18. Using Parenteral Antiepileptic Medications

  1. John W. Miller MD, PhD Director, UW Regional Epilepsy Center, Professor of Neurology and Neurological Surgery2 and
  2. Howard P. Goodkin MD, PhD The Shure Professor of Neurology and Pediatrics, Director, Division of Pediatric Neurology3
  1. Jane G. Boggs

Published Online: 10 JAN 2014

DOI: 10.1002/9781118456989.ch18



How to Cite

Boggs, J. G. (2014) Using Parenteral Antiepileptic Medications, in Epilepsy (eds J. W. Miller and H. P. Goodkin), John Wiley & Sons, Oxford. doi: 10.1002/9781118456989.ch18

Editor Information

  1. 2

    University of Washington, Seattle, WA, USA

  2. 3

    Department of Neurology, University of Virginia, Charlottesville, VA, USA

Author Information

  1. Neurology, Wake Forest University School of Medicine, Comprehensive Epilepsy Center, Winston Salem, NC, USA

Publication History

  1. Published Online: 10 JAN 2014
  2. Published Print: 14 FEB 2014

ISBN Information

Print ISBN: 9781118456941

Online ISBN: 9781118456989



  • benzodiazepines;
  • diazepam;
  • lorazepam;
  • midazolam;
  • barbiturates;
  • ketamine;
  • phenytoin;
  • fosphenytoin;
  • propofol;
  • valproate;
  • levetiracetam;
  • lacosamide


In the hospital and the emergency department, status epilepticus and acute repetitive seizures are typically treated with parenteral antiepileptic drugs (AEDs). Parenteral AEDs are also used in less urgent situations when enteral administration is unavailable. Complexities inherent to use of parenteral AEDs include choosing how and when to use a loading dose, what maintenance doses to give, and whether, and how long, to administer a continuous infusion. Parenteral dosing recommendations depend on underlying medical conditions and potential drug interactions. Finally, laboratory and clinical testing requirements differ between parenteral and enteral AEDs. This chapter reviews these issues for those AED preparations clinically available for parenteral use: benzodiazepines, barbiturates, phenytoin, valproate, levetiracetam, and lacosamide. Approaches to treating status epilepticus are reviewed in Chapters 31 and 32.