title: Rapid infusion of a loading dose of intravenous levetiracetam with minimal dilution: a safety study.
abstract: 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 microg/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.
authors.affiliation: Department of Pediatrics and Neurology, University of Tennessee Health Science Center, LeBonheur Children's Medical Center, Neuroscience Institute, Memphis, Tennessee 38105, USA. jwheless@utmem.edu
authors.forename: James W
authors.initials: JW
authors.lastname: Wheless
authors.forename: Dave
authors.initials: D
authors.lastname: Clarke
authors.forename: Collin A
authors.initials: CA
authors.lastname: Hovinga
authors.forename: Michelle
authors.initials: M
authors.lastname: Ellis
authors.forename: Misha
authors.initials: M
authors.lastname: Durmeier
authors.forename: Amy
authors.initials: A
authors.lastname: McGregor
authors.forename: Fred
authors.initials: F
authors.lastname: Perkins
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006321:Heart / Q000187:drug effects; D006801:Humans; D007275:Injections, Intravenous; D000077287:Levetiracetam; D008297:Male; D010889:Piracetam / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D012640:Seizures / Q000188:drug therapy*; D013997:Time Factors; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam