What is the starting dose of Levetiracetam (Keppra) for a 10-year-old child?

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Last updated: February 24, 2025View editorial policy

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From the FDA Drug Label

Pediatric Patients Ages 4 To <16 Years Treatment should be initiated with a daily dose of 20 mg/kg in 2 divided doses (10 mg/kg BID).

The starting dose of Levetiracetam (Keppra) for a 10-year-old child is 20 mg/kg/day, given as 2 divided doses (10 mg/kg BID) 1.

  • To determine the dose, the child's weight in kilograms should be used to calculate the daily dose.
  • The daily dose should be increased every 2 weeks by increments of 20 mg/kg to the recommended daily dose of 60 mg/kg (30 mg/kg BID).

From the Research

The recommended starting dose of Keppra (levetiracetam) for a 10-year-old child is 10 mg/kg twice daily, with a maximum of 1000 mg twice daily. For oral administration, use the liquid formulation or tablets. If intravenous administration is necessary, use the same dose. This starting dose is based on the child's weight and may be increased gradually to a maintenance dose of 20-60 mg/kg/day, divided into two doses, depending on the clinical response and tolerability 2, 3.

Some key points to consider when administering levetiracetam to a 10-year-old child include:

  • Always round the dose to the nearest practical amount.
  • Monitor for side effects such as drowsiness, irritability, or behavioral changes.
  • Adjust the dose based on seizure control and any adverse effects.
  • Regular follow-ups are essential to ensure optimal therapeutic effect and minimize potential risks.
  • Determination of serum concentration is not needed in all children treated with levetiracetam, but may be valuable in patients with refractory epilepsy for compliance evaluation or in patients with satisfactory control of seizures for determination of their therapeutic baseline 4.

It's also important to note that levetiracetam has been shown to be effective in treating seizures in children with refractory epilepsy, with some studies suggesting that higher doses may be tolerated and even beneficial in certain cases 2, 3. However, the most recent and highest quality study should be prioritized when making treatment decisions, and individual patient response and tolerability should be closely monitored 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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