Drug & supplement interaction

Beta-hydroxybutyrate (bhb) + Levetiracetam

Levetiracetam brand names: Keppra, Elepsia XR, Spritam.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 27, 2026
The bottom line No known interaction

We found no known interaction between Beta-hydroxybutyrate (bhb) and Levetiracetam in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first.

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Interaction report

Beta-hydroxybutyrate (bhb) and Levetiracetam

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Levetiracetam and Beta-hydroxybutyrate (bhb) in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

Worth understanding: our licensed dataset holds no drug-interaction record for Beta-hydroxybutyrate (bhb) at all — not against Levetiracetam, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Beta-hydroxybutyrate (bhb) safety at a glance

Beta-hydroxybutyra... overall Use caution Generally tolerated short-term but may cause stomach upset and adds significant minerals or sodium; long-term safety is not well studied.
Pregnancy Avoid Not enough safety data; avoid during pregnancy unless your doctor advises otherwise.
Breastfeeding Avoid Not enough safety data; best to avoid while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Levetiracetam and Beta-hydroxybutyrate (bhb)? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

What Beta-hydroxybutyrate (bhb) Itself Has Been Linked To

This is not an interaction — nothing below involves Levetiracetam. It is the side-effect record for Beta-hydroxybutyrate (bhb) on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Beta-hydroxybutyrate (bhb), this list is the first place to look. One entry is worth acting on rather than waiting out — marked below.

  • Dehydration Worth acting on Additional detail

    “Orally, BHB has been reported to cause mild dehydration. This is possibly due to the use of the sodium salt of BHB resulting in increased sodium intake.”

    Beta-hydroxybutyrate (bhb) · Natural Medicines adverse-effect record, reported in dehydration.

    2 sources cited
    1. 96084. Gautschi M, Weisstanner C, Slotboom J, Nava E, Zürcher T, Nuoffer JM. Highly efficient ketone body treatment in multiple acyl-CoA dehydrogenase deficiency-related leukodystrophy. Pediatr Res. 2015;77(1-1):91-8. PubMed
    2. 96085. Van Rijt WJ, Heiner-Fokkema MR, du Marchie Sarvaas GJ, et al. Favorable outcome after physiologic dose of sodium-D,L-3-hydroxybutyrate in severe MADD. Pediatrics. 2014;134(4):e1224-8.
  • Bloating or gas / Constipation / Stomach pain Additional detail

    “Orally, BHB may cause indigestion, diarrhea, nausea, gastrointestinal upset, and vomiting in some patients. In a small crossover study, nausea, diarrhea, and vomiting were reported in 37%, 16%, and 11% of patients, respectively, taking two 0.38 gram/kg doses of BHB salts separated by 45 minutes on a single day.”

    Beta-hydroxybutyrate (bhb) · Natural Medicines adverse-effect record, reported in constipation.

    4 sources cited
    1. 96084. Gautschi M, Weisstanner C, Slotboom J, Nava E, Zürcher T, Nuoffer JM. Highly efficient ketone body treatment in multiple acyl-CoA dehydrogenase deficiency-related leukodystrophy. Pediatr Res. 2015;77(1-1):91-8. PubMed
    2. 96096. Gross EC, Sandor P, Fischer D. Preliminary data on exogenous ketone bodies in migraine prevention. Cephalalgia 2017; 37(1S) 52-171.
    3. 102024. Evans M, Patchett E, Nally R, Kearns R, Larney M, Egan B. Effect of acute ingestion of β-hydroxybutyrate salts on the response to graded exercise in trained cyclists. Eur J Sport Sci. 2018;18(3):376-86.
    4. 96088. Clarke K, Tchabanenko K, Pawlosky R, et al. Kinetics, safety and tolerability of (R)-3-hydroxybutyl (R)-3-hydroxybutyrate in healthy adult subjects. Regul Toxicol Pharmacol. 2012;63(3):401-8. PubMed
  • Stomach upset / Diarrhea / Vomiting / Nausea Additional detail

    Recorded for Beta-hydroxybutyrate (bhb) in the same Natural Medicines adverse-effect record shown under Dehydration above.

