Increased levetiracetam clearance and breakthrough seizure in a pregnant patient successfully handled by intensive therapeutic drug monitoring

Alberto M. Cappellari, Dario Cattaneo, Emilio Clementi, Alessandra Kustermann

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

We report a 36-year-old pregnant patient with subtherapeutic trough plasma levels of levetiracetam (LVT) and a breakthrough nocturnal seizure while assuming 3 times a day dosing of the drug. An intensive pharmacokinetic study was performed from immediately before to 11 hours after the morning LVT dose administration and suggested that the patient was not adequately exposed to the drug during the night. After changing the dosing of LVT to 4 times a day, the patient experienced no seizures and delivered a healthy newborn without complications. Afterward, trough plasma levels of LVT remained always within the therapeutic range until delivery, and no major increase of the drug daily dose was required. ©

Original languageEnglish
Pages (from-to)285-287
Number of pages3
JournalTherapeutic Drug Monitoring
Volume37
Issue number3
DOIs
Publication statusPublished - Jun 26 2015

Fingerprint

etiracetam
Drug Monitoring
Seizures
Pharmaceutical Preparations
Pharmacokinetics
Newborn Infant

Keywords

  • epilepsy
  • levetiracetam
  • pregnancy
  • seizure
  • therapeutic drug monitoring

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology

Cite this

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AU - Clementi, Emilio

AU - Kustermann, Alessandra

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AB - We report a 36-year-old pregnant patient with subtherapeutic trough plasma levels of levetiracetam (LVT) and a breakthrough nocturnal seizure while assuming 3 times a day dosing of the drug. An intensive pharmacokinetic study was performed from immediately before to 11 hours after the morning LVT dose administration and suggested that the patient was not adequately exposed to the drug during the night. After changing the dosing of LVT to 4 times a day, the patient experienced no seizures and delivered a healthy newborn without complications. Afterward, trough plasma levels of LVT remained always within the therapeutic range until delivery, and no major increase of the drug daily dose was required. ©

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