Omar Danoun: Levetiracetam May Increase Thromboembolic Risk With DOACs
Omar Danoun, Assistant Professor at Michigan State University, Epileptologist at Henry Ford Health System, shared a post on X about a recent article by Kai Michael Schubert et al. published in JAMA Neurology, adding:
“New study suggests Levetiracetam (Keppra) increases clotting risk.
But context matters, this is not a universal effect of the drug itself. The signal is a drug interaction, nearly double thromboembolic risk specifically when combined with DOACs like apixaban or rivaroxaban. Notably, this interaction has not been seen with warfarin.
Levetiracetam alone does not raise clotting risk.
Clinical takeaway, for patients on a DOAC with a history of atrial fibrillation or DVT, consider switching from levetiracetam to an alternative such as lamotrigine that lacks this interaction, or discuss whether warfarin might be a suitable option instead.”
Title: Safety of Antiseizure Medications During Direct Oral Anticoagulant Therapy in Epilepsy
Authors: Kai Michael Schubert, Carolina Ferreira-Atuesta, Arunachalam Soma, Johan Zelano, David J. Seiffge, Francesco Brigo, Eugen Trinka, Nishant K. Mishra, Emilio Russo, Gregory Y. H. Lip, Gashirai K Mbizvo, Marian Galovic
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