Keppra interactions: Alcohol, medications, and other factors

Before you start treatment with Keppra, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Keppra interacts with supplements, herbs, or vitamins, see the “Keppra and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Keppra. Keep in mind that this table doesn’t include all drugs that may interact with Keppra. Some of these interactions are described in detail just below in “Drug interactions in depth.”

In some cases, factors or conditions could prevent your doctor from prescribing Keppra due to the risk of harm. These are known as contraindications. The contraindications of Keppra include:

Having had an allergic reaction to Keppra or any of its ingredients

If you have had an allergic reaction to Keppra or any of its ingredients, your doctor will likely not prescribe Keppra. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Keppra, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Keppra.

Keppra isn’t known to have interactions with alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Keppra treatment.

This is because drinking alcohol while taking the drug may worsen some of Keppra’s side effects.* For example, you may experience:

• headache
• dizziness
• sleepiness
• problems with balance or coordination

If you consume alcohol during Keppra treatment, these side effects may be more likely to occur. If you have questions about drinking alcohol while taking Keppra, talk with your doctor.

* For details about Keppra’s side effects, see this article.

Here’s a closer look at certain drug interactions of Keppra.

Benzodiazepines

Keppra can interact with benzodiazepines, which are drugs used to treat anxiety and insomnia.

Interaction result: Taking Keppra with a benzodiazepine can increase the risk of sleepiness.

Interaction explained: Benzodiazepines and Keppra can both cause sleepiness. So taking these drugs together can increase this side effect* or make it more likely to occur.

Examples of benzodiazepine drugs: Here are some benzodiazepines that may interact with Keppra:

• alprazolam (Xanax)
• diazepam (Valium)
• lorazepam (Ativan)

Steps you or your doctor may take: If you take Keppra with a benzodiazepine, tell your doctor if you have bothersome sleepiness. They may reduce your dosage of one or both drugs.

If you have questions about taking Keppra with a benzodiazepine, talk with your doctor or pharmacist.

* For details about Keppra’s side effects, see this article.

Certain antidepressants

Keppra can interact with certain antidepressant drugs.

Interaction result: Taking Keppra with certain antidepressants may increase the risk of sleepiness.It may also make Keppra less effective at preventing seizures or make the antidepressant less effective at treating depression.

Interaction explained: Keppra and certain antidepressants can both cause sleepiness. So taking these drugs together can increase this side effect* or make it more likely to occur.

Certain antidepressants can also raise your risk of having seizures. This can make Keppra less effective at preventing seizures.

Keppra can also cause changes in your mood, thoughts, and behavior that could worsen depression. This can make the antidepressant less effective at treating depression.

Examples of antidepressant drugs: Here are some antidepressants that may interact with Keppra:

• amitriptyline
• imipramine
• mirtazapine

Steps you or your doctor may take: If you take Keppra with an antidepressant, tell your doctor if you have bothersome sleepiness. They may adjust your dosage of either medication.

Also, tell your doctor if your seizures become worse or more frequent, or if you have any changes in your mood, feelings, thoughts, or behavior. Your doctor may recommend switching to a different treatment for your seizures or depression.

* For details about Keppra’s side effects, see this article.

Carbamazepine

Keppra may interact with carbamazepine (Tegretol, others), which is used to treat seizures, bipolar disorder, and nerve pain.

Interaction result: Taking Keppra with carbamazepine may raise the risk of carbamazepine side effects, such as vision changes, unsteadiness, dizziness, nausea, or vomiting.

Interaction explained: Keppra and carbamazepine can cause some similar effects in your body. This can raise your risk of carbamazepine side effects.

Steps you or your doctor may take: If you take Keppra with carbamazepine, tell your doctor if you have bothersome side effects, such as vision changes, unsteadiness, dizziness, nausea, or vomiting.Your doctor may lower your dosage of carbamazepine.

Keppra may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Keppra.

Keppra interactions with supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Keppra and herbs

There are no specific reports of herbs interacting with Keppra. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products. They can recommend if there are products not to take with Keppra.

Keppra interactions with vitamins

There are no specific reports of vitamins interacting with Keppra. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Keppra.

Keppra interactions with food

There were no reports of food interactions with Keppra. If you’d like to learn more about eating certain foods during treatment with Keppra, talk with your doctor.

Keppra interactions with vaccines

There aren’t any known interactions between Keppra and vaccines. Talk with your doctor or pharmacist to see whether you’re due for any vaccines.

Keppra interactions with lab tests

Keppra isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

KEPPRA INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Keppra. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Keppra. The impact of cannabis may affect how well you stick to your Keppra treatment plan. Using cannabis may also increase your risk of sleepiness with Keppra.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Keppra. Before you take this drug, be sure to talk with your doctor about your health history. Keppra may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Keppra include:

• Allergic reaction: If you’ve had an allergic reaction to Keppra or any of its ingredients, your doctor will likely not prescribe Keppra. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Mental health conditions: If you have a mental health condition, such as depression, anxiety, bipolar disorder, or schizophrenia, talk with your doctor before taking Keppra. Keppra can cause changes in your mood, thoughts, and behavior that could worsen your condition. It can also raise your risk of suicidal thoughts and actions. Talk with your doctor about whether Keppra is right for you.
• Kidney problems: If you have kidney problems, your doctor may prescribe a dosage of Keppra that’s lower than usual.
• Breastfeeding: It’s not known whether it’s safe to use Keppra while breastfeeding. The drug passes into breast milk, but there isn’t enough information to determine what effects Keppra may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using Keppra. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: There haven’t been enough clinical trials to determine whether Keppra is safe to use while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects) or pregnancy loss. However, keep in mind that studies in animals do not always predict what will happen in humans. Information from pregnancy registries does not suggest that taking Keppra during pregnancy increases the risk of congenital anomalies or pregnancy loss. If you’re pregnant or planning to become pregnant, tell your doctor before starting Keppra. They can advise you on the right treatment plan for you.

Here are some frequently asked questions about Keppra and possible interactions.

Does Keppra have interactions with antibiotics?

No, Keppra is not known to have any interactions with antibiotics, which are drugs used to treat bacterial infections.

If you have questions about taking antibiotics with Keppra, talk with your doctor or pharmacist.

What allergy medication can I take with Keppra?

Allergy medications have not been specifically reported to interact with Keppra. Most allergy medications are usually safe to take with Keppra.

However, Keppra can make some people feel sleepy. Some allergy medications can also cause sleepiness. Examples include sedating antihistamines, such as chlorpheniramine and diphenhydramine (Benadryl). Taking one of these antihistamines with Keppra may increase sleepiness or make it more likely to occur.

If you need an antihistamine while taking Keppra, it’s best to take one that doesn’t tend to cause sleepiness. Examples include cetirizine (Zyrtec) and loratadine (Claritin).

If you need an allergy medication while taking Keppra, ask your doctor or pharmacist to recommend a product that’s most suitable for you.

You can take certain steps to help prevent interactions with Keppra. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Keppra label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Keppra doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Keppra by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.