Keppra

Renal impairment

About two-thirds of administered levetiracetam is cleared by the kidney via glomerular filtration.55 Clearance of levetiracetam decreases in proportion to the decrease in creatinine clearance in patients with renal insufficiency.56 The following table lists the dosing of levetiracetam as a function of creatinine clearance:

Creatinine clearance
(mL/min)
Dosage 
(mg)
Frequency
>80 500–1,500 Every 12 hrs
50–80 500–1,000 Every 12 hrs
30–50 250–750 Every 12 hrs
<30 250–500 Every 12 hrs

Hemodialysis

Levetiracetam is water soluble, has low protein binding, and has a low volume of distribution.55 Approximately 50% of the body pool of levetiracetam is removed during a 4-hour hemodialysis session.56 A supplemental dose of 250 to 500 mg of levetiracetam following dialysis is recommended.57

Adapted from: Browne TR. Renal disorders. In: Ettinger AB and Devinsky O, eds. Managing epilepsy and co-existing disorders. Boston: Butterworth-Heinemann; 2002;49-62. 
With permission from Elsevier (www.elsevier.com). 

Authored By: 
TR Browne
Steven C. Schachter, MD
I<
Authored Date: 
02/2004
Reviewed By: 
Steven C. Schachter, MD
on: 
Sunday, February 1, 2004