From the Guidelines
The recommended Keppra (levetiracetam) bolus dosing for acute seizure management is 30–50 mg/kg IV load at 100 mg/min, as indicated in the evidence from 1. This dosing is supported by the study published in the Annals of Emergency Medicine, which provides guidance on the evaluation and management of adult patients presenting to the emergency department with seizures. Key points to consider when administering Keppra include:
- Monitoring for side effects such as nausea and rash, as noted in 1
- Ensuring the infusion rate does not exceed 100 mg/minute to minimize adverse reactions
- Considering dose adjustments for patients with significant renal impairment, as levetiracetam is primarily eliminated unchanged through the kidneys The evidence from 1 also supports the use of levetiracetam, with a loading dose of 1,500 mg oral load or rapid IV loading safe and well tolerated in doses up to 60 mg/kg, but the most specific and relevant dosing information is provided in 1. It is essential to prioritize the patient's safety and adjust the dosing according to their individual needs and medical history.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION For intravenous infusion only (2.1) Do not dilute prior to its use (2.1) Administer dose-specific bag intravenously over 15-minutes (2.1) The FDA drug label does not answer the question about Keppra bolus dosing, as the provided text only mentions administration over 15 minutes, which is not a bolus dose. 2 2
From the Research
Keppra Bolus Dosing
- The provided studies do not directly mention the specific bolus dosing of Keppra (levetiracetam) 3, 4, 5, 6, 7.
- However, it is mentioned that levetiracetam is used as a treatment for status epilepticus and seizures, often administered intravenously 4, 6, 7.
- A study comparing intravenous levetiracetam to phenytoin for status epilepticus and cluster seizures found that levetiracetam was effective in controlling seizures in 82% of patients with status epilepticus and 81.6% of patients with cluster seizures 7.
- The dosing of levetiracetam is not specified in the provided studies, but it is mentioned that a full loading dose of IV levetiracetam is used as a second-phase treatment for convulsive established status epilepticus 4.
- It is recommended to consult the prescribing information or a medical professional for the specific bolus dosing of Keppra.