Adult Dosing
Adjunctive therapy in the treatment of partial onset seizures
- Initial dose: 1000 mg/day IV, divided as 500 mg every 12 hrs
- Titrate dose: Increase 1,000 mg/day IV q2 wks
- Max: 3,000 mg/day
Myoclonic seizures in patients with juvenile myoclonic epilepsy
- Initial dose: 1000 mg/day IV, divided as 500 mg every 12 hrs
- Titrate dose: Increase 1,000 mg/day IV q2 wks
- Max: 3,000 mg/day
Primary generalized tonic-clonic seizures
- Initial dose: 1000 mg/day IV, divided as 500 mg every 12 hrs
- Titrate dose: Increase 1,000 mg/day IV q2 wks
- Max: 3,000 mg/day
Status Epilepticus [Non-FDA Approved]
- 20 mg/kg IV infused over 5 minutes. This can be repeated with a total of up to 60 mg/kg with maximum cumulative dose of 3000 mg
Pediatric Dosing
Adjunctive therapy in the treatment of partial onset seizures
- >16 yrs: Initial dose: 1000 mg/day IV, divided as 500 mg every 12 hrs
- Titrate dose: Increase 1,000 mg/day IV q2 wks
- Max: 3,000 mg/day
Myoclonic seizures in patients with juvenile myoclonic epilepsy
- >16 yrs: Initial dose: 1000 mg/day IV, divided as 500 mg every 12 hrs
- Titrate dose: Increase 1,000 mg/day IV q2 wks
- Max: 3,000 mg/day
Primary generalized tonic-clonic seizures
- >16 yrs: Initial dose: 1000 mg/day IV, divided as 500 mg every 12 hrs
- Titrate dose: Increase 1,000 mg/day IV q2 wks
- Max: 3,000 mg/day
Status Epilepticus [Non-FDA Approved]
- 20 mg/kg IV infused over 5 minutes. This can be repeated with a total of up to 60 mg/kg with maximum cumulative dose of 3000 mg
[Outline]
Renal Dose Adjustment (Based on CrCl)
- > 80 mL/min: 500 - 1,500 mg q12 hrs
- 50-80 mL/min: 500 - 1,000 mg q12 hrs
- 30-50 mL/min: 250 - 750 mg q12 hrs
- < 30 mL/min: 250 - 750 mg q12 hrs
- ESRD patients using dialysis: 500 - 1,000 mg daily; supplemental dose: 250 - 500 mg following dialysis
Hepatic Dose Adjustment
- Hepatic impairment: No dose adjustment
- Monitor hematologic abnormalities during therapy as cases of decreased hemoglobin or hematocrit have been reported
- Levetiracetam may increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication
- Epilepsy and many other illnesses for which anti-epileptic drugs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior
- Carefully weigh risk vs benefit and observe all patients for clinical worsening, suicidality or unusual changes in behavior; advise family and caregivers for need of close supervision
- It is recommended to withdraw the drug slowly to prevent withdrawal seizures
- At the end of the intravenous treatment period, the patient may be switched to levetiracetam oral administration at the equivalent daily dosage and frequency of the intravenous administration
Cautions: Use cautiously in
- Renal impairment
- Psychiatric disorder
Pregnancy Category:C
Breastfeeding: Excreted in small amounts in breast milk; hence would not be expected to cause any adverse effects in breastfed infants especially if the infant is older than 2 months. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 11 January 2011).According to manufacturer data, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
US Trade Name(s)
US Availability
levetiracetam (generic)
- INJ: 100 mg/mL (5 mL vial)
levetiracetam in NaCl (generic)
- INJ: 500 mg/100 mL
- INJ: 1000 mg/ 100 mL
- INJ: 1500 mg/100 mL
Keppra
- INJ: 100 mg/mL (5 mL vial)
Canadian Trade Name(s)
Canadian Availability
UK Trade Name(s)
UK Availability
Keppra
- INJ: 100 mg/mL (5 mL vial)
Australian Trade Name(s)
Australian Availability
Keppra
- INJ: 100 mg/mL (5 mL vial)
[Outline]