From the Guidelines
Keppra (Levetiracetam) does not have a well-established association with thrombocytopenia. The provided evidence does not mention thrombocytopenia as a potential adverse effect of Levetiracetam 1.
Adverse Effects of Levetiracetam
- Fatigue
- Dizziness
- Rarely, pain at infusion site 1 It is essential to note that the evidence focuses on the loading dose and route of administration strategies for antiepileptic medications in the emergency department setting, rather than the long-term adverse effects of these medications.
Key Considerations
- The choice of administration route for antiepileptic medications, including Levetiracetam, is at the discretion of the emergency physician due to a lack of evidence supporting one route over the other 1.
- Levetiracetam can be loaded orally with a dose of 1,500 mg or rapidly loaded intravenously with doses up to 60 mg/kg, with fatigue and dizziness being potential adverse effects 1.
From the FDA Drug Label
The following adverse events have been identified during post-approval use of levetiracetam... thrombocytopenia Thrombocytopenia is listed as an adverse event that has been reported in patients receiving marketed levetiracetam worldwide 2.
- This suggests that Keppra (Levetiracetam) may cause thrombocytopenia.
From the Research
Adverse Effects of Levetiracetam
- Levetiracetam has been associated with various adverse effects, including behavioral adverse effects, drowsiness, and mood changes 3, 4.
- There have been reports of levetiracetam-induced rhabdomyolysis, a rare but serious side effect characterized by increased creatine kinase (CK) levels 5.
- However, there is no mention of thrombocytopenia, a condition characterized by low platelet count, as a common or rare side effect of levetiracetam in the provided studies.
Efficacy and Safety of Levetiracetam
- Levetiracetam has been shown to be effective in controlling seizures in patients with epilepsy, with a significant reduction in seizure frequency compared to placebo 3, 4.
- The drug has been found to be well-tolerated, with most adverse events being mild to moderate in severity 3, 4.
- A systematic review and meta-analysis found that levetiracetam may be preferred for seizure prophylaxis in patients with supratentorial neurosurgical diseases, but its use in other conditions such as traumatic brain injury, subarachnoid hemorrhage, and intracerebral hemorrhage is not supported by the current evidence 6.
Monitoring and Safety Precautions
- Close monitoring of CK levels and kidney functions is recommended after initiation of levetiracetam, especially in patients with a history of kidney disease or those taking other medications that may affect kidney function 5.
- Patients should be advised to report any signs or symptoms of adverse effects, such as muscle pain or weakness, to their healthcare provider promptly.