levera oral dose
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levetiracetam oral dosing adults pediatrics renal adjustment prescribing information
I'm assuming "Levera" means levetiracetam, since Levera is a common brand name for it. If you meant a different drug, tell me.
Adult oral dose (immediate-release tablets or solution)
| Indication | Start | Titration | Usual target / max |
|---|---|---|---|
| Partial-onset seizures (age 16 and over) | 500 mg twice daily | Increase by 500 mg twice daily every 2 weeks | 1000 to 1500 mg twice daily (max 3000 mg/day) |
| Myoclonic seizures in juvenile myoclonic epilepsy (age 12 and over) | 500 mg twice daily | Increase by 500 mg twice daily every 2 weeks | 1500 mg twice daily |
| Primary generalized tonic-clonic seizures (age 16 and over) | 500 mg twice daily | Increase by 500 mg twice daily every 2 weeks | 1500 mg twice daily |
- Food: It can be taken with or without food.
- Extended-release: Extended-release tablets (500 and 750 mg) are given once daily. Their dosing differs from the above.
- Textbook range: Kaplan & Sadock's gives adjunctive epilepsy dosing of 500 to 1,000 mg/day, increased every 2 weeks by 1,000 mg/day, up to 3,000 mg/day. This matches the label (Kaplan & Sadock's Comprehensive Textbook of Psychiatry, "Dosage and Administration").
Adults with renal impairment
This table comes from my recall of the FDA label. The search snippets I retrieved included only the "normal" row. Please verify it against the FDA prescribing information before using it.
| CrCl (mL/min) | Dose |
|---|---|
| Above 80 | 500 to 1500 mg every 12 h |
| 50 to 80 | 500 to 1000 mg every 12 h |
| 30 to 50 | 250 to 750 mg every 12 h |
| Below 30 | 250 to 500 mg every 12 h |
| ESRD on dialysis | 500 to 1000 mg every 24 h, plus a supplemental 250 to 500 mg after dialysis |
Children (oral, twice daily)
- Weight form: Use the oral solution for children weighing 20 kg or less. Use the solution or tablets above 20 kg. Children over 40 kg are dosed as adults: 500 mg twice daily, rising by 1000 mg/day every 2 weeks to a maximum of 3000 mg/day.
- Partial-onset seizures:
- 1 month to under 6 months: 7 mg/kg twice daily, titrated to 21 mg/kg twice daily.
- 6 months to under 4 years: 10 mg/kg twice daily, titrated to 25 mg/kg twice daily.
- 4 to under 16 years: 10 mg/kg twice daily, titrated to 30 mg/kg twice daily.
- Primary generalized tonic-clonic seizures (age 6 to under 16): 10 mg/kg twice daily, increased every 2 weeks to 30 mg/kg twice daily. This comes from the DailyMed label.
The pediatric partial-onset figures are from my recall of the label and were not in the retrieved snippets.
Practical points
- Switching from IV: The oral dose equals the IV daily dose and frequency.
- Excretion and interactions: Levetiracetam is well absorbed and mostly excreted unchanged in urine, so it has few drug interactions (Lippincott Illustrated Reviews: Pharmacology).
- Mood effects: It can cause irritability, depression or other mood changes, which may need a dose reduction or a switch of drug (Lippincott Illustrated Reviews: Pharmacology).
- Stopping: Taper gradually when stopping. Do not stop abruptly.
Recent evidence
A search of the last 2 years found no meta-analysis or systematic review that contradicts these standard doses. Two recent reviews are relevant to special groups:
- Critically ill patients with augmented renal clearance (PMID 41688794), a 2026 systematic review. These patients may need higher doses.
- Monitoring in pregnancy (PMID 41120802), a 2026 systematic review. Levels fall in pregnancy, so monitoring may be needed.
Do you want IV or loading doses for status epilepticus, or dosing for a specific patient (age, renal function, pregnancy)?
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