What is Levetiracetam ER: Uses, Warnings & Interactions

Updated May 14, 2025  •  Published Dec 30, 2020

Extended-release levetiracetam is a prescription anticonvulsant for adolescents and adults with partial seizures. It has a much more limited use as an anti-seizure medication than immediate-release levetiracetam. It is also never used by itself. Instead, doctors always add it to another drug therapy that isn’t working well enough to control seizures. 

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Levetiracetam ER overview

BRAND NAMES:

  • Keppra XR, Elepsia XR

Generic Names:

  • Levetiracetam ER

Uses:

  • Prevents partial seizures.

Therapeutic Classes:

  • Anticonvulsant

Forms:

  • Extended-release tablet

How it’s taken:

  • By mouth

What is Levetiracetam ER used for?

Levetiracetam ER prevents partial-onset seizures in adolescents and adults with epilepsy. Partial seizures affect only one part of the brain rather than both sides of the brain.

What form(s) does Levetiracetam ER come in

  • Extended-release tablet

    • 500 mg

    • 750 mg

    • 1,000 mg

    • 1,500 mg

What are common Levetiracetam ER doses?

  • For partial-onset seizures: 

    • In adults and children 12 years of age and older weighing more than 50 kg: 3,000 mg extended-release levetiracetam taken once daily

Find more detailed information about levetiracetam dosage, forms, and strengths here.

Common Levetiracetam ER prescriptions

  • levETIRAcetam ER
    500mg tablet extended release 24 hour

  • levETIRAcetam ER
    750mg tablet extended release 24 hour

How to take Levetiracetam ER

  • Take this medicine as directed. The dose may change at the beginning of treatment. 

  • Please read the Medication Guide that comes with this medicine.

  • Take only one dose daily.

  • Take doses with or without food.

  • The inactive part of the tablet may be visible in stools. Do not be concerned.

  • Do not stop taking doses until consulting with a doctor.

  • How to take extended-release levetiracetam tablets:

    • Swallow the tablet whole. Do not crush, break, or chew it.

    • Store the tablets at room temperature away from heat and light.

  • How to take Elepsia XR tablets:

    • Swallow the tablet whole. Do not crush, break, divide, or chew it.

    • Each tablet has a blue layer and a white layer. If one layer is missing, do not take the tablet.

    • Store the tablets at room temperature away from light.

What to do if you miss a dose of Levetiracetam ER

  • Take a missed dose as soon as it’s remembered.

  • Skip the missed dose if it’s almost time for the next dose. Ask the prescriber to clarify what “almost time for the next dose” means.

  • Take the next dose at its regular time.

  • Do not take extra medicine to make up for a missed dose.

Levetiracetam ER contraindications

  • This medicine is not right for everyone. 

  • Do not use it if you have had an allergic reaction to levetiracetam.

Levetiracetam ER warnings

  • Tell any doctor or other healthcare provider who treats you that you are using this medicine.

  • Taking drugs for seizures requires regular check-ups and tests. Keep all healthcare appointments.

  • Contact the prescriber if seizures do not improve or get worse.

  • Before starting levetiracetam ER, make sure the prescribing healthcare professional knows if you are pregnant, breastfeeding, or have:

    • Kidney problems

    • A history of depression, mood disorders, or suicidal thoughts

  • Women taking levetiracetam should immediately tell the doctor if they become pregnant or think they’re pregnant.

  • This medicine can cause serious problems including: 

    • Changes in mood or behavior, including thoughts of suicide

    • Psychotic symptoms including hallucinations

    • Blood disorders

    • Severe allergic, skin, or drug reactions

  • Do not stop taking levetiracetam doses without talking to the prescriber. The sudden discontinuation of levetiracetam could bring on breakthrough seizures. The doctor will gradually decrease the dose when stopping levetiracetam therapy.

  • Do not forget to take daily doses. Missed doses of antiseizure medications are the most common cause of breakthrough seizures.

  • Levetiracetam can cause drowsiness, dizziness, fatigue, and impaired coordination. Do not drive or engage in other risky activities until you know how this medicine affects you.

Levetiracetam ER interactions

  • Tell the prescriber about all prescription drugs, over-the-counter medications, and supplements being taken, particularly drugs that make you sleepy such as narcotic pain medications, benzodiazepines, sleeping pills, antihistamines, CBD, or alcohol.

  • Inform other doctors you are taking levetiracetam. Do not start any new medications until talking to the prescriber.

  • Avoid alcohol while taking levetiracetam ER.

Levetiracetam ER side effects

Serious side effects

Talk to a doctor if you notice any signs or symptoms of a possible serious side effect including:

  • Thoughts about suicide or self-harm

  • Mood changes, aggression, depression, hostility, unusual behaviors

  • Seeing or hearing things that aren’t there

  • Extreme sleepiness, tiredness, weakness

  • Problems with coordination, balance, or walking

  • Change in how much or how often you urinate

  • Fatigue, yellowing of the skin and eyes

  • Fever, chills, cough, sore throat, body aches

  • Unusual bleeding or bruising

  • Severe muscle pain, dark urine

  • Blistering, peeling, red skin rash

  • Swollen, painful, or tender lymph glands in the neck, armpit, or groin

  • Fever, dark urine, facial swelling, unusual bruising, shortness of breath, fatigue, yellowing of the skin or eyes 

  • Allergic reaction: Rash, itching, hives, swelling of the face, neck, mouth, or throat, chest tightness, difficulty breathing

Less serious side effects

  • Sleepiness

  • Flu

  • Irritability

  • Runny, congested nose

  • Dizziness

  • Nausea

Find more information about levetiracetam side effects here.

Sources:

Levetiracetam ER News & Research

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