Oral/IV For IV use, administer as 15 min IV infusion. MonotherapyAdult & adolescent ≥16 yr Initially 250 mg bid, may be increased to 500 mg bid after 2 wk. May be further increased by 250 mg bid every 2 wk. Max: 1,500 mg bid. Add on therapyAdult (≥18 yr) & adolescent (12-17 yr) weighing ≥50 kg Initially 500 mg bid. May be increased up to 1,500 mg bid. May increase or decrease 500 mg bid every 2-4 wk. Childn weighing ≥50 kg Same dose as adult. Childn (4-11 yr) & adolescent (12-17 yr) weighing <50 kg Initially 10 mg/kg bid. May be increased up to 30 mg/kg bid. Dose changes should not exceed increments or decrements of 10 mg/kg bid every 2 wk. Dose recommendations (starting dose: 10 mg/kg bid, max dose: 30 mg/kg bid): Childn & adolescent weighing ≥50 kg 500-1,500 mg bid, 25 kg 250-750 mg bid, 20 kg 200-600 mg bid, 15 kg 150-450 mg bid. Switching from or to oral levetiracetam Initial total daily dose of IV should be equiv to daily dose & frequency of oral levetiracetam. May switch back to oral levetiracetam at equiv daily dose & frequency of administered IV after completion of IV treatment. Renal impairment: Adult & adolescent weighing ≥50 kg w/ normal CrCl >80 mL/min/1.73 m2 500-1,500 mg bid, mild CrCl 50-79 mL/min/1.73 m2 500-1,000 mg bid, moderate CrCl 30-49 mL/min/1.73 m2 250-750 mg bid, severe CrCl <30 mL/min/1.73 m2 250-500 mg bid, ESRD undergoing dialysis 750 mg loading dose on 1st day, followed by 500-1,000 mg once daily & recommended 250-500 mg supplemental dose following dialysis. Childn & adolescent weighing <50 kg w/ normal CrCl >80 mL/min/1.73 m2 10-30 mg/kg bid, mild CrCl 50-79 mL/min/1.73 m2 10-20 mg/kg bid, moderate CrCl 30-49 mL/min/1.73 m2 5-15 mg/kg bid, severe CrCl <30 mL/min/1.73 m2 5-10 mg/kg bid, ESRD undergoing dialysis 15 mg/kg loading dose on 1st day, followed by 10-20 mg/kg once daily & recommended 5-10 mg/kg supplemental dose following dialysis. Severe hepatic impairment Reduce 50% of daily maintenance dose when CrCl is <60 mL/min/1.73 m2.
Discontinue therapy at 1st sign of rash; if signs or symptoms of anaphylaxis or angioedema occur. Permanently discontinue therapy if manifestations suggestive of SJS or TEN occur; if alternative etiology cannot be identified. Increased risk of suicidal behavior or ideation. Anxiety, agitation, hostility, hypomania & mania. Hematologic abnormalities (eg, decreased RBC, WBC & neutrophil counts); agranulocytosis, leukopenia, neutropenia, pancytopenia, thrombocytopenia. Avoid abrupt discontinuation; alcohol intake. Monitor patients for adverse neuropsychiatric effects eg, somnolence & fatigue, coordination difficulties & behavioral/psychiatric abnormalities. Perform CBC in patients w/ signs or symptoms of hematologic abnormalities eg, severe weakness, pyrexia, recurrent infections & coagulation disorders during therapy. May impair ability to drive or operate machinery. Liver & renal disease. May gradually decrease plasma levels of levetiracetam in pregnant women (during 3rd trimester). Closely monitor pregnant patients & throughout postpartum period, especially if dose is adjusted during pregnancy. Lactation. Monitor patients <4 yr for increased diastolic BP during therapy. Ped patients <1 mth for management of partial onset seizure; <12 yr for management of myoclonic seizures; <6 yr for management of primary generalized tonic-clonic seizure; <16 yr for NaCl inj. Behavioral abnormalities eg, paranoia, confusional state & increased aggression in ped patients 4-16 yr w/ partial onset seizures. Monotherapy in childn & adolescents <16 yr.
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