Rapid administration of undiluted intravenous levetiracetam considered safe: Study
Operational delays have the potential to lead to suboptimal time to seizure control during status epilepticus. Levetiracetam (LEV) is an urgent control antiepileptic medication that offers relative lack of adverse effects and ease of monitoring.
There are limited data published demonstrating safety and tolerability of undiluted rapid intravenous (IV) push of LEV in doses of 1000 mg or less. However, rapid IV administration of undiluted LEV is both safe and tolerable in doses of up to 4500 mg, allowing for rapid drug administration, finds a study.
The research is published in the Epilepsia Journal.
John Tyler Haller and colleagues from the Department of Pharmacy, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA evaluated the safety of IV push administration of LEV doses up to 4500 mg.
The authors carried out a retrospective, observational, cohort analysis of adult patients who received at least one dose of undiluted IV push LEV at a large academic medical center in Phoenix, Arizona. Outcomes of interest include safety and tolerability of rapid administration of undiluted LEV.
The results of the study revealed that-
a. There were 953 unique patients included during the study period.
b. LEV was a new medication for witnessed or suspected seizure in 51.9% of patients, and 40.7% of patients had a documented history of epilepsy or seizure disorder.
c. There were 8561 undiluted IV push LEV doses administered, 3674 (42.9%) of which were greater than 1000 mg.
d. LEV was administered most often through a peripheral IV (79.1%).
e. There were 12 patients with documented adverse drug events during the study period, with four potentially directly related to IV push LEV administration.
f. These events were limited to local injection site reactions and included redness, burning, and loss of a peripheral IV line.
Hence, the authors concluded that "rapid IV administration of undiluted LEV is both safe and tolerable in doses of up to 4500 mg, allowing for rapid drug administration, which is paramount during neurologic emergencies."