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Rapid Infusion of a Loading Dose of Intravenous Levetiracetam With Minimal Dilution: A Safety Study

Department of Pediatrics and Neurology, University of Tennessee Health Science Center, LeBonheur Children's Medical Center, Neuroscience Institute, Memphis, Tennessee, jwheless{at}utmem.edu

Dave Clarke, MD

Department of Pediatrics and Neurology, University of Tennessee Health Science Center, LeBonheur Children's Medical Center, Neuroscience Institute, Memphis, Tennessee

Collin A. Hovinga, PharmD

College of Pharmacy, University of Tennessee Health Science Center, LeBonheur Children's Medical Center, Neuroscience Institute, Memphis, Tennessee

Michelle Ellis, RN

Department of Pediatrics and Neurology, University of Tennessee Health Science Center, LeBonheur Children's Medical Center, Neuroscience Institute, Memphis, Tennessee

Misha Durmeier, RN

Department of Pediatrics and Neurology, University of Tennessee Health Science Center, LeBonheur Children's Medical Center, Neuroscience Institute, Memphis, Tennessee

Amy McGregor, MD

Department of Pediatrics and Neurology, University of Tennessee Health Science Center, LeBonheur Children's Medical Center, Neuroscience Institute, Memphis, Tennessee

Fred Perkins, MD

Department of Pediatrics and Neurology, University of Tennessee Health Science Center, LeBonheur Children's Medical Center, Neuroscience Institute, Memphis, Tennessee

Intravenous antiepileptic drugs are required in patients needing urgent treatment or unable to take oral medication. The safety of intravenous levetiracetam has been established in prospective studies of adult epilepsy and healthy participants. The authors performed a prospective, single-center study to evaluate the safety of a rapid loading dose of intravenous levetiracetam. Patients were divided into 3 equal dosing groups (N = 15 each): 20, 40, and 60 mg/kg (corresponding to maximum doses of 1, 2, and 3 g). Electrocardiogram and safety assessment were performed during the infusion. Ages were 4 to 32 years. Postinfusion serum levetiracetam concentrations were 14 to 189 µg/mL. There were no significant changes in blood pressure, no local infusion site reactions, and no electrocardiogram abnormalities. The authors concluded that high serum levels of parenteral levetiracetam can be achieved rapidly and safely, in a small infusion volume. This finding has important implications for the treatment of status epilepticus.

Key Words: antiepileptic drugs • epilepsy • partial seizures • open-label trials • levetiracetam • intravenous

This version was published on August 1, 2009

Journal of Child Neurology, Vol. 24, No. 8, 946-951 (2009)
DOI: 10.1177/0883073808331351


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