Levetiracetam Side Effects

Medically reviewed by Drugs.com. Last updated on Apr 27, 2024.

Applies to levetiracetam: intravenous solution.

Other dosage forms:

• oral solution, oral tablet, oral tablet for suspension, oral tablet extended release

Serious side effects of levetiracetam

Along with its needed effects, levetiracetam may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking levetiracetam:

More common side effects

• cough or hoarseness
• fever or chills
• lower back or side pain
• painful or difficult urination

Incidence not known

• black, tarry stools
• bleeding gums
• blistering, peeling, or loosening of the skin
• bloating
• blood in the urine or stools
• changes in behavior
• darkened urine
• diarrhea
• difficulty having a bowel movement (stool)
• fast heartbeat
• general tiredness and weakness
• indigestion
• itching
• joint or muscle pain
• light-colored stools
• loss of appetite
• nausea and vomiting
• pains in the stomach, side, or abdomen, possibly radiating to the back
• pale skin
• pinpoint red spots on the skin
• red skin lesions, often with a purple center
• red, irritated eyes
• restlessness or agitation
• sore throat
• sores, ulcers, or white spots in the mouth or on the lips
• thoughts or attempts at killing oneself
• twitching, twisting, or uncontrolled repetitive movements of the tongue, lips, face, arms, or legs
• uncontrolled jerking or twisting movements of the hands, arms, or legs
• uncontrolled movements of the lips, tongue, or cheeks
• unusual bleeding or bruising
• unusual tiredness or weakness
• upper right abdominal or stomach pain
• yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur while taking levetiracetam:

Symptoms of overdose

• anxiety
• attack, assault, or force
• decrease, loss, or change in consciousness
• difficult or troubled breathing
• dry mouth
• hyperventilation
• irregular, fast or slow, or shallow breathing
• irregular heartbeats
• irritability
• pale or blue lips, fingernails, or skin
• restlessness
• shaking
• sleepiness or unusual drowsiness
• trouble sleeping

Other side effects of levetiracetam

Some side effects of levetiracetam may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common side effects

• body aches or pain
• congestion
• dizziness
• headache
• lack or loss of strength
• pain
• runny nose
• tender, swollen glands in the neck
• trouble swallowing
• voice changes

Less common side effects

• aggressive or angry
• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• crying
• depersonalization
• discouragement
• double vision or seeing double
• dysphoria
• euphoria
• feeling of constant movement of self or surroundings
• feeling sad or empty
• lightheadedness
• loss of interest or pleasure
• loss of memory
• loss or lack of appetite
• pain or tenderness around the eyes and cheekbones
• paranoia
• problems with memory
• quick to react or overreact emotionally
• rapidly changing moods
• rash
• sensation of spinning
• shakiness and unsteady walk
• sneezing
• stuffy nose
• tiredness
• trouble concentrating
• unsteadiness, trembling, or other problems with muscle control or coordination
• weight loss

Incidence not known

• hair loss or thinning of the hair

For healthcare professionals

Applies to levetiracetam: intravenous solution, oral solution, oral tablet, oral tablet dispersible, oral tablet extended release.

General adverse events

The more commonly reported adverse reactions in adults have included somnolence, asthenia, and dizziness; in children, fatigue, aggression, nasal congestion, decreased appetite, and irritability.

Nervous system

• Very common (10% or more): Headache (14%), somnolence (14%)
• Common (1% to 10%): Dizziness, ataxia, vertigo, paresthesia, coordination difficulties
• Postmarketing reports: Choreoathetosis, dyskinesia^[Ref]

Psychiatric

• Very common (10% or more): Non-psychotic behavioral symptoms (up to 38%), psychotic symptoms (up to 17%)
• Common (1% to 10%): Depression, nervousness, amnesia, anxiety, hostility, emotional lability, irritability, mood swings, hypersomnia, insomnia, apathy, tearfulness, negativism
• Postmarketing reports: Panic attack^[Ref]

