Drug & supplement interaction

Cocoa + Levetiracetam

Levetiracetam brand names: Keppra, Elepsia XR, Spritam.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Cocoa 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. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Cocoa 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 Cocoa 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.

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.

Cocoa safety at a glance

Cocoa overall Use caution Cocoa in food amounts is generally safe, but it contains caffeine and related stimulants, and chocolate products are often high in sugar and calories.
Pregnancy Possibly Safe When used orally in moderate amounts. However, due to the caffeine content of cocoa preparations, intake should be closely monitored during pregnancy to ensure... Read the full pregnancy detail
Breastfeeding Possibly Safe When used in moderate amounts or in amounts commonly found in foods. Due to the caffeine content of cocoa preparations, intake should be closely monitored while... Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Levetiracetam and Cocoa? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Levetiracetam

Interactions in our licensed database are recorded against drug classes, not just single drug names. Levetiracetam is filed under 3 classifications — anticonvulsants, cns depressants, oral drugs. Cocoa has documented interactions with 37 drug classes — the most serious being ace inhibitors (aceis) (moderate), adenosine (adenocard) (moderate) and alcohol (ethanol) (moderate) — and none of Levetiracetam’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Cocoa Does Interact With Other Medications

Cocoa has 635 moderate, 26 minor known drug interactions in our database — Levetiracetam isn’t one of them. If you take anything else, check it against the full list below.

Moderate 635 Minor 26 No known interaction 2,169 (incl. Levetiracetam)
Taking anything else?

Check Another of Your Medications Against Cocoa

Covers the 2,830 medications we’ve checked against Cocoa. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Cocoa and Levetiracetam May Share a Side Effect

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • Headache Additional detail

    Cocoa

    “In some cases, when taken orally, cocoa can cause shakiness and might trigger migraine and other headaches.”

    Cocoa · Natural Medicines adverse-effect record, reported in migraine headache.

    3 sources cited
    1. 13161. Vlachopoulos C, Aznaouridis K, Alexopoulos N, et al. Effect of dark chocolate on arterial function in healthy individuals. Am J Hypertens 2005;18:785-91.. PubMed
    2. 42169. Ried, K., Sullivan, T. R., Fakler, P., Frank, O. R., and Stocks, N. P. Effect of cocoa on blood pressure. Cochrane.Database.Syst.Rev. 2012;8:CD008893. PubMed
    3. 92271. Ottaviani JI, Balz M, Kimball J, et al. Safety and efficacy of cocoa fl avanol intake in healthy adults: a randomized, controlled, double-masked trial. Am J Clin Nutr 2015;102(6):1425-35.

    Levetiracetam

    Listed in the ADVERSE REACTIONS section of the FDA label for Levetiracetam. Read the label on DailyMed ›

Reported for Cocoa but not commonly for Levetiracetam: stomach upset, heartburn, constipation and a fast or pounding heartbeat.

Effects for Levetiracetam come from the ADVERSE REACTIONS section of its FDA label; effects for Cocoa come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Cocoa in Pregnancy & Breastfeeding

Pregnancy Possibly Safe

When used orally in moderate amounts. However, due to the caffeine content of cocoa preparations, intake should be closely monitored during pregnancy to ensure moderate consumption. Fetal blood concentrations of caffeine approximate maternal concentrations. Some research has found that intrauterine exposure to even modest amounts of caffeine, based on maternal blood levels during the first trimester, is associated with a shorter stature in children ages 4-8 years. While many cocoa products contain only small amounts of caffeine (about 2-35 mg per serving), unsweetened, dry cocoa powder can contain up to 198 mg of caffeine per cup. According to a review by Health Canada, and a subsequent large meta-analysis conducted in the US, doses of up to 300 mg daily can be consumed during pregnancy without an increased risk of spontaneous abortion, still birth, preterm birth, fetal growth retardation, or congenital malformations. To be on the safe side, cocoa should be used in amounts that provide less than 300 mg of caffeine daily. Keep in mind that only the amount of ADDED caffeine must be stated on product labels. The amount of caffeine found in ingredients such as cocoa, which naturally contains caffeine, does not need to be provided. This can make it difficult to determine the total amount of caffeine in a given product.

Pregnancy Possibly Unsafe

When used orally in large amounts. Caffeine found in cocoa crosses the placenta producing fetal blood concentrations similar to maternal levels. Consumption of caffeine in amounts over 300 mg daily is associated with a significantly increased risk of miscarriage in some studies. Additionally, high intake of caffeine during pregnancy have been associated with premature delivery, low birth weight, and loss of the fetus. While many cocoa products contain only small amounts of caffeine (about 2-35 mg per serving), unsweetened, dry cocoa powder can contain up to 198 mg of caffeine per cup. To be on the safe side, cocoa should be used in amounts that provide less than 300 mg of caffeine daily. Keep in mind that only the amount of ADDED caffeine must be stated on product labels. The amount of caffeine found in ingredients such as cocoa, which naturally contains caffeine, does not need to be provided. This can make it difficult to determine the total amount of caffeine in a given product. Cocoa and dark chocolate products worldwide also contain heavy metals such as lead and cadmium. In the US, one ounce (approximately 28 grams) of most commercially available dark chocolate products tested contained levels of lead and/or cadmium above the maximum allowable dose level for California, with cadmium levels generally increasing with the percentage of cocoa. Large doses or excessive intake of cocoa should be avoided during pregnancy.

Lactation Possibly Safe

When used in moderate amounts or in amounts commonly found in foods. Due to the caffeine content of cocoa preparations, intake should be closely monitored while breastfeeding. During lactation, breast milk concentrations of caffeine are thought to be approximately 50% of serum concentrations. Moderate consumption of cocoa would likely result in very small amounts of caffeine exposure to a nursing infant. Keep in mind that only the amount of ADDED caffeine must be stated on product labels. The amount of caffeine found in ingredients such as cocoa, which naturally contains caffeine, does not need to be provided. This can make it difficult to determine the total amount of caffeine in a given product.

Lactation Possibly Unsafe

When used orally in large amounts. Consumption of excess chocolate (16 oz per day) may cause irritability and increased bowel activity in the infant. Cocoa and dark chocolate products worldwide also contain heavy metals such as lead and cadmium. In the US, one ounce (approximately 28 grams) of most commercially available dark chocolate products tested contained levels of lead and/or cadmium above the maximum allowable dose level for California, with cadmium levels generally increasing with the percentage of cocoa. Large doses or excessive intake of cocoa should be avoided during lactation.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

From our Q&A

Questions About Cocoa 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 Cocoa 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 Cocoa 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

One more smart check

Taking Cocoa as Part of a Dietary Supplement Product? Check It for Interactions

We hold 844 real supplement products containing Cocoa, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cocoa. Even though Cocoa itself has no known interaction with Levetiracetam, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Cocoa 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 Cocoa
Top 25%

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

29 days ago today
Medication Levetiracetam
Top 10%

#251 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 Cocoa reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Cocoa and Levetiracetam records this page draws on were last updated July 11, 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 Cocoa

What is Cocoa?

Cocoa
  • Heart and blood vessel health
  • High blood pressure
  • High cholesterol
  • Mental focus and mood
  • Skin moisturizing (cocoa butter)

Cocoa is rich in plant compounds called flavanols that may modestly support blood vessel function and blood pressure, but most chocolate products are high in sugar, fat, and calories, which can offset any benefit. Enjoy cocoa as part of a balanced diet, and talk to your pharmacist before using concentrated cocoa supplements, especially if you have heart or blood pressure conditions.

Theobroma cacao · Malvaceae · Seeds (cocoa beans), and the butter (fat) and powder made from them · Cocoa powder, dark chocolate, cocoa extract capsules, flavanol-standardized supplements, cocoa butter (topical)

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

Cocoa: dosing

There is no official standard dose for cocoa. Amounts used in research vary widely, and supplements differ in how much flavanol they contain.If you use a cocoa or cocoa flavanol supplement, follow the directions on the product label.

From our Cocoa monograph — the full record covers uses, side effects and every documented interaction.

Read the full Cocoa monograph & all interactions
Medication

About Levetiracetam

What Is Levetiracetam Used For?

Brand names: Keppra, Elepsia XR, Spritam

Levetiracetam is used to treat several types of seizures. It treats partial-onset seizures (seizures that start in one area of the brain) and is used as add-on therapy for myoclonic seizures (sudden, brief muscle jerks) in people with juvenile myoclonic epilepsy aged 12 and older, and for primary generalized tonic-clonic seizures (grand mal seizures) in people with idiopathic generalized epilepsy aged 6 and older.

