Keppra Critical care Use

Posted On July 26, 2020

Using Keppra in special situations

Craniotomy, seizure prophylaxis

  • 500 mg bid iv, up to 3 gram per day

Status epilepticus

  • Loading dose
    • 1 to 3 gram at 5 mg/kg/minute or
    • 50 mg/kg over 15 minutes, up to 4.5 gram
    • followed by maintenance dose

Subarachnoid Hemorrhage, Traumatic brain injury: short term seizure prophylaxis

  • Loading dose: 20 mg/kg then
  • 1 to 1.5 gram q 12 for 7 days

Altered kidney function, adjust dose

  • CrCl 30-50: upto 750 q 12
  • CrCl 15-30: upto 500 mg q12
  • CrCl less than 15: upto 500 mg q 24 hours
  • Hemodialysis: upto 1 gram after dialysis
  • Peritoneal dialysis: upto 500 mg q 24 hours
  • CRRT: up to 1 g q 12 hours