No Clinically Significant Interaction Between Aspirin 81mg and Keppra
Aspirin 81mg does not interact with Keppra (levetiracetam) and can be safely used together without dose adjustment. 1
Evidence for Lack of Interaction
The pharmacokinetic profile of levetiracetam demonstrates minimal drug interaction potential due to its unique metabolic pathway:
- Levetiracetam is not metabolized by cytochrome P450 enzymes, which are responsible for most drug-drug interactions 1
- The primary metabolite (UCB L057) is formed through enzymatic hydrolysis in blood and liver tissue, a pathway that operates independently of aspirin's mechanisms 1
- In vitro studies specifically tested whether aspirin-like compounds affect levetiracetam metabolism and found no interference with the hydrolysis reaction that converts levetiracetam to its metabolite 1
Clinical Implications
You can prescribe these medications together without concern for:
- Altered levetiracetam blood levels - aspirin does not affect the absorption, distribution, or elimination of Keppra 1
- Reduced aspirin efficacy - levetiracetam does not interfere with aspirin's antiplatelet effects 1
- Need for dose adjustment - neither medication requires dosing changes when used together 1
Important Caveat About NSAIDs (Not Aspirin)
While aspirin 81mg is safe with Keppra, be aware that NSAIDs like ibuprofen, naproxen, celecoxib, or meloxicam can competitively inhibit aspirin's antiplatelet effects when taken concurrently 2. This interaction:
- Occurs through competitive binding at platelet COX-1 receptor sites, preventing aspirin from irreversibly acetylating the enzyme 2
- Is timing-dependent and can be mitigated by administering aspirin at least 2 hours before the NSAID 2
- Does not apply to acetaminophen, which can be used safely for pain management in patients on aspirin 2
This NSAID-aspirin interaction is relevant for seizure patients who may need pain management, but it is completely separate from any concerns about Keppra itself.