Everything above comes from the Natural Medicines adverse-effect record for Beta-hydroxybutyrate (bhb) — expand a row for the licensed statement it rests on. We read the ADVERSE REACTIONS section of Levetiracetam’s FDA label too, and the two lists don’t meaningfully overlap — which is why no Levetiracetam column appears here.

Overlapping uses

What Levetiracetam Is Prescribed For, and What Beta-hydroxybutyrate (bhb) Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Levetiracetam is a prescription medicine with approved uses on its FDA label. Beta-hydroxybutyrate (bhb) is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Levetiracetam is prescribed for: Levetiracetam treats partial-onset seizures (seizures that start in one area of the brain). Many products also add it to other medicines for myoclonic seizures in juvenile myoclonic epilepsy and for primary generalized tonic-clonic seizures in idiopathic generalized epilepsy. Approved ages and uses differ by product. Extended-release products (Keppra XR, Elepsia XR, Levetiracetam ER) are only for partial-onset seizures in ages 12 and older.

Read the rest of what Levetiracetam is prescribed for

The injection is used when swallowing medicine by mouth is temporarily not possible.

Beta-hydroxybutyrate (bhb) has been studied for:

  • Epilepsy studied, not established Beta-hydroxybutyrate (bhb) has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Beta-hydroxybutyrate (bhb) for epilepsy

    Although there is interest in using oral BHB for epilepsy, there is insufficient reliable information about the clinical effects of BHB for this condition.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Levetiracetam on your own; if you are taking Beta-hydroxybutyrate (bhb) for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Beta-hydroxybutyrate (bhb) or Levetiracetam

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Beta-hydroxybutyrate (bhb) or Levetiracetam, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Levetiracetam

This page covers Beta-hydroxybutyrate (bhb) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Levetiracetam page lists 105 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Kava (major).

By severity: 7 major · 82 moderate · 16 minor.

From our pharmacist’s overview on the Levetiracetam page

“I would read this page carefully rather than casually. Levetiracetam (Keppra, Spritam) controls seizures, and both hazards on this list run through that fact.”

Reviewed by 2 · Jul 18, 2026

Open the Levetiracetam interaction page

How much people look this up

Where Beta-hydroxybutyrate (bhb) and Levetiracetam Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Beta-hydroxybutyrate (bhb)
Steady interest

#1,446 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Levetiracetam
Top 10%

#244 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Beta-hydroxybutyrate (bhb) reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 27, 2026. The Beta-hydroxybutyrate (bhb) and Levetiracetam records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Beta-hydroxybutyrate (bhb)

What is Beta-hydroxybutyrate (bhb)?

Beta-hydroxybutyrate (bhb)
  • Weight loss and fat burning
  • Boosting energy on a ketogenic diet
  • Athletic and exercise performance
  • Mental focus and clarity
  • Reducing 'keto flu' symptoms

Beta-hydroxybutyrate (BHB) is a ketone body your liver naturally makes when carbs are low, and it is sold as a supplement marketed for weight loss, energy, and athletic performance. Despite bold marketing claims, human evidence that BHB supplements help with weight loss or performance is limited and mixed. If you want to try it, talk with your pharmacist or doctor first, especially if you have kidney, heart, or blood pressure concerns.

Not applicable (a ketone body made by the body or produced as a synthetic salt) · Capsules, powders, drink mixes (often as BHB salts bound to sodium, calcium, magnesium, or potassium; also BHB esters)

An interaction check asks whether these two react with each other — it does not ask whether Beta-hydroxybutyrate (bhb) is a good idea for someone in your situation. Here is what our Beta-hydroxybutyrate (bhb) record says about it on its own.

Beta-hydroxybutyrate (bhb): dosing

There is no official, standardized dose of BHB. Products vary widely in how much BHB they contain and which minerals they are paired with.The best approach is to follow the directions on the product label and not exceed them. Many people start with a smaller amount to see how their stomach reacts before using more.Because mineral content matters, check how much sodium, calcium, magnesium, or potassium each serving provides.

