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 ORIGINAL ARTICLE
Year : 2012  |  Volume : 60  |  Issue : 2  |  Page : 146--149

An initial experience with therapeutic drug monitoring of levetiracetam as reported from a pediatric clinical setting in India


1 Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, Tamil Nadu, India
2 Department of Neurology, Christian Medical College, Vellore, Tamil Nadu, India

Correspondence Address:
B S Mathew
Clinical Pharmacology Unit, Department of Pharmacology and Clinical Pharmacology, Christian Medical College Hospital, Vellore-632004, Tamil Nadu
India
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Source of Support: Fluid research grant from the institution (Christian Medical College, Vellore, Tamil Nadu, India), Conflict of Interest: None


DOI: 10.4103/0028-3886.96382

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Background and Objectives: Monitoring of levetiracetam in routine clinical practice is not strongly recommended. The aim of this study was to investigate any difference in serum levetiracetam concentration between patients on enzyme-inducing and -inhibiting antiepileptic co-medication and also to identify any correlation between levetiracetam concentration and clinical response. Materials and Methods: This study included pediatric patients with epilepsy from a tertiary care referral hospital in India. Details of antiepileptic co-medication, seizure frequency before and after initiating levetiracetam were recorded. Serum trough levetiracetam concentration was measured. Results: Of the 69 children recruited in the study, 55 children had >50% reduction in seizure frequency compared to baseline seizure frequency. Eight patients showed no improvement. The serum concentration of levetiracetam was more than 10 μg/ml in 78.2% of responders and 75% non-responders. There was no difference in dosing between responders and non-responders. Patients on enzyme-inducing co-medication had lower median serum levetiracetam concentrations (7.3 μg/ml) compared to those on enzyme-inhibiting co-medication (14.4 μg/ml) or those without interfering antiepileptic co-medication (16.6 μg/ml). Conclusion: Levetiracetam monitoring has a role in patients on antiepileptic polypharmacy and for confirmation of compliance.






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