam is often started at a low dose and gradually increased.
  • A typical starting dose is 500 mg twice daily for adults, which may be increased to 1000-2000 mg daily in divided doses based on response and tolerability, as recommended in the study 1.
  • Taking the medication with food may help reduce gastrointestinal side effects. It's crucial to take levetiracetam regularly as prescribed and not to stop abruptly, as this can increase the risk of seizures. Always discuss any concerns or side effects with your healthcare provider to ensure safe and effective treatment. The study 1 provides the most recent and highest quality evidence for the side effects of levetiracetam, and its findings should be prioritized in clinical decision-making.

From the FDA Drug Label

(Adverse Events Occurred In At Least 1% Of Levetiracetam- Treated Patients And Occurred More Frequently Than Placebo-Treated Patients) tem Anorexia32 Nervous System Somnolence158 Dizziness94 Depression42 Nervousness42 Ataxia31 Vertigo31 Amnesia21 Anxiety21 Hostility21 Paresthesia21 Emotional Lability20 Respiratory System Pharyngitis64 Rhinitis43 Cough Increased21 Sinusitis21 Special Senses Diplopia21

The most common side effects of Levetiracetam (Keppra) are:

  • Somnolence (15.8%)
  • Dizziness (9.4%)
  • Pharyngitis (6.4%)
  • Depression (4.2%)
  • Nervousness (4.2%)
  • Anorexia (3.2%)
  • Ataxia (3.1%)
  • Vertigo (3.1%)
  • Amnesia (2.1%)
  • Anxiety (2.1%)
  • Hostility (2.1%)
  • Paresthesia (2.1%)
  • Emotional Lability (2%)
  • Rhinitis (4.3%)
  • Cough Increased (2.1%)
  • Sinusitis (2.1%)
  • Diplopia (2.1%) 2

From the Research

Common Side Effects of Levetiracetam

The most common side effects of Levetiracetam include:

  • Somnolence (sleepiness) 3, 4, 5, 6, 7
  • Asthenia (weakness) 3, 4, 5, 7
  • Dizziness 3, 4, 5, 7
  • Infection 4, 7
  • Headache 6, 7
  • Fatigue 6, 7
  • Vomiting 6, 7
  • Behavioral alterations 6

Less Common Side Effects of Levetiracetam

Less common side effects of Levetiracetam include:

  • Accidental injury 7
  • Pharyngitis 7
  • Pain 7
  • Rhinitis 7
  • Abdominal pain 7
  • Flu syndrome 7
  • Diarrhea 7
  • Convulsion 7
  • Nausea 7
  • Increased cough 7
  • Anorexia 7
  • Upper respiratory tract infection 7
  • Hostility 7
  • Personality disorder 7
  • Urinary tract infection 7
  • Nervousness 7
  • Depression 7
  • Aggression 7
  • Back pain 7
  • Agitation 7
  • Emotional liability 7
  • Psychomotor hyperactivity 7
  • Pyrexia 7
  • Rash 7
  • ECG abnormalities 7
  • Decreased appetite 7
  • Nasal congestion 7
  • Irritability 7
  • Abnormal behaviour 7
  • Epistaxis 7
  • Insomnia 7
  • Altered mood 7
  • Anxiety 7
  • Bloody urine 7
  • Diplopia 7
  • Dissociation 7
  • Memory impairment 7
  • Pruritis 7
  • Increased appetite 7
  • Acne 7
  • Stomach discomfort 7

Rare Side Effects of Levetiracetam

Rare side effects of Levetiracetam include:

  • Rhabdomyolysis 6
  • Refractory hypokalemia 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Levetiracetam: a novel antiepileptic drug.

Pharmacotherapy, 2001

Research

The safety of levetiracetam.

Expert opinion on drug safety, 2007

Research

The adverse effects profile of levetiracetam in epilepsy: a more detailed look.

The International journal of neuroscience, 2014

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.