1 May 2026Injectable drugsSource update: October 2024
Levetiracetam = LEV injectable
Levetiracetam injectable guidance for second-line treatment of convulsive status epilepticus.
Prescription under medical supervision
This guide page is for structured reference only and does not replace a clinician, pharmacist, or emergency review. Dose choice, route choice, interactions, and safety decisions still need professional judgment.
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.
Dose and duration
During and after administration, have ventilation equipment and solutions for fluid replacement ready for use.
In children and adults, 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.
Loading dose
- Child 1 month and over: add 3 ml (300 mg) of LEV to 17 ml of 0.9% sodium chloride to obtain 20 ml of solution containing 15 mg/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 in children, readminister half-dose: 20 mg/kg (max. 1.5 g). Do not exceed a total dose of 60 mg/kg or 4.5 g.
- Adult: 60 mg/kg (max. 4.5 g) as a single dose over 15 minutes.
- Use the diluted 15 mg/ml solution 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% sodium chloride.
Contra-indications, adverse effects, precautions
- Administer with caution to patients with renal impairment, with dosage reduction, or heart disorders.
- May cause drowsiness, headache, asthenia, dizziness, behavioural disturbances, haematologic disorders, gastrointestinal disturbances, cough, and nasopharyngitis.
- Rarely may cause QT prolongation and hypersensitivity reactions, sometimes severe.
- Respiratory depression and coma may occur in overdose.
- Avoid or monitor the combination with mefloquine, drugs that prolong the QT interval, benzodiazepines, opioid analgesics, antipsychotics, first-generation antihistamines, antidepressants, and other antiseizure medications.
- Pregnancy and breast-feeding: the risks linked to status epilepticus appear greater than the risks linked to levetiracetam.
- Do not mix with other drugs in the same syringe or infusion.
Source
MSF Essential drugs practical guidelines (January 2026)
This page reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.
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