Age eligibility varies by product. Keppra oral and Roweepra tablets treat partial-onset seizures in patients as young as 1 month. Spritam and levetiracetam tablets for oral suspension treat partial-onset seizures in patients 4 years and older weighing more than 20 kg. Extended-release products — including Elepsia XR, Keppra XR, and Levetiracetam ER — are approved only for partial-onset seizures in patients 12 years and older. Injectable forms are used intravenously when a patient temporarily cannot take oral medication.

Most-Reported Side Effects for Levetiracetam

From FAERS, the FDA’s public side-effect reporting system (0 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Seizure 15,978 reports
Fatigue 5,591 reports
Somnolence 4,177 reports
Epilepsy 4,136 reports
Convulsion 4,085 reports
See full Levetiracetam drug information
Keep checking

Other Drugs & Cocoa

Browse every other medication we’ve checked against Cocoa — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
635Moderate
26Minor
2,168No known interaction
635 Moderate 26 Minor 2,168 No interaction
Moderate

635 interactions

Showing 60 of 635 moderate interactions — see all 635 on the Cocoa page.

Minor

26 interactions

No interaction 2,168 drugs checked — show the list

We also checked Cocoa against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,168 medications checked with no known interaction — see the full Cocoa list.

See the full Cocoa interactions page
See every supplement checked against Levetiracetam, ranked by severity
Evidence & sources

Cocoa References

The 119 references that drive our Cocoa 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. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  4. Burnham TH, ed. Drug Facts and Comparisons, Updated Monthly. Facts and Comparisons, St. Louis, MO.
  5. Harder S, Fuhr U, Staib AH, Wolff T. Ciprofloxacin-caffeine: a drug interaction established using in vivo and in vitro investigations. Am J Med 1989;87:89S-91S. PubMed
  6. Carbo M, Segura J, De la Torre R, et al. Effect of quinolones on caffeine disposition. Clin Pharmacol Ther 1989;45:234-40. PubMed
  7. Healy DP, Polk RE, Kanawati L, et al. Interaction between oral ciprofloxacin and caffeine in normal volunteers. Antimicrob Agents Chemother 1989;33:474-8. PubMed
  8. Mester R, Toren P, Mizrachi I, et al. Caffeine withdrawal increases lithium blood levels. Biol Psychiatry 1995;37:348-50. PubMed
  9. Jefferson JW. Lithium tremor and caffeine intake: two cases of drinking less and shaking more. J Clin Psychiatry 1988;49:72-3.
  10. Joeres R, Klinker H, Heusler H, et al. Influence of mexiletine on caffeine elimination. Pharmacol Ther 1987;33:163-9. PubMed
  11. Vahedi K, Domingo V, Amarenco P, Bousser MG. Ischemic stroke in a sportsman who consumed MaHuang extract and creatine monohydrate for bodybuilding. J Neurol Neurosurg Psychiatr 2000;68:112-3.
  12. Baron AM, Donnerstein RL, Samson RA, et al. Hemodynamic and electrophysiologic effects of acute chocolate ingestion in young adults. Am J Cardiol 1999;84:370-3. PubMed
  13. Friedman G. Diet and the irritable bowel syndrome. Gastroenterol Clin North Am 1991;20:313-24. DOI
  14. The National Toxicology Program (NTP). Caffeine. Center for the Evaluation of Risks to Human Reproduction (CERHR). Available at: http://cerhr.niehs.nih.gov/common/caffeine.html.
  15. Pollock BG, Wylie M, Stack JA, et al. Inhibition of caffeine metabolism by estrogen replacement therapy in postmenopausal women. J Clin Pharmacol 1999;39:936-40. 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 Cocoa and Levetiracetam Together: Common Questions

Is it safe to take Cocoa with Levetiracetam?
We do not list a known interaction between Cocoa 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.
Do Cocoa and Levetiracetam have any of the same side effects?
Yes — our sources link each of them separately to one of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Cocoa and Levetiracetam combination checked?
Interactions in our licensed database are recorded against drug classes. Levetiracetam is filed under 3 classifications, and Cocoa has documented interactions with 37 drug classes — none of Levetiracetam's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Cocoa interact with any other medications?
Yes. Cocoa has 661 documented drug interactions in our database — Levetiracetam is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Levetiracetam interact with any supplements?
Yes. Levetiracetam has documented interactions with 105 supplements in our database — Cocoa 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

Cocoa 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 119 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Levetiracetam and Cocoa?

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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.