Do we prescribe folic acid to a patient on Keppra (levetiracetam)?

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Last updated: April 10, 2025View editorial policy

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From the Research

Yes, folic acid supplementation is recommended for patients taking Keppra (levetiracetam), with a typical recommended dose of 0.4-0.8 mg of folic acid daily, as supported by the most recent and highest quality study 1. The US Preventive Services Task Force (USPSTF) recommends that all persons planning to or who could become pregnant take a daily supplement containing 0.4 to 0.8 mg (400 to 800 μg) of folic acid to prevent neural tube defects in their offspring 1. While Keppra itself does not directly deplete folate levels like some other antiepileptic drugs, folic acid supplementation is generally advised for all patients on long-term antiepileptic therapy, particularly for women of childbearing potential who take antiepileptic medications, as adequate folate levels help reduce the risk of neural tube defects in potential pregnancies. Key points to consider include:

  • The importance of folic acid supplementation in preventing neural tube defects, as established by the USPSTF 1
  • The recommended dose of 0.4-0.8 mg of folic acid daily for patients taking Keppra, as supported by the most recent evidence 1
  • The potential benefits and harms of folic acid supplementation, including the prevention of neural tube defects and the potential for adverse effects with high doses 2, 1
  • The need for regular monitoring of folate levels in some patients on long-term therapy to ensure adequate supplementation 1.

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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