II. Indications
- Status Epilepticus
-
Seizure Prophylaxis
- Focal onset Seizures (FDA Approved)
- Juvenile Myoclonic Epilepsy (FDA approved for ages >12 years)
- Primary Generalized Tonic Clonic Seizures (FDA approved for ages >6 years)
III. Mechanism
- Broad spectrum anticonvulsant
- Binds Glycoprotein 2A at the synaptic Vesicle and may alter Vesicle fusion
- May also affect Gamma-Aminobutyric Acid (GABA)
IV. Dosing: Seizure Prophylaxis in Adults
- Start: 1000 mg/day orally divided twice daily
- Titrate every 2 weeks (increase dose by 1000 mg)
- Typical target dose: 3000 mg/day (or 80 mg/kg/day) divided twice daily
- Target serum concentration: 12 to 46 mcg/ml
- Maximum: 4000 mg/day
- Intravenous infusion dose is bioequivalent to oral dose
- Load: 20-30 mg/kg IV at 5 mg/kg/min
V. Dosing: Status Epilepticus
- Dose: 60 mg/kg IV (or 2.5 g in adults, up to 4.5 g maximum) over 5 to 15 min for single dose
VI. Adverse Effects
- Most common
- Psychiatric symptoms
- Agitation
- Anxiety
- Depressed mood
- Other symptoms
- Irritability
- Rash
VII. Safety
- Safe in children
- Pregnancy Category C
VIII. References
- LoVecchio and Pringle (2018) Crit Dec Emerg Med 32(12): 28
- Liu (2017) Am Fam Physician 96(2): 87-96 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
| levetiracetam (on 5/31/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| LEVETIRACETAM 1,000 MG TABLET | Generic | $0.29 each |
| LEVETIRACETAM 100 MG/ML SOLN | Generic | $0.04 per ml |
| LEVETIRACETAM 250 MG TABLET | Generic | $0.09 each |
| LEVETIRACETAM 500 MG TABLET | Generic | $0.10 each |
| LEVETIRACETAM 750 MG TABLET | Generic | $0.17 each |
| LEVETIRACETAM ER 500 MG TABLET | Generic | $0.40 each |
| LEVETIRACETAM ER 750 MG TABLET | Generic | $0.54 each |
| keppra (on 2/22/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| KEPPRA 1,000 MG TABLET | Generic | $0.29 each |
| KEPPRA 100 MG/ML ORAL SOLN | Generic | $0.04 per ml |
| KEPPRA 250 MG TABLET | Generic | $0.09 each |
| KEPPRA 500 MG TABLET | Generic | $0.10 each |
| KEPPRA 750 MG TABLET | Generic | $0.17 each |
| KEPPRA XR 500 MG TABLET | Generic | $0.40 each |
| KEPPRA XR 750 MG TABLET | Generic | $0.54 each |