Anyone ever been given IV meds like Keppra?

[trapped]

Hey, I was just wondering if anyone had ever gotten their normal seizure meds thru an IV? I talked to my neurologist yesterday, she was willing to let me wait til today to see if I got better, but unfortunately I haven't- since Friday night I've been sick with what I am guessing is the stomach flu- not entirely sure tho, since I've only been sick with vomiting like this twice before in my entire life. I thought it was a cold at first cuz I was all congested and whatnot so came home early on Friday and fell asleep before 6pm... woke up several hours later puking my guts out tho, and was up all night after that. Finally got a bit more sleep and when I got up Saturday morning tried some small sips of water... threw that up. Tried to take my meds (multiple times) and every time those have come back up too. The neurologist said missing one day of the meds she wouldn't be concerned about, but if by this morning I was still sick to page her and we would come up with a plan, however she did say in all liklihood that plan would involve having to go to the ER to be given the Keppra that I normally take orally, thru an IV, cuz she doesn't want me to go from 2,000mg a day of that to zero. I'm on neurontin too, but the Keppra seemed to be what she was most concerned about, or at least that's the one she mentioned being given thru an IV. I don't have any side effects from the oral Keppra, but I'm wondering if the IV form might have side effects? And how long does the IV form take? I take the Keppra twice a day, but I'm wondering if they'd be able to give it to me just once in the ER and let me come home after that, or if they'd keep me in the observation unit or something similar all day or possibly overnight to give it to me twice a day thru the IV as well up until I'm able to hold down at least one dose of the oral stuff there? I'm pretty afraid of ER's, tho I guess I don't have a choice on this one, and I'm also afraid of having more seizures, so if I call my doctor in like 6 hours (since it's only like 3am now, and I don't want to call her before 9am) and she says I need to go I probably will go, especially since at least she is good about calling the ER to update them before you go, so they'd at least know I was coming (plus she is the neurologist doc on call this weekend, so she would likely meet me at the ER anyway or at least stop by to check on me), because otherwise I wouldn't go in, because I'd feel stupid for going in and saying "I have the flu, so need my Keppra thru an IV"... actually, I didn't even know it could be given IV til last night when I talked to the doctor. I felt really stupid for paging her, but was getting concerned that the last dose of Keppra I had had was Friday morning and I was still having issues keeping stuff down. She was happy I called to ask about it though, which was a relief... I just had never ever thought of asking the question of "if I ever get so severely sick that I vomit up everything including my seizure meds, what do I do?" I guess it's just something you don't really think of until it happens.

[Nakamova]

Hi trapped --

I had Dilantin through an IV when I was in the ER after my very first seizures. Almost all the anti-epileptic drug meds can be administered this way. As to how long you'll need to be there, how often you'll need to get dosed, or whether the absorption rate will be different -- these are all good questions to ask your neurologist when you talk to her.

I found the following info on the levetiracetam (Keppra) website:
-- Administer IV levetiracetam as 15-min infusion following dilution in 100 mL of a compatible diluent.
-- Patient may be switched from oral to IV administration at the equivalent dose and frequency.

This suggests that it will take 15 minutes for the IV, but if you currently take Keppra twice a day, you may need to get the IV twice a day too. The dose would be equivalent to your current dose, so you shouldn't experience any new side effects.

Again, though, you should discuss with your neurologist if there's a once-a-day IV option, perhaps with extended release Keppra. And ask again about the Neurontin -- my guess is she's less concerned about it because it has a longer half-life than the Keppra. It lingers longer in your system, whereas the Keppra tends to cycle out very quickly.

I hope you feel better soon, your flu sounds absolutely miserable.

BTW, who's your neurologist? I used to have one in Boston at the Beth Israel Hospital. She was nice, though we didn't always see eye to eye...

[trapped]

Thanks Nakamova! I go to the BI too. I see Dr Herman there, she's pretty awesome. Well, I see a few neurologists, but she's the one that treats the seizures.

I did end up having to go to the ER, the IV Keppra wasn't at all scary like I thought it'd be. They kept me there all day giving me the Keppra and lots of fluids since I was so dehydrated, and some IV meds for the nausea. It seemed to work, until this morning when I threw up, again Although, I'm uncertain if the throwing up this morning was related to this virus I caught, or if it could have been a result of potentially hitting my head this morning... I don't really remember what happened, apart from I didn't feel right, I went to get out of bed, and woke up on the floor trying to figure out where I was. So I'm not quite sure if it was a seizure, or if I stood up and passed out, I don't think I had managed to even fully stand up tho, but can't really recall much... but, since I was on the floor, I assume that there is a possibility I hit my head, which maybe could cause the vomiting? I'm waiting to hear back from a couple of my doctors so I guess I'll find out, tho I'm afraid they'll tell me to go to the hospital, and then that the hospital will keep me, and I don't want that at all

[Nakamova]

While it's possible that a head injury could make you puke, my guess is that it's the virus still messing with you since that's what's been upsetting your stomach for the last few days. Do you have a fever? Have you been able to keep anything down at all? You're probably still pretty dehydrated, which can cause fainting when you sit up or stand up. Fingers-crossed that you didn't have a seizure, but it's probably worth mentioning to your neurologist anyway. Feel better!

[trapped]

Thanks Nakamova... no, I don't have a fever any more. True that it could still be the virus messing with me... it just seems like a super long time, since it's been messing with me since Friday! I was able to keep down Pedialyte last night and up until this morning, took my seizure meds after I got up, and after taking some compazine for the nausea, within 10-15 minutes of taking the Keppra and neurontin, threw up both of those. I've since tried more Pedialyte, but so far that isn't staying down either.

[Nakamova]

A lot of the anti-epileptic drugs affect the immune system, so that may be why it's taking a bit longer to shake the bug.