Keppra Injection Generic Name & Formulations
Legal Class
Rx
General Description
Levetiracetam 100mg/mL; IV infusion after dilution.
Pharmacological Class
Antiepileptic.
See Also
How Supplied
Tabs 250mg, 500mg, 750mg—120; 1000mg—60; XR—60; Soln—16oz; Single-use vials (5mL)—10
Manufacturer
Mechanism of Action
The exact mechanism by which levetiracetam exerts its antiepileptic effect is unknown. However, it may be contributed to its interaction with the SV2A protein.
Keppra Injection Indications
Indications
Use when oral administration is temporarily not feasible: partial onset seizures in patients ≥1 month old; and adjunct in myoclonic seizures in patients ≥12yrs old with juvenile myoclonic epilepsy; and as adjunct in primary generalized tonic-clonic seizures in patients ≥6yrs old with idiopathic generalized epilepsy.
Keppra Injection Dosage and Administration
Adult
Infuse over 15mins. Partial onset: ≥16yrs: initially 500mg twice daily; may increase at 2-week intervals in increments of 1g/day; max 3g/day. Myoclonic (≥12yrs), tonic-clonic (≥16yrs): initially 500mg twice daily; increase at 2-week intervals in increments of 1g/day to target dose of 3g/day. Renal impairment: CrCl 50–80mL/min: 500mg–1g every 12hrs; CrCl 30–50mL/min: 250–750mg every 12hrs; CrCl <30mL/min: 250–500mg every 12hrs; ESRD on dialysis: 500mg–1g every 24hrs and a supplement of 250–500mg post-dialysis.
Children
Infuse over 15mins. Give in 2 divided doses. Partial onset: <1 month: not established. 1 month–<6mos: initially 14mg/kg/day; increase at 2-week intervals by 14mg/kg/day to target dose of 42mg/kg/day. 6mos–<4yrs: initially 20mg/kg/day; increase at 2-week intervals by 20mg/kg/day to target dose of 50mg/kg/day. 4–<16yrs: initially 20mg/kg/day; increase at 2-week intervals by 20mg/kg/day to target dose of 60mg/kg/day; max 3g/day. May reduce dose if intolerant. Myoclonic: <12yrs: not established. Tonic-clonic: <6yrs: not established. 6–<16yrs: initially 20mg/kg/day; increase at 2-week intervals by 20mg/kg/day to target dose of 60mg/kg/day.
Keppra Injection Contraindications
Not Applicable
Keppra Injection Boxed Warnings
Not Applicable
Keppra Injection Warnings/Precautions
Warnings/Precautions
Monitor for behavioral abnormalities, psychiatric symptoms, emergence or worsening of depression, suicidal ideation, somnolence, fatigue. Hematologic abnormalities: do CBCs in those experiencing significant weakness, pyrexia, recurrent infections, or coagulation disorders. Discontinue if anaphylaxis or angioedema develops. Discontinue at the 1st sign of rash; do not resume if Stevens-Johnson syndrome or toxic epidermal necrolysis is suspected. Renal impairment. Avoid abrupt cessation. Elderly (consider monitoring renal function). Pregnancy: monitor carefully (esp. during 3rd trimester). Nursing mothers.
Keppra Injection Pharmacokinetics
Distribution
Volume of distribution is close to the volume of intracellular and extracellular water. Plasma protein bound: <10%.
Elimination
Renal (66%). Plasma half-life: 7±1 hour. Total body clearance: 0.96 mL/min/kg. Renal clearance: 0.6 mL/min/kg.
Keppra Injection Interactions
Not Applicable
Keppra Injection Adverse Reactions
Adverse Reactions
Somnolence, asthenia, infection, dizziness; behavioral abnormalities (eg, irritability, aggression, anger, depression, anxiety, apathy), psychotic symptoms, coordination difficulties (eg, ataxia, abnormal gait), hematologic abnormalities, dermatological reactions (may be serious). Children: also fatigue, nasal congestion, decreased appetite; BP increases in children 1 month–4yrs (monitor).
Keppra Injection Clinical Trials
See Literature
Keppra Injection Note
Notes
Enroll pregnant patients exposed to levetiracetam in the North American Antiepileptic Drug pregnancy registry (888) 233-2334 or the UCB AED Pregnancy Registry (888) 537-7734.
Keppra Injection Patient Counseling
See Literature