What is the Teratam maximum dose in neonates ?
In LD we may reach to 150mg/kg/day
In MD we may reach to 120mg/kg/day
According to
Micromedex Neofax
Seizure
Loading Dose: In a retrospective study, neonates received total loading doses of 20 to 150 mg/kg/day IV with doses typically divided into multiple smaller doses administered within a 24-hour period [1] .
Maintenance Dose: In retrospective studies that included term and preterm neonates, maintenance doses were 41.7 mg/kg/day [2] to 65 mg/kg/day IV [1] ; upper range doses were 100 mg/kg/day [1] to 106.2 mg/kg/day [2] . Doses were typically administered every 12 hours [1] . When the route was switched from IV to oral, plasma levETIRAcetam concentrations remained within the same range [3] . The total daily IV dosage is equivalent to the total daily oral dosage in patients 1 month or older [4] .
Lexicomp:
Neonatal seizures: Limited data available; optimal dose not established:
Preterm and term neonates:
IV:
Loading dose: IV: 20 to 60 mg/kg as a single dose; if seizures not controlled or recur within 15 minutes, a repeat dose of 20 to 50 mg/kg may be given (Ref); cumulative loading doses have been reported to range from 20 to 150 mg/kg (Ref). Loading doses on the higher end (eg, 60 mg/kg) may be more effective than lower doses (Ref). Higher cumulative loading doses were reported in patients on extracorporeal membrane oxygenation (ECMO) following congenital heart disease repair (48 to 80 mg/kg) compared to non-ECMO patients (20 to 40 mg/kg); for patients requiring ECMO, seizure burden was unchanged with levetiracetam and all required treatment with multiple antiepileptic medications
:Maintenance dose: IV: Initial: 20 to 60 mg/kg/day divided twice daily; dividing dose 3 times daily has also been reported. Doses may be increased by 10 to 20 mg/kg/day based on clinical response; reported range is highly variable and includes doses up to 120 mg/kg/day
In neonates not responding to the standard used levetiracetam doses, incremental increases to 80-100 mg/kg/day may be considered.
Ref:
Hnaini, M., Darwich, M., Koleilat, N., Jaafar, F., Hanneyan, S., Rahal, S., El Mikati, I., Shbarou, R.M., Nabout, R., Maalouf, F.I. and Obeid, M., 2020. High-dose levetiracetam for neonatal seizures: a retrospective review. Seizure, 82, pp.7-11.