Keppra Dosage

Generic name: levetiracetam (oral/injection)
Brand names: Keppra, Keppra XR
Drug class: Pyrrolidine anticonvulsants

Medically reviewed by  A Ras MD.

Recommended Adult Dosing

Dosage forms:  TAB: 250 mg, 500 mg, 750 mg, 1000 mg; SOL: 100 mg per mL; INJ: various

Partial seizures

[500-1500 mg PO/IV q12h]

Start: 500 mg PO/IV q12h, may incr. by 1000 mg/day q2wk; Max: 3000 mg/day; Info: dose adjustment may be needed during pregnancy and/or postpartum; do not cut/crush/chew tab; taper dose gradually to D/C

Juvenile myoclonic epilepsy, adjunct tx

[1500 mg PO/IV q12h]

Start: 500 mg PO/IV q12h, incr. by 1000 mg/day q2wk; Max: 3000 mg/day; Info: dose adjustment may be needed during pregnancy and/or postpartum; do not cut/crush/chew tab; taper dose gradually to D/C

Primary generalized tonic clonic seizures, adjunct tx

[1500 mg PO/IV q12h]

Start: 500 mg PO/IV q12h, incr. by 1000 mg/day q2wk; Max: 3000 mg/day; Info: dose adjustment may be needed during pregnancy and/or postpartum; do not cut/crush/chew tab; taper dose gradually to D/C

Renal dosing

[adjust dose amount, frequency]

CrCl 50-80: 500-1000 mg q12h; CrCl 30-50: 250-750 mg q12h; CrCl <30: 250-500 mg q12h

HD: 500-1000 mg q24h; give 250-500 mg as supplement after dialysis; PD: 500-1000 mg q24h; no supplement

Hepatic dosing

[no adjustment]

Recommended Peds Dosing

Dosage forms:  TAB: 250 mg, 500 mg, 750 mg, 1000 mg; SOL: 100 mg per mL; INJ: various

Partial seizures

[oral solution or IV form, 1-5 mo]

Dose: 42 mg/kg/day PO/IV divided q12h; Start: 14 mg/kg/day PO/IV divided q12h, incr. by 14 mg/kg/day q2wk; Info: taper dose gradually to D/C

[oral solution or IV form, 6 mo-3 yo]

Dose: 50 mg/kg/day PO/IV divided q12h; Start: 20 mg/kg/day PO/IV divided q12h, incr. by 20 mg/kg/day q2wk; Info: taper dose gradually to D/C

[oral solution or IV form, 4-15 yo]

Dose: 60 mg/kg/day PO/IV divided q12h; Start: 20 mg/kg/day PO/IV divided q12h, incr. by 20 mg/kg/day q2wk; Max: 3000 mg/day; Info: taper dose gradually to D/C

[oral solution or IV form, 16 yo and older]

Dose: 500-1500 mg PO/IV q12h; Start: 500 mg PO/IV q12h, may incr. by 1000 mg/day q2wk; Max: 3000 mg/day; Info: taper dose gradually to D/C

[oral tab, 4-15 yo, 20-40 kg]

Dose: 750 mg PO q12h; Start: 250 mg PO q12h x2wk, then incr. by 500 mg/day q2wk; Max: 1500 mg/day; Info: do not cut/crush/chew tab; taper dose gradually to D/C

[oral tab, 4-15 yo, >40 kg]

Dose: 1500 mg PO q12h; Start: 500 mg PO q12h x2wk, then incr. by 1000 mg/day q2wk; Max: 3000 mg/day; Info: do not cut/crush/chew tab; taper dose gradually to D/C

[oral tab, 16 yo and older]

Dose: 500-1500 mg PO q12h; Start: 500 mg PO q12h, may incr. by 1000 mg/day q2wk; Max: 3000 mg/day; Info: do not cut/crush/chew tab; taper dose gradually to D/C

Juvenile myoclonic epilepsy, adjunct tx

[12 yo and older]

Dose: 1500 mg PO/IV q12h; Start: 500 mg PO/IV q12h, incr. by 1000 mg/day q2wk; Max: 3000 mg/day; Info: do not cut/crush/chew tab; taper dose gradually to D/C

Primary generalized tonic clonic seizures, adjunct tx

[6-15 yo]

Dose: 60 mg/kg/day PO/IV divided q12h; Start: 20 mg/kg/day PO/IV divided q12h, incr. by 20 mg/kg/day q2wk; Max: 3000 mg/day; Info: do not cut/crush/chew tab; taper dose gradually to D/C

[16 yo and older]

Dose: 1500 mg PO/IV q12h; Start: 500 mg PO/IV q12h, incr. by 1000 mg/day q2wk; Max: 3000 mg/day; Info: do not cut/crush/chew tab; taper dose gradually to D/C

Renal dosing

[adjust dose amount, frequency]

CrCl <50: decr. usual dose by 50%

HD: give 50% usual dose q24h; give supplement after dialysis, amount not defined; PD: give 50% usual dose q24h; no supplement

Hepatic dosing

[no adjustment]

SRC: NLM .