• Partial onset seizures:
    • Adults: IV/PO 500mg BD
      • May increase every 2 weeks by 500mg/dose
      • Max 3000mg/day
    • 1-5 months: IV/PO solution 42mg/kg/day divided BD
      • Initially PO/IV 14mg/kg/day divided BD
      • Increased by 14mg/kg/day every 2 weeks
    • 6 months-3 years: IV/PO solution 50mg/kg/day divided BD
      • Initially IV/PO 20mg/kg/day divided BD
      • Increased by 20mg/kg/day every 2 weeks
    • 4-15 years: IV/PO solution 60mg/kg/day divided BD
      • Initially IV/PO 20mg/kg/day divided BD
      • Increased by 20mg/kg/day every 2 weeks
      • Max: 3000mg/day
    • >16 years: IV/PO solution 500-1500mg BD
      • Initially 500mg IV/PO BD
      • Increased by 1000mg/day every 2 weeks
      • Max: 3000mg/day
    • Oral tablet: 4-11 years (20-40kg): 750mg BD
      • Initially 250mg BD *2/52, then increased by 500mg/day every 2 weeks
      • Max: 1500mg/day
    • Oral tablet: 4-11 years (>40kg): 1500mg BD
      • 500mg BD *2/52, then increased by 1000mg/day every 2 weeks
      • Max: 3000mg/day
    • Oral tablet: 12-15 years (20-40kg): 750mg BD
      • Initially 250mg BD *2/52, then increased by 500mg/day every 2 weeks
      • Max: 1500mg/day
    • Oral tablet: 12-15 years (>40kg): 1500mg BD
      • 500mg BD *2/52, then increased by 1000mg/day every 2 weeks
      • Max: 3000mg/day
    • Oral tablet: >16 years: 500-1500mg BD
      • Initially 500mg BD, then increased by 1000mg/day every 2 weeks
      • Max: 3000 mg/day
  • Adjunct treatment in juvenile myoclonic seizures:
    • Adults: IV/PO 500mg BD
      • May increase every 2 weeks by 500mg/dose to recommended dose of 1500mg BD
    • > 12 years: PO 500-1500mg BD
      • Initially PO 500mg BD,then increased by 1000mg/day every 2 weeks
      • Max: 3000mg/day
  • Adjunct treatment in primary generalized tonic clonic seizures:
    • Adults: IV/PO 500mg BD
      • May increase every 2 weeks by 500mg/dose to recommended dose of 1500mg BD
    • 6-15 years: PO/IV 60mg/kg/day divided BD
      • Initially PO/IV 20mg/kg/day divided BD, then increased by 20mg/kg/day every 2 weeks
      • Max: 3000mg/day
    • >16 years: PO 500-1500mg BD
      • Initially 500mg BD, increased by 1000mg/day every 2 weeks
      • Max: 3000mg/day
  • Tablet:
    • 250mg
    • 500mg
    • 750mg
  • Oral solution:
    • 100mg/mL
  • Injection:
    • 500mg/5mL
  • Infuse IV over 15 minutes
  • Oral forms can be taken with or without food
  • Oral solution recommended for children who weigh <20 kg

The exact mechanism not known but thought to inhibit voltage-dependent N-type calcium channels

  • Headache
  • Increased BP (patients <4 years)
  • Somnolence
  • Asthenia
  • URI
  • Vomiting
  • Infection
  • Fatigue
  • Aggressive behavior
  • Dizziness
  • Anorexia
  • Irritability
  • Pain
  • Diarrhea
  • Emotional lability
  • Depression
  • Nausea
  • Vertigo
  • Agitation
  • Anxiety
  • Ataxia
  • Leukopenia
  • Neutropenia
  • Confusion
  • Hostility
  • Amnesia
  • Alopecia
  • Hypersensitivity to components
  • Abrupt withdrawal
  • Amifampridine
  • Bupropion
  • Dalfampridine
  • Metoclopramide

                          Drug Status

Availability Prescription only
Pregnancy Category C
Breastfeeding Unknown; weigh risk vs benefit
Schedule Controlled
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Kepam 500mg/5mL Injection 10’s Pharma Jordan Generics Africa
Keppra 750mg Tablet 60’s GSK Ltd GSK Ltd
Keppra 500mg Tablet 50’s GSK Ltd GSK Ltd
Keppra 250mg Tablet 60’s GSK Ltd GSK Ltd
Keppra 100mg/mL Suspenion 300mL GSK Ltd GSK Ltd
Levigress 250mg Tablet 30’s La Renon Wessex Pharma
Levigress 500mg Tablet 30’s La Renon Wessex Pharma
Levipil 250mg Tablet 30’s Sun Pharma Sun Pharma
Levipil 500mg Tablet 30’s Sun Pharma Sun Pharma
Levipil 750mg Tablet 30’s Sun Pharma Sun Pharma
Torleva 250mg Tablet 30’s Torrent Pharma C/O Medox Medox Pharma
Torleva 500mg Tablet 30’s Torrent Pharma C/O Medox Medox Pharma