For young adults, Keppra is usually started at 500 milligrams (mg) twice daily. The dosage can be increased by 1,000 mg per day every two weeks, up to 4,000 mg daily (divided into 2 doses) if that much is needed for seizure control and if side effects are not troublesome.

People over age 65 generally need to start at a lower dose (usually 125 mg once or twice a day). Their final daily dosage will also be lower. Similarly, doses in people with kidney disorders should be reduced by 50% compared to other young adults.

The doctor occasionally may suggest checking the level of medication in the blood to see whether it falls within the range that is usually considered appropriate for the dose used (the "therapeutic level"). No therapeutic level has been established for Keppra, however, so whether the dosage of Keppra needs to be adjusted generally depends on whether seizures or side effects are occurring.