|Reviewed by Kiri Aikman, Brenda Hughes, Elizabeth Oliphant, Cynthia Sharpe & Malcolm Battin|
Management of Levetiracetam Administration
PLEASE NOTE: There are TWO strenghts of Levetiracetam injection:
Oral: 100mg/ml oral suspension (prepared by Pharmacy)
The injection is unlicensed in New Zealand and is supplied under section 29 of the Medicines Act.
Ensure patient is well hydrated before and during administration.
Dilute to 10 mg/mL in glucose 5 % or sodium chloride 0.9%.
Infuse over 15 minutes.
Do not use if solution contains particulate matter or is discoloured.
Flush line with sodium chloride 0.9% before and after administration of levetiracetam.
Diluent to be added
Manufactured by Pharmacy.
Oral solution may be further diluted with water if necessary.
Oral solution is fully funded in community pharmacies. Contact ward pharmacist prior to discharge.
Observe for signs of adverse effects.
Monitor fluid balance closely.
Do not administer the injection undiluted via the intravenous route.
Assess and document any signs of seizure activity.
Unopened vials should be stored at room temperature (25o C)
Discard unused portions of opened vials.
Oral liquid - refer to bottle label for storage and expiry details
|1||Sharpe C, Capparelli E, Mower M et al. A seven-day study of the pharmacokinetics of intravenous levetiracetam in neonates: marked changes in the pharmacokinetics occur during the first week of life. Paediatric Research 2012;72:43-9|
|2||Phelps SJ, Hagemann TM, Lee KR, Thompson AJ. Pediatric Injectable Drugs, The Teddy Bear Book (10th ed.). Bethesda: American Society of Health-System Pharmacists, 2013.|
|3||Taketomo CK, Hodding JH, Kraus DM (eds). Pediatric & Neonatal Dosage Handbook (19th ed.). Hudson (OH): Lexi-Comp, 2012.|
|4||Sweetman SC (ed). Martindale: The Complete Drug Reference (37th ed.) London: Pharmaceutical Press, 2011.|
|5||Levetiracetam-Rex data sheet. Auckland: Rex Medical Limited, 2012.|
|6||Paediatric Injectable Guidelines (4th ed.). Melbourne: Royal Children’s Hospital, 2011.|
|7||Ramantani, G, Ikonomidou C, Walter B et al. Levetiracetam: safety and efficacy in neonatal seizures. European Journal of Paediatric Neurology, 2011; 15: 1-7.|
|8||Merhar SL, Schibler KR, Sherwin CM et al. Pharmacokinetics of levetiracetam in neonates with seizures. J Pediatr 2011; 159:152-4.|