LEVETIRACETAM = LEV injectable

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    Last updated: October 2024

     

    Prescription under medical supervision

     

     
    During and after administration, have ventilation equipment (Ambu and mask) and solutions for fluid replacement ready for use.

     

    Therapeutic action

    • Antiseizure (anticonvulsant)

    Indications

    • Second-line treatment of convulsive status epilepticus

    Forms and strengths, route of administration

    • 500 mg in 5 ml vial (100 mg/ml) for slow IV injection or IV infusion in 0.9% sodium chloride or 5% glucose
    • DO NOT ADMINISTER THE SOLUTION UNDILUTED BY IV INJECTION. DO NOT ADMINISTER BY SC INJECTION.

    Dosage and duration 

    • Loading dose:
      • Child 1 month and over:
        • Use diluted solution: add 3 ml (300 mg) of LEV to 17 ml of 0.9% NaCl to obtain 20 ml of solution containing 15 mg of LEV per ml.
        • Administer 40 mg/kg (max. 3 g) over 10 minutes by IV infusion using a syringe pump or by very slow IV injection. 
        • If seizures do not stop after the end of the first dose, readminister half-dose: 20 mg/kg (max. 1.5 g) as above.
        • Do not exceed the total dose of 60 mg/kg or 4.5 g.
      • Adult:
        • 60 mg/kg (max. 4.5 g) single dose over 15 minutes 
        • Use diluted solution as above (15 mg/ml) if administered by IV infusion using a syringe pump.
        • Use undiluted solution if administered by IV infusion in a bag of 100 ml of 0.9% NaCl.

     

    In children and adult, do not exceed an infusion rate of 5 mg/kg/minute.

     

    • If maintenance treatment is indicated after the loading dose: change to oral route as soon as possible.

    Contra-indications, adverse effects, precautions

    • Administer with caution to patients with renal impairment (reduce dosage) or heart disorders.
    • May cause:
      • drowsiness, headache, asthenia, dizziness, behavioural disturbances;
      • haematologic disorders, gastrointestinal disturbances, cough, nasopharyngitis;
      • rarely: QT prolongation, hypersensitivity reactions sometimes severe;
      • respiratory depression and coma in the event of overdose.
    • Avoid or monitor the combination with:
      • mefloquine (reduced effect of LEV);
      • drugs that prolong the QT interval (antimalarials, antipsychotics, fluconazole, fluoroquinolones, hydroxyzine, macrolides, ondansetron, etc.);
      • benzodiazepines, opioid analgesics, antipsychotics, first-generation antihistamines (hydroxyzine, promethazine), antidepressants, other antiseizure medications, etc. (increased sedation).
    • Pregnancy and breast-feeding: the risks linked to status epilepticus appear greater than risks linked to LEV.

    Remarks

    • Do not mix with other drugs in the same syringe or infusion.

    Storage

     
    –  Below 25 °C 
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