Levetiracetam

For an informed discussion with your doctor or pharmacist. This information collection is not a clinically validated interaction checker. Missing data do not establish safety. Do not change or stop prescribed medicines on the basis of this information. The findings apply to the specific conditions studied; laboratory and animal studies cannot be directly extrapolated to humans.

Active substance: Levetiracetam

Examples of brand names: Keppra [EU/DE]

ATC code: N03AX14

Main use (for orientation): Epilepsy

Documented research summary

Human findings are inconsistent: small controlled ancillary analyses without an apparent levetiracetam pharmacokinetic effect, later expanded-access concentration association only in children (n=51 overall, including 25 children; paediatric p=0.0250; overall analysis Table 2 p=0.0222, text p=0.0207). Animal pharmacodynamics are model-dependent: CBD attenuates levetiracetam in an acute 6-Hz mouse model but enhances it in a chronic kainate rat model. No universal enhancement or attenuation can be inferred.

Uncertainties and limitations

Does not establish safety for less-studied cannabinoids or untested formulations/doses.

Do not infer clinical dosage from preclinical effects or enzyme hypotheses.

Separately recorded findings

6 separately recorded findings. Each statement applies to its documented study context.

CBD – clinically studied

Finding ID: B0015

Type of result: No / minor effect under the conditions studied

Observation: No measured pharmacokinetic effect.

Mechanism: Pharmacokinetics investigated

Study type: Double-blind phase II ancillary analysis

Context studied: Concomitant medicine in the clobazam trial.

Clinical interpretation: Null finding with limited evidential value

Limitations and uncertainties: Small non-primary subgroup; do not equate with overall n.

Original sources for this finding: A Phase 2, Double-Blind, Placebo-Controlled Trial to Investigate Potential Drug-Drug Interactions Between Cannabidiol and Clobazam [CL04]

CBD – clinical signals

Finding ID: B0055

Type of result: Positive finding / indication

Observation: Levetiracetam concentration increase associated with rising CBD dose; paediatric p=0.0250. Overall analysis: Table 2 p=0.0222, results text p=0.0207 (internal source discrepancy).

Mechanism: Mechanism uncertain

Study type: Observational study

Context studied: 51 overall (26 adults, 25 children); increase only in children in the separate age analysis (n=25).

Clinical interpretation: Clinical significance unclear

Limitations and uncertainties: Naturalistic association; flexible co-medication and unadjusted multiple tests. Not causality or safety evidence. Results name an adverse-event-profile association for levetiracetam (p=0.0053; example effect <1 point), whereas abstract/discussion broadly state none; internally unresolved.

Original sources for this finding: Final analysis of potential drug-drug interactions between highly purified cannabidiol and anti-seizure medications in an open-label expanded access program [CL20]

CBD – laboratory and animal studies

Finding ID: B0359

Type of result: Preclinical

Observation: In the 6-Hz mouse model, CBD attenuated levetiracetam seizure protection without measurable changes in either serum/brain concentration.

Mechanism: Pharmacodynamics; see context

Study type: Animal experiment

Context studied: Acute mouse model, pharmacodynamic signal.

Clinical interpretation: Limited and contradictory

Limitations and uncertainties: Contrasts with the chronic kainate model; not proof of reduced effect in humans.

Original sources for this finding: Acute effect of cannabidiol on the activity of various novel antiepileptic drugs in the maximal electroshock- and 6 Hz-induced seizures in mice: Pharmacodynamic and pharmacokinetic studies. [CA_P_31377197]

CBD – laboratory and animal studies

Finding ID: B0360

Type of result: Preclinical

Observation: In the chronic kainate model, the combination reduced seizure count and cumulative duration relative to its own pretreatment phase; monotherapies not significant.

Mechanism: Pharmacodynamics; see context

Study type: Animal experiment

Context studied: 22 epileptic rats, combination group n=5; levetiracetam 300 mg/kg/day by minipump, CBD 120 mg/kg/day subcutaneously, 7 days.

Clinical interpretation: Limited and contradictory

Limitations and uncertainties: Pilot model, very high experimental animal doses; no measured pharmacokinetics or clinical synergy evidence.

Original sources for this finding: Subthreshold Cannabidiol Potentiates Levetiracetam in the Kainic Acid Model of Temporal Lobe Epilepsy: A Pilot Study. [C_PR_39338349]

CBD-rich cannabis extract (CBD pharmacokinetics measured; not an isolate study) – clinical signals

Finding ID: B0361

Type of result: Clinical signal

Observation: Concomitant levetiracetam was associated with the CBD elimination constant.

Mechanism: Pharmacokinetic investigation

Study type: Observational study

Context studied: 29 evaluable children in total, oral CBD-rich extract, observational pharmacokinetics.

Clinical interpretation: Limited and contradictory

Limitations and uncertainties: Direction/magnitude not quantified in the abstract read; no causality.

Original sources for this finding: Disposition of Oral Cannabidiol-Rich Cannabis Extracts in Children with Epilepsy. [C_PR_32048179]

CBD – clinical signals

Finding ID: B0362

Type of result: Clinical signal

Observation: The small randomised Dravet dose study showed no apparent change in levetiracetam exposure.

Mechanism: Pharmacokinetic investigation

Study type: Randomised study, secondary pharmacokinetics

Context studied: 34 children overall, CBD 5/10/20 mg/kg/day or placebo, 3 weeks, only a few levetiracetam co-medications.

Clinical interpretation: Limited and contradictory

Limitations and uncertainties: Descriptive, sparsely sampled pharmacokinetics; not equivalence or safety evidence.

Original sources for this finding: Randomized, dose-ranging safety trial of cannabidiol in Dravet syndrome. [C_PR_29540584]

References and access status

[C_LABEL_D0048] LEVETIRACETAM LEVETIRACETAM (LEVETIRACETAM) SOLUTION [ATLANTIC BIOLOGICALS CORP.]

Original source / bibliographic reference

Authors: ATLANTIC BIOLOGICALS CORP.

Year: 2026

Source type: US Structured Product Label

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

[C_PR_39338349] Subthreshold Cannabidiol Potentiates Levetiracetam in the Kainic Acid Model of Temporal Lobe Epilepsy: A Pilot Study.

Original source / bibliographic reference

Authors: Lucchi C, Marcucci M, Aledresi KAMS, Costa AM, Cannazza G, Biagini G.

Year: 2024

Source type: Primary source, full text read

DOI: 10.3390/ph17091187

PMID: 39338349

Source access – 23 October 2026: Automated direct retrieval was restricted; this does not establish that the link is broken.

Bibliographic attribution or source identity cross-checked.

PubMed – bibliographic reference / abstract

PubMed Central – archived text

DOI – publisher access (access restrictions may apply)

[CL20] Final analysis of potential drug-drug interactions between highly purified cannabidiol and anti-seizure medications in an open-label expanded access program

Original source / bibliographic reference

Authors: Gaston TE; Bebin EM; Cutter GR; Grayson L; Szaflarski JP

Year: 2023

Source type: Open-label longitudinal observational study

DOI: 10.1002/epi4.12815

PMID: 37593907

Source access – 23 October 2026: Automated direct retrieval was restricted; this does not establish that the link is broken.

Bibliographic attribution or source identity cross-checked.

PubMed – bibliographic reference / abstract

DOI – publisher access (access restrictions may apply)

Europe PMC – full-text access according to the literature database – Listed as freely available HTML full text in the official Europe PMC metadata. Direct retrieval was not fully verified here.

[CL04] A Phase 2, Double-Blind, Placebo-Controlled Trial to Investigate Potential Drug-Drug Interactions Between Cannabidiol and Clobazam

Original source / bibliographic reference

Authors: VanLandingham KE; Crockett J; Taylor L; Morrison G

Year: 2020

Source type: Randomised double-blind phase II study

DOI: 10.1002/jcph.1634

PMID: 32652616

Source access – 23 October 2026: Direct retrieval could not be fully verified; availability remains unresolved.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

PubMed Central – full-text access according to the literature database – Archive attribution confirmed by Europe PMC metadata. Direct retrieval was not fully verified here; access may require a browser check.

Europe PMC – full-text access according to the literature database – Listed as freely available HTML full text in the official Europe PMC metadata. Direct retrieval was not fully verified here.

[C_PR_29540584] Randomized, dose-ranging safety trial of cannabidiol in Dravet syndrome.

Original source / bibliographic reference

Authors: Devinsky O, Patel AD, Thiele EA, Wong MH, Appleton R, Harden CL, Greenwood S, Morrison G, Sommerville K, GWPCARE1 Part A Study Group.

Year: 2018

Source type: Primary source, full text read

DOI: 10.1212/wnl.0000000000005254

PMID: 29540584

Source access – 23 October 2026: Automated direct retrieval was restricted; this does not establish that the link is broken.

Bibliographic attribution or source identity cross-checked.

PubMed – bibliographic reference / abstract

PubMed Central – archived text

DOI – publisher access (access restrictions may apply)

[CA_P_31377197] Acute effect of cannabidiol on the activity of various novel antiepileptic drugs in the maximal electroshock- and 6 Hz-induced seizures in mice: Pharmacodynamic and pharmacokinetic studies.

Original source / bibliographic reference

Authors: Socała K, Wyska E, Szafarz M, Nieoczym D, Wlaź P.

Year: 2019

Source type: Research Support, Non-U.S. Gov't; Journal Article

DOI: 10.1016/j.neuropharm.2019.107733

PMID: 31377197

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[C_PR_32048179] Disposition of Oral Cannabidiol-Rich Cannabis Extracts in Children with Epilepsy.

Original source / bibliographic reference

Authors: Wang GS, Bourne DWA, Klawitter J, Sempio C, Chapman K, Knupp K, Wempe MF, Borgelt L, Christians U, Leonard J, Heard K, Bajaj L.

Year: 2020

Source type: Primary source, abstract read

DOI: 10.1007/s40262-020-00869-z

PMID: 32048179

Source access – 23 October 2026: Direct retrieval could not be fully verified; availability remains unresolved.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

Research as of 23 October 2026. Not all original full texts could be reviewed in full. Source accessibility and the strength of scientific evidence must be assessed separately. An accessible link does not establish medical approval; a bibliographic record with an abstract does not replace the original full text.

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