Abstracts

Rationale: Intravenous Levetiracetam (iv LEV) was approved in 2006 by the FDA for adjunctive use in partial onset seizures in adults with epilepsy when oral administration is temporarily not feasible. We suspected that there would be considerable off-label use of this widely used drug. Methods: A retrospective chart review was made for all patients who received iv LEV at the Temple University Hospital after it was introduced. Usage patterns and compliance with FDA indications were analyzed.Results: There were 48 instances of iv LEV use in the 8 months over which the drug use was analyzed. There were 27 males and 21 females with a mean age of 69 years. Twelve subjects were on oral LEV at admission. Thirty patients received monotherapy with iv LEV. Most patients (n=34) received iv LEV for less than 5 days. The most common indication was Nil Per Oral (NPO) status of the patient (n=37). Nine patients who received iv LEV were in status epilepticus which is not an approved indication of use. The use of iv LEV was mostly in the Departments(n) of Neurology(16) , Medicine(15), Neurosurgery(10) and Trauma(5). Conclusions: Most of the use of ivLEV was off-label. The most common off-label use was as a monotherapy followed by use in Status Epilepticus or repetitive seizures. The rapid adoption of this formulation by Neurology and other departments may be attributed to ease of use and comfort level accorded by its favorable side effect profile.