Adults and adolescents older than 16 years: The initial therapeutic dose is 500 mg twice daily. This dose can be started on the first day of the treatment.
Depending upon the clinical response and tolerance, the daily dose can be increased up to 1500 mg twice daily. Dose changes can be made in 500 mg twice daily increments or decrements every two to four weeks.
Elderly (65 years and older): Adjustment of the dose is recommended in elderly patients with compromised renal function (see "Patients with renal impairment" as follows).
Children: There are insufficient data to recommend the use of Levetiracetam in children and adolescents under 16 years of age.
Patients with renal impairment: The daily dose must be individualized according to renal function. Refer to the following table and adjust the dose as indicated. To use this dosing table, an estimate of the patient's creatinine clearance (Clcr) in mL/minute is needed. The Clcr in mL/minute may be estimated from serum creatinine (mg/dl) determination using the following formula: See equation and table.


Patients with hepatic impairment: No dose adjustment is needed in patients with mild to moderate hepatic impairment. In patients with severe hepatic impairment, the creatinine clearance may underestimate the renal insufficiency. Therefore a 50% reduction of the daily maintenance dose is recommended when the creatinine clearance is < 70 mL/minute.