Anticonvulsants

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Pediatric Anticonvulsants Table

Drug Dose Infusion Rate (Minutes) Age Comments/Cautions
Levetiracetam
  • 60 mg/kg/dose IV/IO
  • MAX: 4500 mg/dose
≥5 Any Most commonly used agent
Fosphenytoin
  • 20 mg phenytoin equivalent (PE)/kg/dose IV/IO/IM
  • MAX: 1000 PE/dose
≥10 Any Choose alternate drug if on phenytoin at home; may decrease BP/HR; not for toxin-induced seizures
Valproic acid
  • 40 mg/kg/dose IV/IO
  • MAX: 3000 mg/dose
≥10 ≥2 years Caution in patients with liver dysfunction, mitochondrial disease, urea disorder, thrombocytopenia, or unexplained developmental delay
Phenytoin
  • 20 mg/kg/dose IV/IO
  • MAX: 1000 mg/dose
≥20 Any Choose alternate drug if on phenytoin at home; may decrease BP/HR; not for toxin-induced seizures
Phenobarbital
  • 20 mg/kg/dose IV/IO
  • MAX: 1000 mg/dose
≥20 <6 months First line for most neonatal seizures. Respiratory depression, especially in combination with benzodiazepines

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