From the Research
There is no significant interaction between flucloxacillin and levetiracetam (Keppra) that would make Keppra less effective, as evidenced by the lack of pharmacokinetic interactions with other drugs, including antibiotics like flucloxacillin 1, 2. These medications can generally be taken together without concern for reduced seizure control. Flucloxacillin is an antibiotic that works by inhibiting bacterial cell wall synthesis, while Keppra is an antiepileptic drug that binds to synaptic vesicle protein SV2A in the brain to control seizures. Unlike some other antibiotics that can affect seizure threshold or anticonvulsant levels, flucloxacillin does not significantly impact the metabolism or effectiveness of Keppra. Keppra is primarily eliminated unchanged through the kidneys rather than being metabolized by liver enzymes, which makes it less susceptible to drug interactions compared to other antiepileptic medications. However, if you're taking both medications and notice any change in seizure control or unusual side effects, contact your healthcare provider promptly. Always inform all healthcare providers about all medications you're taking to ensure safe treatment.
Some key points to consider:
- Levetiracetam has a novel structure and unique mechanisms of action, involving neuronal binding to synaptic vesicle protein 2A and inhibiting calcium release from intraneuronal stores 1, 2.
- It lacks cytochrome P450 isoenzyme-inducing potential and is not associated with clinically significant pharmacokinetic interactions with other drugs, including other AEDs 1, 2.
- The efficacy of oral immediate-release levetiracetam in controlling seizures has been established in numerous randomized, double-blind, controlled, multicentre trials in patients with epilepsy 1, 2.
- Although treatment-emergent adverse events were commonly reported in the clinical trials of levetiracetam, the overall proportion of patients who experienced at least one treatment-emergent adverse event was broadly similar in the levetiracetam and placebo treatment groups, with most events being mild to moderate in severity 1, 2.
It's also important to note that while levetiracetam is generally well-tolerated, there have been reports of acute kidney injury associated with its use, particularly at high doses 3, 4. However, this is not directly related to the interaction between flucloxacillin and levetiracetam. In any case, monitoring kidney function and reporting any changes in seizure control or unusual side effects to the healthcare provider is crucial when taking these medications together.