Levetiracetam - Revision history

Zeki at 05:32, 5 September 2024

2024-09-05T05:32:09Z

← Older revision		Revision as of 01:32, 5 September 2024
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	[[Category: Drugs]] [[Category: Seizures]]		[[Category: Drugs]][[Category: Anticonvulsant]] [[Category:Seizures]]

			[[:Category: Anticonvulsant \| '''Anticonvulsant''']]

	'''Levetiracetam''' (中文: [[左乙拉西坦]])is an anticonvulsant medication used to treat epilepsy. It is taken either by mouth as an immediate or extended release formulation or by injection into a vein.		'''Levetiracetam''' (中文: [[左乙拉西坦]])is an anticonvulsant medication used to treat epilepsy. It is taken either by mouth as an immediate or extended release formulation or by injection into a vein.

Helen: /* Pharmacokinetics */

2020-10-12T08:37:41Z

Pharmacokinetics

← Older revision		Revision as of 04:37, 12 October 2020
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	{\|class="wikitable"		{\|class="wikitable"
	!Oral bioavailability		!style="text-align: left"\|Oral bioavailability
	\|Levetiracetam is readily absorbed after oral doses.		\|Levetiracetam is readily absorbed after oral doses.
	\|-		\|-
	!Onset of action		!style="text-align: left"\|Onset of action
	\|Peak plasma concentrations occur within 1.3 hours of oral doses and steady state after 2 days.		\|Peak plasma concentrations occur within 1.3 hours of oral doses and steady state after 2 days.
	\|-		\|-
	!Metabolism		!style="text-align: left"\|Metabolism
	\|It is not extensively metabolized in the liver		\|It is not extensively metabolized in the liver
	\|-		\|-
	!Elimination half-life		!style="text-align: left"\|Elimination half-life
	\|It is excreted almost entirely in urine.		\|It is excreted almost entirely in urine.
	The mean elimination half-life is about 7 hours.		The mean elimination half-life is about 7 hours.

Helen: /* Dosage */

2020-10-12T08:36:27Z

Dosage

← Older revision		Revision as of 04:36, 12 October 2020
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	{\|class="wikitable"		{\|class="wikitable"
	!style="text-align: left"\| Very common (>10% incidence)		!style="text-align: left"\| Very common (>10% incidence)
	\|*Dizziness		\|
			*Dizziness
	*drowsiness		*drowsiness
	*weakness		*weakness
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	\|-		\|-
	!style="text-align: left"\| Common (1-10% incidence)		!style="text-align: left"\| Common (1-10% incidence)
	\|*Ataxia		\|
			*Ataxia
	*Gl effects include abdominal pain, anorexia, diarrhoea, dyspepsia, nausea, vomiting		*Gl effects include abdominal pain, anorexia, diarrhoea, dyspepsia, nausea, vomiting
	*Insomnia		*Insomnia

Helen: /* Drug interaction= */

2020-10-09T04:10:38Z

Drug interaction=

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	*changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.		*changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.

	===Drug interaction====		===Drug interaction===
	No significant pharmacokinetic interactions were observed between levetiracetam and concomitant medications. However, levetiracetam possibly increases risk of CARBAMAZEPINE toxicity.		No significant pharmacokinetic interactions were observed between levetiracetam and concomitant medications. However, levetiracetam possibly increases risk of CARBAMAZEPINE toxicity.

	===Caution===		===Caution===

Helen at 03:11, 9 October 2020

2020-10-09T03:11:39Z

← Older revision		Revision as of 23:11, 8 October 2020
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	\|Levetriacetam infusion 100mg/ml 5 ml		\|Levetriacetam infusion 100mg/ml 5 ml
	\|LEVE05		\|LEVE05
	\|		\|P1S1S3
	\|}		\|}

Helen at 03:09, 9 October 2020

2020-10-09T03:09:19Z

← Older revision		Revision as of 23:09, 8 October 2020
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	The mean elimination half-life is about 7 hours.		The mean elimination half-life is about 7 hours.
	\|}		\|}

			==Drug Management==
			===Monitoring===
			*Liver and kidney function tests to monitor side effects
			*changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.

			===Drug interaction====
			No significant pharmacokinetic interactions were observed between levetiracetam and concomitant medications. However, levetiracetam possibly increases risk of CARBAMAZEPINE toxicity.

			===Caution===
			*Avoid abrupt withdrawal (taper off over 2 weeks or longer) unless serious skin reaction occurs
			*Use with care in patients with osteoporosis
			*Dose adjustments for patients with hepatic impairment and renal impairment

			===Hepatic impairment===
			Halve dose in severe hepatic impairment if creatinine clearance less than 60 mL/minute.

			===Renal impairment===
			*Maximum 2 g daily if creatinine clearance 50 - 80 mL/minute.
			*Maximum 1.5 g daily if creatinine clearance 30 – 49 mL/minute.
			*Maximum 1 g if creatinine clearance less than 30 mL/minute
			*Patients receiving dialysis may be given a loading dose of 750 mg when starting levetiracetam followed by doses of 0.5 to 1 g once daily; a supplemental dose of 250 to 500 mg is recommended after dialysis

			===Pregnancy===
			Women of child-bearing potential should discuss with a specialist the impact of both epilepsy, and its treatment, on the outcome of pregnancy. There is an increased risk of teratogenicity associated with the use of antiepileptic drug (especially if used during the first trimester)

			===Breast-feeding===
			Use during breast feeding is not recommended.

