LEVETIRACETAM
(Keppra)Standard Prescription
levitiracetam __ mg PO / IV___ (frequency) (__ mg/kg/24 hr)
Dosages
Seizures:
Children > 1 month:
Refractory status epileticus:
Children > 1 month:
Initial: 5-10 mg/kg/dose PO/IV BID.
Increase dose by: 5-10 mg/kg/dose PO/IV BID every 3-7 days.
Maintenance: 15-30 mg/kg/dose PO/IV BID.
Maximum: 50 mg/kg/dose PO/IV BID or 1500 mg/dose PO/IV BID, whichever is less.
Adolescents:
Initial: 250 mg/dose PO/IV BID.
Increase dose by: 250 mg/dose PO/IV BID every 3-7 days.
Maintenance: 500-1500 mg/dose PO/IV BID.
Maximum: 1500 mg/dose PO/IV BID
Refractory status epileticus:
60 mg/kg/dose IV once
(Max: 4500 mg/dose).
(Consider lower dose if patient already on maintenance therapy).
Mechanism of Action
Anticonvulsant
Forms Supplied
tablets: 250 mg, 500 mg, 750 mg (tablets are scored and can be crushed).
suspension (BCCH): 50 mg/mL
injection: 100 mg/mL
Comments
IV form restricted to status epilepticus or patients already taking levetiracetam who are unable to take enteral medication.
Rapid titration can be used to control seizures.
Dose adjustment required in renal impairment.
Children < 12 years old appear to have a clearance 40% greater than adults.
Adverse effects similar with injectable and enteral forms of levetiracetam.
Common adverse effects: behavioural problems, headache, drowsiness, weakness, nausea, vomiting.
Rare adverse effect: psychosis.
Beneficial for generalized and focal seizures (exempting absence) and myoclonus.
Rapid titration can be used to control seizures.
Dose adjustment required in renal impairment.
Children < 12 years old appear to have a clearance 40% greater than adults.
Adverse effects similar with injectable and enteral forms of levetiracetam.
Common adverse effects: behavioural problems, headache, drowsiness, weakness, nausea, vomiting.
Rare adverse effect: psychosis.
References
32, 44, 334, 335, 336, 557
Last Edited
2022-07-04 19:14:12