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==General==
*Type: [[Anticonvulsants]]
*Dosage Forms: PO 250mg, 500mg, 750mg, 1000mg; 500mg ER, 750mg ER; IV 100mg/mL
*Common Trade Names: Keppra

==Adult Dosing==
*[[Status Epilepticus]]
**20-40mg/kg IV loading dose
*Partial [[seizures]], adjunct 
**500-1500mg PO/IV q12h. 
***Start 500 q12 or 1000 QD, inc by 1000mg/day q2wk
***Max 3000mg/day
*Generalized tonic clonic [[seizures]], adjunct
**1500mg PO/IV q12h or 
***Start 500 q12, inc by 1000mg/day q2wk
***Max 3000mg/day

==Pediatric Dosing==
*Partial seizures, adjunct 
**4-15 yo
***60mg/kg/day PO divided bid
***Start 20mg/kg/day PO divided bid, inc by 20mg/kg/day q2wk
***Max 3000mg/day
**>16 yo
***500-1500mg PO/IV q12h. 
***Start 500 q12 or 1000 QD, inc by 1000mg/day q2wk
***Max 3000mg/day
*Generalized tonic clonic seizures, adjunct
**6-15 yo
***60mg/kg/day PO divided bid
***Start 20mg/kg/day PO divided bid, inc by 20mg/kg/day q2wk
***Max 3000mg/day
**>16 yo
***1500mg PO/IV q12h
***Start 500 q12, inc by 1000mg/day q2wk
***Max 3000mg/day

==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C
*Lactation: probably safe
*Renal Dosing
**Adult
***CrCl 50-80: 500-1000mg q12h IR; 1000-2000mg QD ER
***CrCl 30-50: 250-750mg q12h IR; 500-1500mg QD ER
***CrCl <30: 250-500mg q12h; 500-1000mg QD ER
***HD: 500-1000mg q24h IR, do not use ER
**Pediatric
***CrCl <50, IR: decrease dose 50%
***CrCl 50-80: 1000-2000mg QD ER
***CrCl 30-50: 500-1500mg QD ER
***CrCl <30: 500-1000mg QD ER

*Hepatic Dosing: no adjustment

==Contraindications==
*Allergy to class/drug

==Adverse Reactions==
===Serious===
*Depression
*Hostility
*Aggressive behavior
*Psychosis
*Suicidality
*Leukopenia
*Neutropenia
*Drug rash with eosinophilia and systemic sx
*Stevens-Johnson
*Toxic epidermal necrolysis
*Erythema multiforme
*withdrawal seizures if abrupt discharge

===Common===
*Somnolence
*Asthenia
*Vomiting
*Headache
*URI sx
*Anorexia
*Infection
*Hostility
*Fatigue
*Nervousness
*Dizziness
*[[Diarrhea]]
*Behavioral changes
*Irritability
*Pain
*Agitation
*Emotional lability
*Depression
*Nausea
*Vertigo
*Ataxia
*Leukopenia
*Neutropenia
*Anxiety
*Confusion
*Amnesia
*Alopecia

==Pharmacology==
*Half-life: 6-8h
*Metabolism: hydrolysis minimally
*Excretion: urine
*Mechanism of Action: exact mechanism unknown

==See Also==
*[[Seizure]]
*[[Anticonvulsants]]
*[[Anticonvulsant levels and reloading]]

==References==
epocrates

<references/>
[[Category:Pharmacology]] [[Category:Neurology]]