Xcopri vs. Keppra: Comparing side effects, uses, costs, and more

This article explains the main similarities and differences between Xcopri and Keppra. If you’re considering taking one of these drugs, discussing this information with your doctor can help you decide whether one of these treatments may be right for you.

Note: For more comprehensive information about these two drugs, you can refer to our Xcopri and Keppra articles.

Here’s information about the generic status for Xcopri and Keppra, as well as details on their active ingredients.

Xcopri and Keppra have been approved by the Food and Drug Administration (FDA) for the following uses.

Xcopri isn’t approved by the Food and Drug Administration (FDA) for use in children under 18 years of age.

The approved uses of Keppra in children depend on the form prescribed (see the “Dosage, forms, and administration” section for details).

Keppra XR is approved to treat focal onset seizures in children ages 12 years and older. (XR means extended release, which means the medication is released slowly into the body over time.)

Note: For more information about the drugs’ uses, see our articles about Xcopri and Keppra.

Your doctor will initially start Xcopri or Keppra treatment by prescribing a low dosage. They’ll adjust it over time to reach the right amount for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following table highlights the recommended dosages and administration of Xcopri and Keppra for focal onset seizures in adults. Measurements are given in milligrams (mg).

Xcopri and Keppra both treat focal onset seizures. These drugs can cause some of the same side effects, as well as different ones. Some of the side effects reported in clinical trials of these drugs are listed here.

For more details about the side effects of these two drugs, see our side effect articles about Xcopri and Keppra. You can also refer to the prescribing information for:

The following table lists some of the more commonly reported mild side effects of Xcopri and Keppra. The table may also include mild side effects that are less common but you may have concerns about in some cases.

These side effects may be temporary, lasting a few days to weeks. If the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

The following table lists reported serious side effects of Xcopri and Keppra.

If you have serious side effects while using Xcopri or Keppra, call your doctor immediately. If the side effects feel life threatening or you believe you’re having a medical emergency, call 911 or your local emergency number right away.

For some people, Xcopri or Keppra can cause an allergic reaction.

In general, symptoms of an allergic reaction can be mild or serious.

For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.

For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Xcopri or Keppra, your doctor may recommend taking a different medication instead.

Here are answers to some common questions about Xcopri and Keppra.

Xcopri and Keppra start to work after your first dose, although Keppra may start working more quickly. This is because Xcopri requires a slow dose increase over several weeks to reduce the risk of side effects, so it takes longer to reach its full effectiveness. Your doctor will monitor you during treatment to check whether the drug is working to treat your condition.

Talk with your doctor if you have questions about what to expect with Xcopri or Keppra treatment.

Studies suggest Xcopri may cause physical dependence and withdrawal. With dependence, your body relies on a drug to function as usual. Dependence is not the same as addiction. Dependence can happen with long-term use of many substances, including certain prescription drugs, even if you take the medication as prescribed.

Withdrawal symptoms are side effects that can occur when you stop taking a drug that your body has become dependent on. If you suddenly stop taking Xcopri, you may experience withdrawal symptoms. Examples of withdrawal symptoms include:

To end your Xcopri treatment, your doctor will slowly lower your dosage over time. Doing so can help reduce your risk of withdrawal symptoms after you stop taking Xcopri.

If you have withdrawal symptoms after you’ve stopped taking Xcopri, talk with your doctor. They can recommend ways to ease these symptoms.

Xcopri and Keppra are effective options to help treat focal onset seizures.

Review of studies: Xcopri and Keppra are both effective treatment options for focal onset seizures. A 2024 study suggests that Xcopri may be more effective than Keppra for people with drug-resistant focal onset seizures, which are seizures that haven’t responded to other treatments.

In the study, Xcopri had a higher 12-month retention rate compared with other seizure medications, including Keppra. This means more people continued treatment with Xcopri over time, likely due to its balance of effectiveness and side effects. These findings may help doctors choose the best treatment option for people whose seizures haven’t responded to other drugs. For more information, talk with your doctor.

Prescribing information: For details about how these drugs performed in clinical trials, see the prescribing information for Xcopri, Keppra, and Keppra XR. Keep in mind that trial results may not apply to your individual health situation.

Treatment guidelines: Another way to determine whether a drug is considered effective is to look at treatment guidelines. When an organization includes certain drugs in treatment guidelines, this means research has shown the drug to be safe and effective.

Keppra is recommended as a treatment option for people with focal onset seizures in guidelines from the American Academy of Neurology (AAN) and the American Epilepsy Society (AES).

Xcopri is approved by the Food and Drug Administration (FDA) for treating focal onset seizures in adults. It is not specifically mentioned in the 2018 AAN/AES treatment guidelines because it was approved after those guidelines were published. However, studies show that Xcopri is an effective option for adults with focal onset seizures.

How much Xcopri or Keppra costs depends on the treatment plan your doctor prescribes, your insurance plan, and your pharmacy.

Both Xcopri and Keppra are brand-name drugs. Keppra also comes in generic forms. Brand-name medications often cost more than generics. Talk with your doctor or pharmacist to learn about the generic forms of Keppra.

For more information on ways to save on these medications, see our articles about the cost of Xcopri and Keppra.

Xcopri and Keppra may not be right for you if you have certain medical conditions or other factors that affect your health. These drugs have some of the same precautions, but they also have different ones. Some of these precautions are mentioned here.

If any of the following medical conditions or other health factors are relevant to you, talk with your doctor before starting Xcopri or Keppra.

Note: For more comprehensive information about these drugs, you can refer to our Xcopri and Keppra overview articles.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

Switching between Xcopri and Keppra is possible.

Talk with your doctor if you’d like to know more about switching between Xcopri and Keppra. They can give you additional details and determine the treatment plan for your situation. Even if two drugs treat the same condition or are in the same drug class, your body can still respond to them differently.

It’s important that you do not stop, start, or switch any of your drug treatments without your doctor’s recommendation.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.