Retrospective Safety Review of Undiluted IV Push Levetiracetam in Pediatric Patients.

OBJECTIVE

Levetiracetam is traditionally given as an intravenous (IV) piggyback over a span of 15 minutes. Studies have shown administration of levetiracetam via IV push is safe and effective in adults; however, there are limited data within pediatrics. The objective of this study was to assess the safety and tolerability of IV push administration of undiluted levetiracetam in pediatric patients from neonates to 17 years of age.

METHODS

This was a single-center, retrospective observational study of pediatric patients who received at least 1 dose of undiluted IV push levetiracetam at a combined pediatric and adult community medical center. Patients were included if they were younger than 18 years and received an IV push dose of levetiracetam of 19 mg or greater. Patients were excluded if they received IV push lacosamide in addition to IV push levetiracetam. The primary outcome was treatment-associated adverse events within 1 hour of levetiracetam administration.

RESULTS

A total of 103 patients, with an associated 446 levetiracetam administrations, were identified for inclusion in this study. The mean age at the time of levetiracetam administration was 8 years (range, 1 day-17 years). There were 46 treatment-associated adverse events (10.3%) identified within the first hour after administration. The most common adverse events identified included increased blood pressure (85%), agitation (4%), drowsiness (4%), and hypotension (4%). The highest score obtained was 6 on the Naranjo Adverse Drug Reaction Scale, which is considered a probable reaction.

CONCLUSIONS

Undiluted, IV push levetiracetam appears to be safe in pediatric patients from neonates to 17 years of age.