Can Robaxin (Methocarbamol) Be Taken with Keppra (Levetiracetam)?
Yes, Robaxin (methocarbamol) can be safely taken with Keppra (levetiracetam) as there are no significant drug interactions between these medications, though patients should be monitored for additive sedative effects.
Drug Interaction Profile
Levetiracetam has a highly favorable drug interaction profile that makes it compatible with most medications:
Levetiracetam has minimal effects on the cytochrome P450 enzyme system, resulting in significantly fewer drug-drug interactions compared to older antiepileptic medications like carbamazepine, phenytoin, or valproate 1, 2.
Non-enzyme-inducing antiepileptic drugs like levetiracetam are specifically preferred to avoid interactions with other medications, chemotherapy, targeted therapies, and steroids 1.
The National Comprehensive Cancer Network specifically recommends levetiracetam because it does not have significant drug interactions, unlike phenytoin, phenobarbital, or carbamazepine 3.
Clinical Monitoring Considerations
While these medications can be taken together, there are important monitoring considerations:
Both methocarbamol (a muscle relaxant) and levetiracetam can cause sedation, so patients should be monitored for additive sedative effects including increased drowsiness or somnolence 3, 2.
Common side effects to watch for include dizziness, somnolence, or fatigue, which can occur with levetiracetam and might be additive when combined with other CNS depressants 2.
No dose adjustments are required solely because these medications are being used together 2.
Practical Recommendations
Start with standard doses of each medication as clinically indicated 3.
Adjust levetiracetam doses based on renal function if necessary, as this is the primary consideration for dosing rather than drug interactions 3.
Counsel patients about the potential for increased sedation and advise caution with activities requiring alertness, particularly when first starting the combination.
Unlike older antiepileptic drugs, levetiracetam does not require cardiac monitoring during administration and has fewer documented interactions with other medications 4.