The following is a summary of “Adverse events of undiluted intravenous push levetiracetam,” published in the November 2023 issue of Emergency Medicine by Summerlin, et al.

Seizure duration is a crucial prognostic indicator in patients experiencing seizures, emphasizing the urgency of timely administration of antiepileptic medications. While retrospective studies suggested the safety of rapidly administering undiluted intravenous (IV) levetiracetam, there still needs to be more in the existing literature. 

For a study, researchers sought to assess adverse events (AEs) associated with the rapid administration of undiluted IV levetiracetam.

Conducted in the emergency department (ED) of a large community teaching hospital, this study observed adult patients receiving rapid administration of undiluted IV levetiracetam at doses up to 4,500 mg. The primary endpoint was the incidence of predefined AEs. Secondary endpoints included the incidence of specific AEs, seizure termination rates, and the time taken for drug administration in actively seizing patients.

Among 318 patients receiving 321 doses of IV push levetiracetam, 250 patients were included in the study. AEs were observed in 5.6% of cases, predominantly related to injection site reactions (9/14). Clinically relevant changes in blood pressure (hypotension, tachycardia, and hypertension) occurred in five patients. In actively seizing patients, 79% (15/19) achieved seizure termination, with a median time of 12 minutes from medication order to therapy completion.

The study concluded that the rapid administration of undiluted IV levetiracetam in ED patients was associated with a low incidence of AEs, supporting its safety and potential efficacy in reducing seizure duration.

Source: sciencedirect.com/science/article/abs/pii/S0735675723004655