levetiracetam

Adult Dosing .

Dosage forms:  TAB: 250 mg, 500 mg, 750 mg, 1000 mg; ER TAB: 500 mg, 750 mg; DISPERSE TAB: 250 mg, 500 mg, 750 mg, 1000 mg; SOL: 100 mg per mL; INJ: various

partial seizures

[500-1500 mg PO/IV q12h]

Start: 500 mg PO/IV q12h, may incr. by 1000 mg/day q2wk; Max: 3000 mg/day; Alt: start 1000 mg ER PO qd, may incr. by 1000 mg/day ER q2wk up to 3000 mg ER PO qd; Info: dose adjustment may be needed during pregnancy and/or postpartum; do not cut/crush/chew tab; taper dose gradually to D/C

juvenile myoclonic epilepsy, adjunct tx

[1500 mg PO/IV q12h]

Start: 500 mg PO/IV q12h, incr. by 1000 mg/day q2wk; Max: 3000 mg/day; Info: dose adjustment may be needed during pregnancy and/or postpartum; do not cut/crush/chew tab; taper dose gradually to D/C

primary generalized tonic clonic seizures, adjunct tx

[1500 mg PO/IV q12h]

Start: 500 mg PO/IV q12h, incr. by 1000 mg/day q2wk; Max: 3000 mg/day; Info: dose adjustment may be needed during pregnancy and/or postpartum; do not cut/crush/chew tab; taper dose gradually to D/C

cyclic vomiting syndrome prophylaxis, moderate-severe (off-label)

[1000-2000 mg/day PO in divided doses]

Start: 250 mg PO bid, incr. by 500 mg/day q2wk; Info: dose adjustment may be needed during pregnancy and/or postpartum; do not cut/crush/chew tab; taper dose gradually to D/C

renal dosing

[immediate-release form, moderate-severe cyclic vomiting syndrome prophylaxis]

renal impairment: decr. usual dose, amount not defined

HD/PD: not defined

[immediate-release form, all other indications]

CrCl 50-80: 500-1000 mg q12h; CrCl 30-50: 250-750 mg q12h; CrCl <30: 250-500 mg q12h

HD: 500-1000 mg q24h; give 250-500 mg as supplement after dialysis; PD: 500-1000 mg q24h; no supplement

[extended-release form]

CrCl 50-80: 1000-2000 mg ER qd; CrCl 30-50: 500-1500 mg ER qd; CrCl <30: 500-1000 mg ER qd

HD/PD: not defined; Info: consider IR form

hepatic dosing

[no adjustment]

Peds Dosing .

Dosage forms:  TAB: 250 mg, 500 mg, 750 mg, 1000 mg; ER TAB: 500 mg, 750 mg; DISPERSE TAB: 250 mg, 500 mg, 750 mg, 1000 mg; SOL: 100 mg per mL; INJ: various

partial seizures

[oral solution or IV form, 1-5 mo]

Dose: 42 mg/kg/day PO/IV divided q12h; Start: 14 mg/kg/day PO/IV divided q12h, incr. by 14 mg/kg/day q2wk; Info: taper dose gradually to D/C

[oral solution or IV form, 6 mo-3 yo]

Dose: 50 mg/kg/day PO/IV divided q12h; Start: 20 mg/kg/day PO/IV divided q12h, incr. by 20 mg/kg/day q2wk; Info: taper dose gradually to D/C

[oral solution or IV form, 4-15 yo]

Dose: 60 mg/kg/day PO/IV divided q12h; Start: 20 mg/kg/day PO/IV divided q12h, incr. by 20 mg/kg/day q2wk; Max: 3000 mg/day; Info: taper dose gradually to D/C

[oral solution or IV form, 16 yo and older]

Dose: 500-1500 mg PO/IV q12h; Start: 500 mg PO/IV q12h, may incr. by 1000 mg/day q2wk; Max: 3000 mg/day; Info: taper dose gradually to D/C

[oral tab, 4-11 yo, 20-40 kg]

Dose: 750 mg PO q12h; Start: 250 mg PO q12h x2wk, then incr. by 500 mg/day q2wk; Max: 1500 mg/day; Info: do not cut/crush/chew tab; taper dose gradually to D/C

[oral tab, 4-11 yo, >40 kg]

Dose: 1500 mg PO q12h; Start: 500 mg PO q12h x2wk, then incr. by 1000 mg/day q2wk; Max: 3000 mg/day; Info: do not cut/crush/chew tab; taper dose gradually to D/C

[oral tab, 12-15 yo, 20-40 kg]

Dose: 750 mg PO q12h; Start: 250 mg PO q12h x2wk, then incr. by 500 mg/day q2wk; Max: 1500 mg/day; Alt: start 1000 mg ER PO qd, may incr. by 1000 mg/day ER q2wk up to 3000 mg ER PO qd; Info: do not cut/crush/chew tab; taper dose gradually to D/C

[oral tab, 12-15 yo, >40 kg]

Dose: 1500 mg PO q12h; Start: 500 mg PO q12h x2wk, then incr. by 1000 mg/day q2wk; Max: 3000 mg/day; Alt: start 1000 mg ER PO qd, may incr. by 1000 mg/day ER q2wk up to 3000 mg ER PO qd; Info: do not cut/crush/chew tab; taper dose gradually to D/C

[oral tab, 16 yo and older]

Dose: 500-1500 mg PO q12h; Start: 500 mg PO q12h, may incr. by 1000 mg/day q2wk; Max: 3000 mg/day; Alt: start 1000 mg ER PO qd, may incr. by 1000 mg/day ER q2wk up to 3000 mg ER PO qd; Info: do not cut/crush/chew tab; taper dose gradually to D/C

juvenile myoclonic epilepsy, adjunct tx

[12 yo and older]

Dose: 1500 mg PO/IV q12h; Start: 500 mg PO/IV q12h, incr. by 1000 mg/day q2wk; Max: 3000 mg/day; Info: do not cut/crush/chew tab; taper dose gradually to D/C

primary generalized tonic clonic seizures, adjunct tx

[6-15 yo]

Dose: 60 mg/kg/day PO/IV divided q12h; Start: 20 mg/kg/day PO/IV divided q12h, incr. by 20 mg/kg/day q2wk; Max: 3000 mg/day; Info: do not cut/crush/chew tab; taper dose gradually to D/C

[16 yo and older]

Dose: 1500 mg PO/IV q12h; Start: 500 mg PO/IV q12h, incr. by 1000 mg/day q2wk; Max: 3000 mg/day; Info: do not cut/crush/chew tab; taper dose gradually to D/C

renal dosing

[immediate-release form]

CrCl <50: decr. usual dose by 50%

HD: give 50% usual dose q24h; give supplement after dialysis, amount not defined; PD: give 50% usual dose q24h; no supplement

[extended-release form]

CrCl 50-80: 1000-2000 mg ER qd; CrCl 30-50: 500-1500 mg ER qd; CrCl <30: 500-1000 mg ER qd

HD/PD: not defined; Info: consider IR form

hepatic dosing

[no adjustment]