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What Factors Affect a Sufficient Levetiracetam Dose?

By S. Berger
Updated May 17, 2024
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Levetiracetam is a medication that is classified as an anticonvulsant, and is used to treat and prevent seizures and convulsions. Several variables can affect an appropriate levetiracetam dose for patients. The age and weight of a patient, as well as certain health conditions such as the presence of kidney problems, may all influence the size of a dose recommended by doctors.

Adults taking this medication for seizures usually start with a levetiracetam dose of 1,000 milligrams (mg) per day, often split into two equal doses when an instant release formulation is used. Extended release formulations require just one dosing period each day. Every two weeks, this dose may be increased, if needed, by another 1,000 mg, up to 3,000 mg each day. The dosage for oral administration and intravenous (IV) use is the same, unlike many other medications.

Children taking this drug often take a levetiracetam dose that is based on their weight. At first, an initial dose of 20 mg per 1 kilogram (kg) or 2.2 pounds (lb) of body weight is used. This dose can be provided as a single dose of extended release oral formulation, or twice-daily doses of instant release oral or IV formulation. Every two weeks, if needed, the dose may be increased by another 20 mg per 1 kg, or 2.2 lb, of body weight, up to a maximum dose of 60 mg per 1 kg, or 2.2 lb, body weight.

For children over 12 years of age, taking this drug for myoclonic seizures, a simplified levetiracetam dose regimen can often be used. This regimen starts with a beginning dose of 500 mg of immediate release oral medication, taken twice a day. At two week intervals, the dose can be increased by another 500 mg, up to 1,500 mg total.

Patients with kidney damage may not be able to clear this medication from their system as quickly, and it will exert its effects on the body for a longer period of time. This situation usually requires a lower levetiracetam dose. Adults with a creatinine clearance of 80 milliliters (mL) per minute may take 500 mg to 1,500 mg of levetiracetam twice a day. Patients with a creatinine clearance of less than 30 mL/min should only take 250 mg to 500 mg twice a day.

Limitations on levetiracetam dosage in the event of kidney problems also apply to children. The cutoff point for a dose alteration occurs for children with less than 50 mL/min creatinine clearance. In this case, the child is usually advised to take half of a normal levetiracetam dose.

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