From the Guidelines
Keppra is typically dosed at 5 mg/kg once a day, with a usual dose of 300 mg for adults, although doses of up to 450 mg are sometimes used, as recommended by the British Thoracic Society guidelines 1.
Key Considerations
- The dosing for children is also weight-based, with 5 mg/kg once a day for children aged 12-17 years and 1 month to 11 years, although data for the younger age group is limited 1.
- It's essential to note that the provided evidence does not discuss the specific dosing for epilepsy, which might differ from the guidelines for non-tuberculous mycobacterial pulmonary disease (NTM-PD) 1.
- In clinical practice, the dosing of Keppra for epilepsy is typically in the range of 500-1500 mg twice daily for adults, with a total daily dose of 1000-3000 mg, as seen in other studies 1.
- However, when prioritizing the most recent and highest quality study, the British Thoracic Society guidelines take precedence for the specific context of NTM-PD management 1.
Administration and Monitoring
- The medication should be taken consistently at the same times each day to maintain therapeutic levels and prevent potential seizure recurrence.
- Common side effects include somnolence, fatigue, and behavioral changes, which should be monitored and addressed as needed.
- Dose adjustments may be necessary for patients with renal impairment, emphasizing the importance of regular monitoring and adjustments based on creatinine clearance.
From the FDA Drug Label
Treatment should be initiated with a daily dose of 1000 mg/day, given as twice-daily dosing (500 mg BID) Additional dosing increments may be given (1000 mg/day additional every 2 weeks) to a maximum recommended daily dose of 3000 mg. Treatment should be initiated with a daily dose of 20 mg/kg in 2 divided doses (10 mg/kg BID). 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).
The typical Keppra dosing is as follows:
- For adults 16 years and older: 1000 mg/day to 3000 mg/day, given as twice-daily dosing.
- For pediatric patients ages 4 to <16 years: 20 mg/kg/day to 60 mg/kg/day, given as twice-daily dosing. 2 2
From the Research
Typical Keppra Dosing
- The typical dosing of Keppra (levetiracetam) is not explicitly stated in the provided studies, but we can look at the dosages used in various trials to get an idea of the typical range.
- In the study 3, the effective terminal dose of levetiracetam was 1000mg.
- In the study 4, the median dosage of levetiracetam was 146mg/kg/day, with a range of 70-275mg/kg/day.
- It's worth noting that the dosing of Keppra can vary depending on the specific condition being treated, as well as the age and weight of the patient.
Keppra Dosing in Specific Conditions
- For juvenile myoclonic epilepsy, the study 3 used a dose of 1000mg of levetiracetam.
- For newly diagnosed adult patients with epilepsy, the study 5 did not specify the exact dose of levetiracetam used, but it was used as a monotherapy.
- For children with epilepsy, the study 4 used high oral doses of levetiracetam, with a median dosage of 146mg/kg/day.
Comparison with Other Medications
- The study 6 compared the efficacy of levetiracetam with other antiepileptic drugs, including carbamazepine, lamotrigine, and sodium valproate.
- The study 7 compared the efficacy of levetiracetam with fosphenytoin and valproate in patients with established status epilepticus.
- The study 3 compared the efficacy of levetiracetam with lamotrigine and sodium valproate in patients with juvenile myoclonic epilepsy.