For tablet and oral solution-
Treatment should be initiated with a daily dose of 1000 mg/day, given as twice-daily dosing (500 mg twice daily). Additional dosing increments may be given (1000 mg/day additional every 2 weeks) to a maximum recommended daily dose of 3000 mg.
Use in Pediatric Patients-
1 Month To <6 Months: Initial Daily dose 7 mg/kg twice daily & Incremental Daily dose 21 mg/kg twice daily
6 Months To <4 Years: Initial Daily dose 10 mg/kg twice daily & Incremental Daily dose 25 mg/kg twice daily
4 Years To <16 Years: Initial Daily dose 10 mg/kg twice daily & Incremental Daily dose 30 mg/kg twice daily
Adolescent with 20-40 kg body weight: Initial Daily dose 250 mg twice daily & Incremental Daily dose 750 mg twice daily
The daily dose should be increased every 2 weeks.
Levetiracetam injection is for intravenous use only and must be diluted prior to administration. Levetiracetam injection (500 mg/5 mL) should be diluted in 100 mL of compatible diluents and administered intravenously as a 15-minute IV infusion. Product with particulate matter or discoloration should not be used.
Dosing Instructions: Preparation and Administration-
Dose 500 mg: Withdraw Volume 5 ml, Volume of Diluent 100 ml, Infusion Time 15 minutes
Dose 1000 mg: Withdraw Volume 10 ml, Volume of Diluent 100 ml, Infusion Time 15 minutes
Dose 1500 mg: Withdraw Volume 15 ml, Volume of Diluent 100 ml, Infusion Time 15 minutes
For example, to prepare a 1000 mg dose, dilute 10 ml of Levetiracetam injection in 100 ml of a compatible diluents and administer intravenously as a 15-minute infusion.
The exact mechanism of anticonvulsant effect is unknown but does not involve inhibitory and excitatory neurotransmission. Stereo-selective binding of Levetiracetam was confined to synaptic plasma membranes in the central nervous system with no binding occurring in peripheral tissue.
Studies show that levetiracetam affects intraneuronal Ca levels by partial inhibition of N-type Ca currents and by reducing the release of Ca from intraneuronal stores; facilitates GABA-ergic inhibitory transmission through displacement of negative modulators; reduces delayed rectifier K current; and/or binds to synaptic proteins which modulate neurotransmitter release.