In studies, non-psychotic behavioral symptoms (reported as aggression, agitation, anger, anxiety, apathy, depersonalization, depression, emotional lability, hostility, hyperkinesias, irritability, nervousness, neurosis, and personality disorder) were reported in 13% of adults and 38% of pediatric patients aged 4 to 16 years compared to 6% and 19%, respectively in placebo patients. In patients less than 4 years old, irritability was reported in 12% compared to 0% in placebo patients. In adult patients, behavioral symptoms resulted in dose reduction or discontinuation 0.8% and 1.7% of patients, respectively. Dose reduction or discontinuation due to behavioral symptoms occurred in 11% of pediatric patients.

In studies, psychotic symptoms were reported in 1%, 2%, and 17% of patients receiving this drug aged adult, 4 to 16 years old, and less than 4 years compared to 0.2%, 2%, and 5% in placebo patients, respectively.^[Ref]

Hematologic

• Common (1% to 10%): Decreased white blood cell count (WBC), decreased neutrophil count, increased lymphocyte counts, higher eosinophil counts
• Frequency not reported: Decreases in white blood cell, neutrophil, and red blood cell counts; decreased in hemoglobin and hematocrit; increases in eosinophil counts
• Postmarketing reports: Pancytopenia (with bone marrow suppression reported in some cases), thrombocytopenia, agranulocytosis^[Ref]

In adults, 3.2% of patients receiving this drug had at least 1 WBC of 2.8 x 10(9)/L or lower and 2.4% had at least 1 neutrophil count of 1 x 10(9)/L or lower compared to 1.8% and 1.4% of placebo patients, respectively. Of those with a low neutrophil count, only 1 patient did not have resolution with continued treatment. No patient discontinued therapy due to a low neutrophil count. In pediatric patients 4 to 16 years old, mean decreases in WBC and neutrophils were 0.4 x 10(9)/L and 0.3 x 10(9)/L, respectively, compared to small increases in placebo patients. Mean relative lymphocyte counts increased by 1.7% in patients receiving this drug (placebo=decrease of 4%).^[Ref]

Hypersensitivity

• Postmarketing reports: Anaphylaxis

Dermatologic

• Frequency not reported: Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN)
• Postmarketing reports: Erythema multiforme, alopecia, angioedema^[Ref]

Alopecia reported with this drug resolved with discontinuation of therapy in most cases.^[Ref]

Other

• Very common (10% or more): Asthenia (15%), fatigue (10%)
• Common (1% to 10%): Pain, vertigo^[Ref]

Respiratory

• Common (1% to 10%): Pharyngitis, rhinitis, increased cough, sinusitis^[Ref]

Gastrointestinal

• Common (1% to 10%): Diarrhea, gastroenteritis, constipation
• Uncommon (0.1% to 1%): Nausea
• Postmarketing reports: Pancreatitis^[Ref]

Ocular

• Common (1% to 10%): Diplopia^[Ref]

Hepatic

• Postmarketing reports: Abnormal liver function tests, hepatic failure, hepatitis^[Ref]

Musculoskeletal

• Common (1% to 10%): Neck pain
• Postmarketing reports: Muscular weakness^[Ref]

Immunologic

• Very common (10% or more): Infection (13%)
• Common (1% to 10%): Influenza
• Postmarketing reports: Drug reaction with eosinophilia and systemic symptoms (DRESS)^[Ref]

Metabolic

• Common (1% to 10%): Anorexia
• Postmarketing reports: Weight loss, hyponatremia^[Ref]

Cardiovascular

• Very common (10% or more): Increased diastolic blood pressure (less than 4 years of age; 17%)^[Ref]

In a clinical trial in patients 1 month to less than 4 years, 17% of patients had a significantly elevated diastolic blood pressure (placebo=2%). No overall difference in mean diastolic blood pressure was observed in treated patients compared with placebo nor was this effect observed in trials with older pediatric patients or adults.^[Ref]

Renal

• Postmarketing reports: Acute kidney injury

Further information

Levetiracetam side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer