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Table 1 Comparison of phenytoin and levetiracetam

From: Emergency treatment with levetiracetam or phenytoin in status epilepticus in children—the EcLiPSE study: study protocol for a randomised controlled trial

  Phenytoin Levetiracetam
Easy to administera
Rapid onset of actiona
Intermediate to long actiona
Broad spectruma
Minimal morbiditya
Useful as maintenance AEDa
IV solution compatibilitya
Rate of infusion 20 min (minimum) 5 min (minimum)
Effectiveness in CSE (seizure termination rate) 50–60% 75–100%
Evidence base   
Cost   
Interactions with other drugs   
Adverse effects   
Potentially fatal Cardiac arrhythmia
Cardiac asystole
Stevens-Johnson syndrome
 
Non-fatal Hypotension
Hepatotoxicity
Phlebitis
Severe extravasation injury (‘purple glove syndrome’)
Dizziness
Somnolence
Headache
Agitation
IV site irritation
  1. aCharacteristics of ideal intravenous AEDs as outlined by Wheless and Treiman [41]
  2. AED anti-epileptic drug, CSE convulsive status epilepticus, IV intravenous