Does Keppra Make You Bruise Easily? A Pharmacological Review

October 11, 2025 •

3 min read

While not a common side effect, reports indicate that the antiepileptic drug Keppra (levetiracetam) can, in rare cases, cause you to bruise easily. This phenomenon is typically linked to a decrease in blood cell counts, specifically platelets, which are essential for normal blood clotting. It is important for patients and caregivers to be aware of this potential, though uncommon, adverse reaction and to seek medical advice if they notice unexplained bruising.

Quick Summary

Easy bruising is a rare but reported side effect of Keppra, primarily associated with thrombocytopenia, or low blood platelet count. This condition can affect the body's ability to clot blood, leading to easy bleeding or bruising. The risk, frequency, and management of this hematological issue require careful consideration and medical supervision.

Key Points

Easy bruising is a rare side effect of Keppra: It is not a common occurrence but has been reported in post-marketing experience.
Low platelets (thrombocytopenia) is the likely cause: The bruising can be a symptom of a decrease in blood platelet counts, which are necessary for proper blood clotting.
Monitor for other symptoms: Bruising accompanied by fever, unusual weakness, or frequent infections could indicate low blood cell counts.
Contact a healthcare provider immediately: If you experience easy bruising or unusual bleeding, inform your doctor so they can investigate the cause and order a blood test.
Do not stop Keppra suddenly: Abruptly discontinuing the medication can trigger seizures; always consult your doctor before making any changes.
Blood tests can confirm the issue: A complete blood count (CBC) can determine if your blood cell levels are low and help guide the next steps for treatment.
Treatment involves medical supervision: Management may include dosage adjustment or switching to an alternative medication, depending on the severity of the condition.

Understanding the Link Between Keppra and Easy Bruising

Keppra (levetiracetam) is an antiepileptic medication used to control seizures. Easy bruising and unusual bleeding have been reported as rare, serious side effects. This is believed to be due to Keppra's potential impact on blood cell production, particularly platelets, which are crucial for blood clotting.

The Mechanism: Low Blood Platelets (Thrombocytopenia)

Platelets are blood components essential for stopping bleeding by forming clots. Thrombocytopenia is a condition characterized by a low platelet count, and Keppra has been associated with it in rare instances. This can impair the body's ability to clot, leading to increased bruising from minor injuries. While the exact mechanism is unclear, it may involve bone marrow suppression or an immune response.

Clinical Evidence and Incidence

Although most Keppra clinical trials did not show significant changes in platelet counts, post-marketing reports and case studies have linked levetiracetam use to thrombocytopenia and pancytopenia (a deficiency in all blood cell types). These reports, though rare, emphasize the need for vigilance.

Managing Potential Hematologic Side Effects

If you are taking Keppra and notice increased bruising or bleeding, do not stop your medication suddenly without consulting a doctor, as this can cause seizures. Instead, monitor your symptoms, note the characteristics of any unusual bruises, and look for other signs of low blood cell counts like petechiae, fatigue, or fever. Contact your healthcare provider immediately to discuss your observations. They may order a complete blood count (CBC) to check your platelet levels. Regular blood monitoring may be recommended if you have a history of blood disorders or are on other medications affecting blood counts. If thrombocytopenia is confirmed, your doctor may adjust your Keppra dose or suggest an alternative antiepileptic medication.

Comparison of Common Medication Side Effects

Understanding how Keppra's potential hematologic side effects compare to other medications can be helpful:


Medication Category	Examples	Potential Side Effects Related to Bruising	Notes
Antiepileptic (Keppra)	Levetiracetam	Rare thrombocytopenia (low platelets) leading to easy bruising and bleeding.	Serious but uncommon side effect. Requires immediate medical evaluation.
Blood Thinners	Warfarin (Coumadin), Apixaban (Eliquis)	High risk of easy bruising and bleeding due to reduced blood clotting ability.	This is the intended effect of the medication.
NSAIDs	Ibuprofen (Advil), Naproxen (Aleve)	Increased risk of bruising, especially with long-term or high-dose use, due to anti-platelet effects.	Should be used with caution, especially if also on blood thinners.
Corticosteroids	Prednisone	Increased risk of bruising due to thinning of the skin and potential impact on blood vessels.	Risk increases with the duration of use.
Antidepressants	SSRIs	Rare reports of easy bruising and bleeding.	Mechanism is not fully understood, but may involve platelet function.

Conclusion

Easy bruising is a rare but reported side effect of Keppra (levetiracetam), often linked to thrombocytopenia, a decrease in platelets. While not all patients will experience this, those who do should seek immediate medical attention. A blood test can diagnose the issue, and dose adjustments or medication changes can manage this rare but serious side effect.

For more detailed information on drug safety and reported side effects, you can visit the official FDA drug safety page: [https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-rare-serious-drug-reaction-antiseizure-medicines-levetiracetam-keppra-keppra-xr-elepsia-xr].

Frequently Asked Questions

Yes, in rare cases, Keppra can cause you to bruise more easily, sometimes with little or no apparent reason. This is often due to a rare side effect of the medication causing low blood platelet levels, which are vital for clotting.

Thrombocytopenia is a condition where a person has an abnormally low number of blood platelets. Keppra has been linked to this condition in rare post-marketing reports, as it may interfere with the body's production of platelets. This can lead to increased bleeding and bruising tendencies.

If you notice you are bruising easily, you should contact your healthcare provider immediately. They can perform a blood test, such as a complete blood count (CBC), to check your platelet levels and determine if the bruising is related to the medication.

Yes, easy bruising can be a sign of a serious, though rare, side effect related to low blood cell counts. If left unaddressed, it can lead to more significant bleeding issues. Immediate medical attention is necessary to diagnose the cause and manage the risk.

Bruising may resolve on its own, especially if the cause is minor. However, if the bruising is related to thrombocytopenia caused by Keppra, it will not improve unless the underlying issue is addressed. A doctor may need to adjust your dosage or change your medication to resolve the problem.

Yes, other potential signs of low blood cell counts include fever, chills, unusual weakness or tiredness, pale skin, frequent infections, or red pinpoint spots (petechiae) on the skin. If you experience any of these symptoms, report them to your doctor immediately.

Regular blood count monitoring is not routinely required for all patients on Keppra. However, it may be recommended for those who have pre-existing blood disorders, take other medications affecting blood counts, or if they start to show symptoms like easy bruising or bleeding.