From our Beta-hydroxybutyrate (bhb) monograph — the full record covers uses, side effects and every documented interaction.

Read the full Beta-hydroxybutyrate (bhb) monograph & all interactions
Medication

About Levetiracetam

What Is Levetiracetam Used For?

Brand names: Keppra, Elepsia XR, Spritam

Levetiracetam treats partial-onset seizures (seizures that start in one area of the brain). Many products also add it to other medicines for myoclonic seizures in juvenile myoclonic epilepsy and for primary generalized tonic-clonic seizures in idiopathic generalized epilepsy.

Approved ages and uses differ by product. Extended-release products (Keppra XR, Elepsia XR, Levetiracetam ER) are only for partial-onset seizures in ages 12 and older. The injection is used when swallowing medicine by mouth is temporarily not possible.

See full Levetiracetam drug information
Keep checking

Other Drugs & Beta-hydroxybutyrate (bhb)

Browse every other medication we’ve checked against Beta-hydroxybutyrate (bhb) — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

We also checked Beta-hydroxybutyrate (bhb) against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Beta-hydroxybutyrate (bhb) list.

See the full Beta-hydroxybutyrate (bhb) interactions page
See every supplement checked against Levetiracetam, ranked by severity
Evidence & sources

Beta-hydroxybutyrate (bhb) References

The 6 references that drive our Beta-hydroxybutyrate (bhb) monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Gautschi M, Weisstanner C, Slotboom J, Nava E, Zürcher T, Nuoffer JM. Highly efficient ketone body treatment in multiple acyl-CoA dehydrogenase deficiency-related leukodystrophy. Pediatr Res. 2015;77(1-1):91-8. PubMed
  2. Van Rijt WJ, Heiner-Fokkema MR, du Marchie Sarvaas GJ, et al. Favorable outcome after physiologic dose of sodium-D,L-3-hydroxybutyrate in severe MADD. Pediatrics. 2014;134(4):e1224-8.
  3. Clarke K, Tchabanenko K, Pawlosky R, et al. Kinetics, safety and tolerability of (R)-3-hydroxybutyl (R)-3-hydroxybutyrate in healthy adult subjects. Regul Toxicol Pharmacol. 2012;63(3):401-8. PubMed
  4. Gross EC, Sandor P, Fischer D. Preliminary data on exogenous ketone bodies in migraine prevention. Cephalalgia 2017; 37(1S) 52-171.
  5. Evans M, Patchett E, Nally R, Kearns R, Larney M, Egan B. Effect of acute ingestion of β-hydroxybutyrate salts on the response to graded exercise in trained cyclists. Eur J Sport Sci. 2018;18(3):376-86.
  6. Malhi MS, Duerson F, Salabei JK, Okonoboh P. Starvation Ketoacidosis Induced by Ketogenic Diet and Consumption of Ketone Supplement. Cureus. 2021;13(6):e15778. Published 2021 Jun 20. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Beta-hydroxybutyrate (bhb) and Levetiracetam Together: Common Questions

Is it safe to take Beta-hydroxybutyrate (bhb) with Levetiracetam?
We do not list a known interaction between Beta-hydroxybutyrate (bhb) and Levetiracetam. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Are Beta-hydroxybutyrate (bhb) and Levetiracetam used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Beta-hydroxybutyrate (bhb) in each. That is a conversation for your prescriber, especially if Levetiracetam is being adjusted to a target.
Does Levetiracetam interact with any supplements?
Yes. Levetiracetam has documented interactions with 105 supplements in our database — Beta-hydroxybutyrate (bhb) is not one of them. The Levetiracetam interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Beta-hydroxybutyrate (bhb) monograph Uses, safety profile, and every drug interaction in one place Levetiracetam drug information The full plain-English guide to this medication Levetiracetam supplement interactions Every supplement checked against Levetiracetam, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 6 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Levetiracetam and Beta-hydroxybutyrate (bhb)?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.