【藥品性質提示】 根據 2019 AGS Beers Criteria，本藥品為【潛在不適當用藥 (PIM)】，用於腎功能不佳 (CrCl≤80mL/min) 之老年人須降低劑量。

治療癲癇 Adjunctive therapy of myoclonic seizure, partial seizure, primary generalized tonic-clonic seizure

Anticonvulsant, Miscellaneous

Distribution:
1. Protein binding: 3.4%
2. Vd: 0.7 L/kg
Metabolism:
Liver, insignificant ; Enzymatic hydrolysis, primary pathway (24% of dose)
Excretion 1. Renal excretion: 66% (unchanged)
2. Renal clearance: 0.6 mL/min/kg (parent compound)
3. Dialyzable: Yes (hemodialysis), 50%
4. Total body clearance: 0.96 mL/minute/kg
Elimination Half Life: 6 to 8 hours

Hypersensitivity to levetiracetam

C(FDA) B3(AUS)

Infant risk cannot be ruled out.

Common
Loss of appetite, Vomiting, Infectious disease, Decreased bone mineral density, Neck pain, Asthenia, Dizziness, Headache, Abnormal behavior, Irritability, Cough, Nasopharyngitis, Fatigue
Serious
Stevens-Johnson syndrome, Toxic epidermal necrolysis, Decreased erythrocyte production, Decreased white blood cell count, Eosinophil count raised, Neutropenia, Pancytopenia, Thrombocytopenia, Liver failure, Anaphylaxis, Somnolence, Suicidal intent, Angioedema

General Dosage Information
1. Switch from oral to IV: Initial total daily IV dose should be equivalent to the total daily dose and frequency of oral dose.
2. Levetiracetam injection is for IV use only

Myoclonic seizure; Adjunct:
Initial, 500 mg IV twice daily; titration, increase by increments of 1000 mg/day every 2 weeks to 3000 mg/day
Partial seizure; Adjunct:
Initial, 500 mg twice daily IV; titration, may increase by increments of 1000 mg/day every 2 weeks in 2 divided doses to MAX, 3000 mg/day
Tonic-clonic seizure, Primary generalized; Adjunct:
Initial, 500 mg IV twice daily; titration, increase by increments of 1000 mg/day every 2 weeks to target dose of 3000 mg/day in 2 divided doses

Myoclonic seizures:
Children ≥12 years and Adolescents: Refer to adult dosing.

Partial onset seizures:

Infants 1-6 months:	1. Initial 7 mg/kg twice daily 2. Increase every 2 weeks by 7 mg/kg/dose to a recommended dose of 21 mg/kg twice daily
Infants and Children 6 months to <4 years:	1. Initial 10 mg/kg twice daily 2. Increase every 2 weeks by 10 mg/kg/dose to a recommended dose of 25 mg/kg twice daily. If the patient cannot tolerate 50 mg/kg/day, reduce the daily dose
Children and Adolescents 4 to <16 years:	1. Initial 10 mg/kg twice daily 2. Increase every 2 weeks by 10 mg/kg/dose to the recommended dose of 30 mg/kg twice daily. If the patient cannot tolerate 60 mg/kg/day, reduce the daily dose
Adolescents ≥16 years	Refer to adult dosing

Tonic-clonic seizures:
1. Children and Adolescents 6 to <16 years: Initial 10 mg/kg twice daily; increase every 2 weeks by 10 mg/kg/dose to the recommended dose of 30 mg/kg twice daily. Efficacy of doses lower than 60 mg/kg/day has not been established.
2. Adolescents ≥16 years: Refer to adult dosing.

1. Mild impairment (CrCl 50-80 mL/min/1.73 m²): Usual dosage, 500 to 1000 mg IV every 12 hours
2. Moderate impairment (CrCl 30 to 50 mL/min/1.73 m²):Usual dosage, 250 to 750 mg IV every 12 hours
3. Severe impairment (CrCl <30 mL/min/1.73 m²): Usual dosage, 250 to 500 mg IV every 12 hours
4. ESRD in adults on hemodialysis: Usual dosage, 500 to 1000 mg IV every 24 hours and a 250- to 500-mg supplemental dose after each dialysis session

No adjustment needed