After benzodiazepines, which IV antiseizure medication is commonly given as a second-line for established status epilepticus, and what is its typical dose?

• A. Phenytoin 20 mg/kg IV
• B. Lacosamide 200 mg IV
• C. Levetiracetam 60 mg/kg IV (maximum 4.5 g per dose)
• D. Valproate 40 mg/kg IV

Answer: (C)

When establishing treatment after benzodiazepines for status epilepticus, you want an IV antiseizure that acts quickly, is easy to use, and has a favorable safety profile. Levetiracetam fits that need well: it provides rapid seizure control with minimal drug interactions and no significant hepatic or cardiac concerns, making it a reliable second-line choice in both adults and children. The typical dose is 60 mg/kg given IV, with a maximum of 4.5 g per dose, usually infused over about 10 minutes. This dosing balance offers effective coverage while limiting the risks associated with some older agents.