Do levetiracetam and alcohol mix?

In this article:

• Levetiracetam and alcohol
• Levetiracetam interaction with alcohol
• Contraindications
• How long should you wait to drink
• Levetiracetam alternatives
• The bottom line

In this article

• Levetiracetam and alcohol
• Levetiracetam interaction with alcohol
• Contraindications
• How long should you wait to drink
• Levetiracetam alternatives
• The bottom line

Levetiracetam, known by the brand name Keppra, is an important medication for many people who live with seizure disorders. If you’ve been prescribed levetiracetam, it’s usually on a long-term basis so you might wonder about drinking alcohol while attending social events or simply unwinding after work. Unfortunately, mixing alcohol with levetiracetam is generally not recommended as it can increase side effects like drowsiness and dizziness or increase the risk of seizures. Your healthcare provider can help you determine what’s safe for you.

Can you drink on levetiracetam?

Levetiracetam is an anticonvulsant medication approved to treat epilepsy. Mixing levetiracetam with alcohol is not generally recommended. The combination can slow activity in the central nervous system (CNS), which may lead to increased side effects of both substances. 

For some people taking levetiracetam, drinking in moderation might be acceptable if their healthcare provider gives the green light. Moderation usually means no more than one standard drink per day for women and up to two standard drinks for men. However, the way each person reacts to drinking alcohol and taking levetiracetam is not black and white. In addition, factors like dosage, body weight, and overall health can make a difference. 

However, you might find you have less of an interest in drinking once you start on the medication. Interestingly, levetiracetam has been studied as a potential treatment option for alcohol dependence. In one open-label clinical trial, participants taking levetiracetam showed a significant decrease in their daily alcohol intake, dropping from about five drinks per day to fewer than two drinks per day. The medication was generally well-tolerated and helped reduce alcohol cravings in people with alcohol use disorder or alcohol withdrawal symptoms.

What happens if you mix levetiracetam and alcohol?

Mixing levetiracetam with alcohol can lead to several adverse effects. Although CNS depressant effects are the most common side effects of combining the two, other severe complications can occur. 

Drowsiness

Drowsiness and fatigue are two of the most common side effects of levetiracetam. Alcohol can also cause these side effects. Mixing the two can intensify this feeling, sometimes causing sedation that can interfere with daily activities. Intensified drowsiness may also make it unsafe to drive or operate machinery. 

Cognitive impairment

Both levetiracetam and alcohol can impair thinking on their own, but when combined, they have a stronger effect on cognitive function. Mixing the two can negatively affect memory, attention, and sound decision-making skills. For example, some people may find their motor skills and reaction times slow down, making it hard to make quick choices, while others might be more easily confused or disoriented. Problem-solving abilities may also be affected, leading to difficulty concentrating.

Mood changes

Irritability and aggression are possible side effects of levetiracetam. A couple of drinks could cause similar mood shifts. Mixing levetiracetam and alcohol may make these effects more intense and unpredictable. For example, some people may experience increased irritability, emotional outbursts, or aggressive behavior, which can worsen existing mental health disorders and overall well-being. Since alcohol is a depressant, it can also bring on a sense of sadness or anxiety.

Increased risk of seizures

Drinking alcohol may lower the seizure threshold, making breakthrough seizures more likely. Heavy alcohol consumption has been linked to seizures in those with epilepsy, with one study showing that around 18% of people reporting alcohol-related seizures consumed at least seven standard drinks. In other words, drinking alcohol may counteract the effects of levetiracetam. Even moderate alcohol consumption may reduce the effectiveness of levetiracetam for seizure control. 

Are certain people at greater risk of side effects?

Some people have a higher risk of potential side effects when they take levetiracetam and drink alcohol. The risk varies from person to person, with factors such as age and health conditions affecting how the body processes both the medication and alcohol.

Older adults

Older adults may be more sensitive to the side effects of medications like levetiracetam because their bodies might take longer to process drugs, leading to higher drug levels in their blood. Mixing levetiracetam with alcohol may cause more severe dizziness, drowsiness, and trouble focusing, increasing the risk of falls or accidents. Both alcohol and this medication can also make memory problems worse and lead to confusion. In addition, older adults often take several medications, which can increase the risk of harmful interactions when alcohol is involved.

People with kidney problems

Levetiracetam is mostly removed from the body by the kidneys. People with kidney problems can take longer to process this medication than those with healthy kidneys, so they may need a lower dose based on their kidney function. Mixing alcohol with levetiracetam can make things worse since alcohol can stress the kidneys and affect how they work—resulting in stronger side effects and possibly worsened kidney impairment.

How long after taking levetiracetam can you drink alcohol?

Levetiracetam has a half-life of around six to eight hours in adults with normal kidney function. Half-life refers to how long it takes for half of the drug to be eliminated from your body. It typically takes four to five half-lives for a medication to be mostly cleared from your system. This means levetiracetam could remain in your body for around 24 to 40 hours after your last dose.

To minimize the risk of a potential interaction between levetiracetam and alcohol, wait at least one to two days after your last dose of levetiracetam before consuming alcohol. Waiting a full day or two gives your body time to process the medication and reduces the risk of side effects.

Are all anticonvulsants affected by alcohol?

Most anticonvulsants work in similar ways and can have negative interactions with alcohol. Anticonvulsants and alcohol can affect the CNS, leading to amplified side effects when taken together. 

The way alcohol interacts with antiepileptic drugs often depends on several factors. These include your reaction to both the medication and alcohol, whether you’re just starting your treatment plan or have been on it for a while, and the amount of alcohol consumed. Some people may experience more severe effects than others.

Common anticonvulsants that may interact with alcohol include:

• Topamax (topiramate) 
• Tegretol (carbamazepine) 
• Dilantin (phenytoin)
• Depakote (valproic acid) 
• Klonopin (clonazepam)
• Lamictal (lamotrigine)
• Neurontin (gabapentin)
• Vimpat (lacosamide)

Alcohol can greatly affect thinking and memory when mixed with anticonvulsant medications. Many of these drugs already cause side effects like drowsiness and dizziness, with alcohol potentially worsening these side effects. Drinking alcohol may be especially risky with medications like benzodiazepines that influence GABA, a neurotransmitter that slows brain activity.

Healthcare professionals generally advise against drinking alcohol while taking anticonvulsant medications. If you choose to drink while on an anticonvulsant, it should be discussed with a healthcare provider to understand the potential risks.

The bottom line

Mixing alcohol with levetiracetam is not recommended, as doing so can worsen drowsiness, dizziness, and cognitive impairment while also increasing mood changes and seizure risks. For people taking levetiracetam to control epilepsy, drinking alcohol can lower the seizure threshold, which could lead to more seizures. Older adults and those with kidney problems are at an even higher risk when they mix the two. If you’re thinking about drinking alcohol while on levetiracetam, it’s best to talk to a healthcare provider first. Wait at least one to two days after stopping the medication before drinking to avoid any potential levetiracetam interactions with alcohol.