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Serious dermatological reactions, including stevens-johnson syndrome sjs and toxic epidermal necrolysis ten , have been reported in both pediatric and adult patients treated with keppra.

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KEPPRA can cause hematologic abnormalitiesHematologic abnormalities occurred in clinical trials and included decreases in white blood cellWBCneutrophiland red blood cellRBCcountsdecreases in hemoglobin and hematocritand increases in eosinophil countsCases of agranulocytosispancytopeniaand thrombocytopenia have been reported in the postmarketing settingA complete blood count is recommended in patients experiencing significant weaknesspyrexiarecurrent infectionsor coagulation disorders.

A randomized double-blindplacebo-controlled study was performed to assess the neurocognitive and behavioral effects of KEPPRA as adjunctive therapy in pediatric patients4 to 16 years of ageThe results from an exploratory analysis indicated a worsening in KEPPRA-treated patients on aggressive behaviorone of eight behavior dimensionsas measured in a standardized and systematic way using a validated instrumentthe Achenbach Child Behavior ChecklistCBCL/6-18

Keppra is not recommended during pregnancy and in women of childbearing potential not using contraception unless clinically necessary.

There was about a 22increase of apparent total body clearance of levetiracetam when it was co-administered with enzyme-inducing AEDsDose adjustment is not recommendedLevetiracetam had no effect on plasma concentrations of carbamazepinevalproatetopiramateor lamotrigine.

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