Disclaimer to the Online Edition
This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.
levETIRAcetam (Keppra®)
Indication
- Management of neonatal seizures
Dosage Guidelines
- Loading dose: 60 mg/kg/dose ORAL/IV x 1
- Initial maintenance dose 10 mg/kg/dose ORAL/IV q12 hours
- May titrate dose up by 10 mg/kg/day up to effective dose
- Dose limit: 60 mg/kg/day
Administration
- ORAL
- IV intermittent slow infusion over 15 minutes
IV solution must be diluted to 15 mg/mL prior to infusion
To make 20 mL of a 15 mg/mL solution:
- 1. Draw up 3 mL (300 mg) of the 100 mg/mL solution
- 2. Add to 17 mL of sodium chloride 0.9% to make a total volume of 20 mL (Final concentration 15 mg/mL)
Adverse Effects
- CNS depression, fatigue, vomiting
- Increased diastolic blood pressure
Comments
- If IV route needed initially, transition to oral administration as soon as able
Supplied As
- 100 mg/mL oral liquid
- 100 mg/mL (500 mg/5 mL) vial to prepare loading doses
- 15 mg/mL IV syringe prepared by Pharmacy (immediate use product – nurse to request from Pharmacy)
References
LexiComp Pediatric and Neonatal, LexiComp SickKids