Can I Take phenobarbital and keppra Together?

SUMMARY:

Phenobarbital and levetiracetam (Keppra) can be used together in many patients; there is no major pharmacokinetic interaction expected, but the combination can increase central nervous system depression (sedation, dizziness, impaired coordination).

ADDITIONAL NOTES:

Phenobarbital is a barbiturate and CNS depressant and an enzyme inducer; levetiracetam is an anticonvulsant primarily excreted unchanged by the kidneys with minimal CYP metabolism. The main concern is additive CNS adverse effects (excessive sedation, drowsiness, impaired balance, slowed thinking), and increased risk of respiratory depression in vulnerable patients or when combined with other depressants (opioids, benzodiazepines, alcohol). Monitor for increased sedation, cognitive or motor impairment, and seizure control; check renal function for levetiracetam dosing. Dose adjustments may be needed based on clinical response and tolerability.