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
- 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
| kg | ||
| Mode: | ||
| Weight: | ||
| Cefazolin for fractures/prophylaxis |
| Presentation: /mL |
| Calculated dose: in |
Adult (IV)
- 30mg/kg (rounded up to nearest 5kg) over 15 minutes
- Single dose only
- Maximum total dose 3g
Paediatric
- 40mg/kg (rounded up to nearest 5kg) over 15 minutes
- Single dose only
- Maximum total dose 3g
Adult
- 1000mg (1g) IV loading dose
- Single dose only
Paediatric
- 40mg/kg (rounded up to nearest 5kg) over 15minutes
- Single dose only
- Total maximum dose of 3g
Side Effects:
- Drowsiness
- Dizziness
- Headache
- Fatigue
500mg vial in 5ml
| Settings | |
|---|---|
| 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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