			===Epilepsy and driving===
			Driving by patients with epilepsy is generally regulated. Also, antiepileptic drugs may produce CNS-related adverse effects, including dizziness and drowsiness, that could impair a patient’s ability to drive a vehicle or operate machinery, particularly during the initial stages of therapy.

			== FAQ ==
			=== How should I take the tablet? ===
			You can take levetiracetam with or without food. If you take it twice day, try to space your doses evenly through the day – for example, first thing in the morning and in the evening. Swallow tablet whole with a drink of water. Do not chew them.
			=== What should I avoid while using? ===
			Avoid abruptly discontinue the medication. Avoid alcohol
			=== What happen if I overdose? ===
			Contact your primary care doctor.
			If emergency situation, call 999
			=== What happen if I miss a dose? ===
			Take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Helen at 03:05, 9 October 2020

2020-10-09T03:05:35Z

← Older revision		Revision as of 23:05, 8 October 2020
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	In a study, the incidence of decreased bone mineral density of patients on levetiracetam was significantly higher than those for other epileptic medications.		In a study, the incidence of decreased bone mineral density of patients on levetiracetam was significantly higher than those for other epileptic medications.

			==Pharmacokinetics==

			{\|class="wikitable"
			!Oral bioavailability
			\|Levetiracetam is readily absorbed after oral doses.
			\|-
			!Onset of action
			\|Peak plasma concentrations occur within 1.3 hours of oral doses and steady state after 2 days.
			\|-
			!Metabolism
			\|It is not extensively metabolized in the liver
			\|-
			!Elimination half-life
			\|It is excreted almost entirely in urine.
			The mean elimination half-life is about 7 hours.
			\|}

Helen: /* Dosage */

2020-10-09T03:03:44Z

Dosage

← Older revision		Revision as of 23:03, 8 October 2020
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	*Max. per dose 1.5 g twice daily		*Max. per dose 1.5 g twice daily
	\|}		\|}

			A modified-release preparation is available for once-daily dosing as an adjunct in the treatment of focal seizures in patients aged 16 years and over.
			As with other antiepileptics, withdrawal of levetiracetam therapy or transition to or from another type of antiepileptic therapy should be made gradually to avoid precipitating an increase in the frequency of seizures. It is recommended:
			*Those weighing more than 50 kg, the dose reduction of 1 g every 2 to 4 weeks;
			*Those weighing less than 50 kg, the dose reduction should not exceed 20 mg/kg every 2 weeks.

			Adverse drug reactions associated with the use of levetiracetam include:

			{\|class="wikitable"
			!style="text-align: left"\| Very common (>10% incidence)
			\|*Dizziness
			*drowsiness
			*weakness
			*somnolence
			\|-
			!style="text-align: left"\| Common (1-10% incidence)
			\|*Ataxia
			*Gl effects include abdominal pain, anorexia, diarrhoea, dyspepsia, nausea, vomiting
			*Insomnia
			*Irritability
			*tremor
			\|-
			!style="text-align: left"\| Rare (<0.1% of incidence)
			\|
			*Agrtanulocytosis, causing increased vulmerability to infection.
			*Choreoathetosis
			*Hepatitis, hepatic failure
			*Hyponatraemia
			*Pancreatitis
			*Stevens-Johnson syndrome
			*Toxic epidermal necrosis
			\|}

			In a study, the incidence of decreased bone mineral density of patients on levetiracetam was significantly higher than those for other epileptic medications.

Helen: /* Dosage */

2020-10-09T02:57:53Z

Dosage

← Older revision		Revision as of 22:57, 8 October 2020
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	*Max. per dose 1.5 g twice daily		*Max. per dose 1.5 g twice daily

	\|''By intravenous infusion		''By intravenous infusion
	CHILD 4-17 years (body-weight up to 50 kg):		CHILD 4-17 years (body-weight up to 50 kg):
	*Initially 10 mg.kg once daily, then increased in steps of up to 10 mg/kg twice daily every 2 weeks		*Initially 10 mg.kg once daily, then increased in steps of up to 10 mg/kg twice daily every 2 weeks

Helen: /* Dosage */

2020-10-09T02:57:40Z

Dosage

← Older revision		Revision as of 22:57, 8 October 2020
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	*Increased in steps of 500 mg twice daily every 2-4 weeks		*Increased in steps of 500 mg twice daily every 2-4 weeks
	*Max. per dose 1.5 g twice daily		*Max. per dose 1.5 g twice daily
			\|-
	!style="text-align: left"\| Adjunctive therapy of myoclonic seizures and tonic-clonic seizures		!style="text-align: left"\| Adjunctive therapy of myoclonic seizures and tonic-clonic seizures
	\|''By mouth, or by intravenous infusion		\|''By mouth, or by intravenous infusion