What is the potential drug-drug interaction between Levetiracetam (Keppra) and Orlistat?

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From the Guidelines

There is a potential drug-drug interaction between Levetiracetam (Keppra) and Orlistat, as Orlistat can decrease the absorption of antiepileptics, including Levetiracetam.

Mechanism of Interaction

The mechanism of this interaction is related to Orlistat's effect on fat absorption in the gastrointestinal tract, which can also affect the absorption of other medications, including antiepileptics like Levetiracetam 1.

Clinical Implications

This interaction may lead to decreased efficacy of Levetiracetam, potentially resulting in reduced seizure control.

Recommendations

To minimize this interaction, patients taking both Levetiracetam and Orlistat should be closely monitored for signs of reduced Levetiracetam efficacy, such as increased seizure frequency or severity 1.

Key Considerations

It is essential to note that Orlistat can also reduce the absorption of fat-soluble vitamins (A, D, E, and K), which may indirectly affect overall health 1.

Patient Management

Patients taking both medications should maintain regular follow-ups with their healthcare provider to monitor for any unexpected effects, and adjustments to the Levetiracetam dose or administration schedule may be necessary to ensure adequate seizure control 1.

From the Research

Potential Drug-Drug Interaction between Levetiracetam and Orlistat

There are no direct studies on the potential drug-drug interaction between Levetiracetam (Keppra) and Orlistat. However, we can look at the general properties of these drugs to assess potential interactions.

  • Levetiracetam Properties: Levetiracetam is an antiepileptic drug with a novel structure and unique mechanisms of action 2. It is associated with rapid and complete absorption, high oral bioavailability, minimal metabolism, and primarily renal elimination. Levetiracetam lacks cytochrome P450 isoenzyme-inducing potential and is not associated with clinically significant pharmacokinetic interactions with other drugs, including other AEDs 2.
  • Orlistat Properties: Orlistat is a weight loss drug that works by inhibiting pancreatic lipase, an enzyme that breaks down fats in the intestine. While there are no direct studies on the interaction between Orlistat and Levetiracetam, Orlistat can affect the absorption of fat-soluble vitamins and other drugs.
  • Potential Interaction: Since Levetiracetam is not significantly metabolized by cytochrome P450 enzymes and does not have significant interactions with other drugs, the potential for a pharmacokinetic interaction with Orlistat is low. However, Orlistat may affect the absorption of Levetiracetam if it is taken with a high-fat meal, as Orlistat can inhibit the absorption of fats and potentially other drugs.

General Considerations for Drug-Drug Interactions

  • Drug-drug interactions can occur through various mechanisms, including pharmacodynamic and pharmacokinetic interactions 3.
  • Pharmacists can play a critical role in managing the medication therapy of patients at risk for clinically important drug-drug interactions 4.
  • The potential for drug-drug interactions should be considered when prescribing multiple medications, especially in patients who are taking multiple drugs or have underlying medical conditions.

Note: There are no research papers to directly assist in answering the question about the potential drug-drug interaction between Levetiracetam and Orlistat. The information provided is based on the general properties of these drugs and the potential for interactions.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Clinically important potential drug-drug interactions in outpatient settings.

Research in social & administrative pharmacy : RSAP, 2007

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.

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