Levetiracetam (Keppra) is a second generation, non-sedating anticonvulsant medication used to treat epileptic seizures. It is also commonly prescribed for seizure prophylaxis in patients with traumatic brain injuries1.

Onset (IV) Rapid
Peak 30mins – 2 hours
Duration (IV) 1 – 2 days
Half-life 6 – 8 hours
  • Convulsive status epilepticus continuing > 20 minutes post first midazolam administration
  • Prophylaxis of post-traumatic seizures in moderate to severe head injuries (GCS <13)2

Absolute contraindications:

  • Known allergy AND/OR adverse reaction
  • Patient < 1 year old

Relative contraindications:

  • Toxicological related seizures – ASMA consult required
 Precautions / Notes
  • All cannula and IV lines must be flushed thoroughly with 0.9% NaCl following each medication administration
  • If patient is currently on anticonvulsant therapy, the following protocol is still valid
  • Prepare the required dose of levetiracetam in an appropriately sized syringe.
  • Inject preparation into a 50ml syringe of 0.9% NaCl and administer over 15 minutes
 Weight-based Calculations
Cefazolin for fractures/prophylaxis
Presentation: /mL
Calculated dose:  in

Critical Care
Convulsive Status Epilepticus

Adult (IV)

  • 30mg/kg (rounded up to nearest 5kg) over 15 minutes
  • Single dose only
  • Maximum total dose 3g


  • 40mg/kg (rounded up to nearest 5kg) over 15 minutes
  • Single dose only
  • Maximum total dose 3g
Seizure prophylaxis in traumatic brain injury


  • 1000mg (1g) IV loading dose
  • Single dose only


  • 40mg/kg (rounded up to nearest 5kg) over 15minutes
  • Single dose only
  • Total maximum dose of 3g
 Special Considerations

Side Effects:

  • Drowsiness
  • Dizziness
  • Headache
  • Fatigue

500mg vial in 5ml

Current mode:
Extended Care:
Colour assist:


Bakr A &  Belli A. 2018. A systematic review of levetiracetam versus phenytoin in the prevention of late post-traumatic seizures and survey of UK neurosurgical prescribing practice of antiepileptic medication in acute traumatic brain injury, British Journal of Neurosurgery;32(3): 237-244, DOI: 10.1080/02688697.2018.1464118

Nichol H, Boyd J, Trier J. 2020. Seizure prophylaxis following moderate to severe traumatic brain injury: Retrospective investigation of Clinical Practice and the Impact of clinical Guidelines. Cureus; 12(4):e7709. Doi:10.7759/cureus.7709.

Prescribers Digital Reference – Levetiracetam. www.pdr.net/drug-summary/Keppra-injection-levetiracetam-1055

Brophy GM, Bell R, Classen J et al. 2012. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care. Doi:10/1007/s12028-012-9695-z.

Dalziel S, Borland M, Furyk J, Bonisch M, Neutze J, et al. 2019.Levetiracetam versus phenytoin for second-line treatment of convulsive status epilepticus in children (ConSEPT): an open-label, multicentre, randomised controlled trial. The Lancet: doi.org/10.1016/S0140-6736(19)30722-6

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Head of Clinical Services


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