se of an intercurrent illness. For those patients, the IV dosage used was equivalent to their previous oral regimen. For acute repetitive seizures or SE, levetiracetam was administered every 8 hours in infants and every 12 hours in older children; for maintenance or prophylactic therapy, an every 12 hours dosage schedule was used for all patients. No adverse effects were reported. The authors note that the majority of patients were very ill, and therefore adverse effects such as sedation or behavioral problems may have been overlooked.
For the adjunctive treatment of primary generalized tonic-clonic seizures in those with idiopathic generalized epilepsy.
Oral dosage (immediate-release tablets and oral solution [Keppra and generic equivalents])
Adults and Adolescents 16 years and older
Initially, 500 mg PO twice daily. Increase the dose every 2 weeks by 500 mg/dose (i.e., 1,000 mg/day) increments to the recommended dosage of 1,500 mg PO twice daily. Max: 3,000 mg/day. It is unknown whether doses lower than 3,000 mg/day are effective.
Children and Adolescents 6 to 15 years
Initially, 10 mg/kg/dose PO twice daily. Increase the dose every 2 weeks by 10 mg/kg/dose (i.e., 20 mg/kg/day) increments to a recommended dose of 30 mg/kg/dose PO twice daily rounded to the nearest whole tablet size. Max: 3,000 mg/day. It is unknown whether doses lower than 60 mg/kg/day are effective. If body weight 20 kg or less, administer oral solution; if body weight more than 20 kg, administer either solution or tablets.
Infants† and Children younger than 6 years†
Safety and efficacy have not been established. Initial doses of 5 to 10 mg/kg PO twice daily titrated to a mean daily dose of 30 to 50 mg/kg/day PO divided twice daily have been used in multiple retrospective reviews, controlled trials, and case series that include over 360 infants and children younger than 4 years of age. However, a wide dosage range has been used (9 to 139 mg/kg/day PO). One prospective, observational study of 285 pediatric patients ages 0 to 17 years with refractory epilepsy reported that the majority of patients that responded to levetiracetam did so at doses in the 30 to 40 mg/kg/day range. Infants and young children were included in this study, but their data were not reported separately.
Oral dosage (fast-melting tablets [Spritam])
Adults, Adolescents, and Children 6 years and older weighing more than 40 kg
Initially, 500 mg PO twice daily. Increase the dose every 2 weeks by 500 mg/dose (i.e., 1000 mg/day) increments to a maximum recommended dosage of 1500 mg PO twice daily (Max: 3000 mg/day). The effectiveness of doses lower than 3000 mg/day has not been adequately studied.
Adolescents and Children 6 years and older weighing 20 to 40 kg
Initially, 250 mg PO twice daily. Increase the dose every 2 weeks by 250 mg/dose (i.e., 500 mg/day) increments to a maximum recommended dose of 750 mg PO twice daily (Max: 1,500 mg/day).
Intravenous dosage
Adults and Adolescents 16 years and older
Initially, 500 mg IV twice daily. Increase the dose every 2 weeks by 500 mg/dose (i.e., 1,000 mg/day) increments to the recommended dose of 1,500 mg IV twice daily. Max: 3,000 mg/day. It is unknown if doses lower than 3,000 mg/day are effective.
Children and Adolescents 6 to 15 years
Initially, 10 mg/kg/dose IV twice daily. Increase the dose every 2 weeks by 10 mg/kg/dose (i.e., 20 mg/kg/day) increments to the recommended dosage of 30 mg/kg/dose IV twice daily. Max: 3,000 mg/day. It is unknown whether doses lowe |
