Most drugs are known for something. If Viagra or Cialis are mentioned what do you think of first? How effective either one is for erectile dysfunction, the pros and cons of each, Viagra’s weird side effect of cyanopsia (where everything you see is tinted blue), or that your hard-on can last over four hours and if it does you’re supposed to call Dr. Buzzkill about it.

Fun fact: if all else fails it can require surgery to correct your never-ending boner (priapism).1

Crazy meds are no different. Most of them are notorious for some reason. Lamictal is best known for “The Rash” (or “The Lamictal Rash”), but it’s also the best drug on the planet to treat Bipolar II. Topamax is also known as Dopamax and Stupamax, and here at Crazy Meds we coined the term “supermodel drug” for both Topamax and Zonegran, because they can make you skinny and stupid, yet Topamax is also a Godsend for a lot of people with migraines and/or various forms of epilepsy, and is the first thing a lot of neurologists will prescribe.
This page also has the black box warnings2 i.e. side effects that can be especially hazardous, if not fatal. These are often, but not always, what a med is most notorious for, e.g. The Lamictal Rash is a black box warning.
If a drug has a black box warning here is a verbatim copy of it from its full US PI sheet. We may comment on any black box warning. E.g. Translate doctorese, note just how rare the problem is, or how the warning is the result of the nexus of panic and politics.

1.  Black Box Warnings

None

2.  Black Box Comments

Not only does Keppra have no black box warning (just like Topamax), it has fewer warnings than most other drugs. Some of the ones listed in the PI sheet look like they are there for standardization/CYA purposes. It pretty much boils down to “It’s a 1 in 10,000 chance that Keppra will mess with your liver, and it’s less likely to mess with your blood than any other antiepileptic drug AED on the market. But we’ve got to list those things in the warnings section and not just the adverse effects sections.”

3.  What Keppra-XR (levetiracetam) is Best Known for

Being the AED that will either fix you when nothing else can - even if you’re taking it for something other than epilepsy, or kill you because it’ll make you suicidally depressed and/or so enraged at the world that you’ll die because half-a-dozen cops had to tase you.

4.  Noted Traits & Effects

That under normal circumstances (i.e. special snowflakes aren’t taking it), Keppra has no pharmacokinetic drug-drug interaction. It doesn’t even interact with warfarin, and warfarin interacts with practically every drug on the planet.

Drugs can sometimes have lesser-known traits and effects that make them unique, such as Keppra’s ability to stop mania immediately as if it were an antipsychotic. Some are good, some are bad, some are just weird. Some might be helpful for you to know about in order to make the best use a med, or to help it suck less. Others are meaningful only to pharmacology geeks.

5.  Noted Drug-Whatever Interactions

Not a damn thing, which is noteworthy in of itself. This study suggests that maybe there are some in a few people, but the data aren’t clear and the differences are too small to matter.

Practically every other med will interact with something else, because even if they are just substrates of (are metabolized by) the same CYP450 or UGT enzymes there can be competition. Even Neurontin is self-inhibiting - take too much and you’ll get less and less out of it. But it just doesn’t work that way with Keppra.

And until its derivative, or the other med based upon it, hits the market, there isn’t much in the way of pharmacodynamic (what the meds do in your brain) interactions because Keppra works in a way that is truly unique.
Only one pharmacodynamic interaction has been reported when combining Keppra and Tegretol (carbamazepine). Mixing the two can cause the symptoms of taking too much Tegretol, even though there is no change in blood levels. This may or may not have something to do with this odd thing of one-way cross-tolerance in rats given Keppra and Tegretol. So if you are taking these two meds there is a small chance you may need to reduce the amount of carbamazapine you take, or stop taking whichever one didn’t work as well for you.

Just in case you missed it on the Pharmacokinetics page, here are any really important drug-drug interactions, or the ones that haven’t made it into the PI sheets and/or drug-drug interaction checkers, as these are noted traits as well.

Drugs.com’s drug-drug and drug-food interaction checker

‹ Expanded Mechanism/Methods of Action | Keppra-XR Index | Expanded Comments ›
Crazy Meds Comprehensive Keppra-XR pages

Bibliography

1 See Erectile function and dysfunction following low flow priapism: a comparison of distal and proximal shunts* for the gory details, with pictures, of the surgery required.

2 Called "black box warnings" because they appear in a box at the top of the PI sheets, written in big, bold print, and originally surrounded by a thick, black outline. Some companies still put black box warnings in a black box. There is no relationship to the black boxes in airplanes, although I haven't tried burning a number of different PI sheets to see if the black box warnings are still legible in the ashes.


Date created Tuesday, 04 October 2011 at 11:12:28 Page Creator: Kassiane S. Last edited by:

Keppra-XR Expanded Notable Traits & Effects is copyright 2011 Kassiane S.

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Almost all of the material on this site is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, and 2011 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and the following disclaimer, I’m usually cool with it.

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‘Everything is true, nothing is permitted.’ - Jerod Poore


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