Levetiracetam: Difference between revisions
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==Adult Dosing== | ==Adult Dosing== | ||
*Partial seizures, adjunct | *[[Status Epilepticus]] | ||
**20-40mg/kg IV loading dose | |||
*Partial [[seizures]], adjunct | |||
**500-1500mg PO/IV q12h. | **500-1500mg PO/IV q12h. | ||
***Start 500 q12 or 1000 QD, inc by 1000mg/day q2wk | ***Start 500 q12 or 1000 QD, inc by 1000mg/day q2wk | ||
***Max 3000mg/day | ***Max 3000mg/day | ||
*Generalized tonic clonic seizures, adjunct | *Generalized tonic clonic [[seizures]], adjunct | ||
**1500mg PO/IV q12h | **1500mg PO/IV q12h or | ||
***Start 500 q12, inc by 1000mg/day q2wk | ***Start 500 q12, inc by 1000mg/day q2wk | ||
***Max 3000mg/day | ***Max 3000mg/day | ||
Latest revision as of 13:48, 19 April 2021
General
- Type: Anticonvulsants
- Dosage Forms: PO 250mg, 500mg, 750mg, 1000mg; 500mg ER, 750mg ER; IV 100mg/mL
- Common Trade Names: Keppra
Adult Dosing
- Status Epilepticus
- 20-40mg/kg IV loading dose
- Partial seizures, adjunct
- 500-1500mg PO/IV q12h.
- Start 500 q12 or 1000 QD, inc by 1000mg/day q2wk
- Max 3000mg/day
- 500-1500mg PO/IV q12h.
- Generalized tonic clonic seizures, adjunct
- 1500mg PO/IV q12h or
- Start 500 q12, inc by 1000mg/day q2wk
- Max 3000mg/day
- 1500mg PO/IV q12h or
Pediatric Dosing
- Partial seizures, adjunct
- 4-15 yo
- 60mg/kg/day PO divided bid
- Start 20mg/kg/day PO divided bid, inc by 20mg/kg/day q2wk
- Max 3000mg/day
- >16 yo
- 500-1500mg PO/IV q12h.
- Start 500 q12 or 1000 QD, inc by 1000mg/day q2wk
- Max 3000mg/day
- 4-15 yo
- Generalized tonic clonic seizures, adjunct
- 6-15 yo
- 60mg/kg/day PO divided bid
- Start 20mg/kg/day PO divided bid, inc by 20mg/kg/day q2wk
- Max 3000mg/day
- >16 yo
- 1500mg PO/IV q12h
- Start 500 q12, inc by 1000mg/day q2wk
- Max 3000mg/day
- 6-15 yo
Special Populations
- Pregnancy Rating: C
- Lactation: probably safe
- Renal Dosing
- Adult
- CrCl 50-80: 500-1000mg q12h IR; 1000-2000mg QD ER
- CrCl 30-50: 250-750mg q12h IR; 500-1500mg QD ER
- CrCl <30: 250-500mg q12h; 500-1000mg QD ER
- HD: 500-1000mg q24h IR, do not use ER
- Pediatric
- CrCl <50, IR: decrease dose 50%
- CrCl 50-80: 1000-2000mg QD ER
- CrCl 30-50: 500-1500mg QD ER
- CrCl <30: 500-1000mg QD ER
- Adult
- Hepatic Dosing: no adjustment
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
- Depression
- Hostility
- Aggressive behavior
- Psychosis
- Suicidality
- Leukopenia
- Neutropenia
- Drug rash with eosinophilia and systemic sx
- Stevens-Johnson
- Toxic epidermal necrolysis
- Erythema multiforme
- withdrawal seizures if abrupt discharge
Common
- Somnolence
- Asthenia
- Vomiting
- Headache
- URI sx
- Anorexia
- Infection
- Hostility
- Fatigue
- Nervousness
- Dizziness
- Diarrhea
- Behavioral changes
- Irritability
- Pain
- Agitation
- Emotional lability
- Depression
- Nausea
- Vertigo
- Ataxia
- Leukopenia
- Neutropenia
- Anxiety
- Confusion
- Amnesia
- Alopecia
Pharmacology
- Half-life: 6-8h
- Metabolism: hydrolysis minimally
- Excretion: urine
- Mechanism of Action: exact mechanism unknown
See Also
References
epocrates