Levetiracetam

Haria, Malini; Balfour, Julia A.

doi:10.2165/00023210-199707020-00006

Cited by 44 publications

(21 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The chemical structure of LEV is the α-ethyl analog of piracetam and is unrelated to other AEDs [132]. LEV is a safe and well-tolerated new AED and no significant drug interactions were noted between LEV and concomitant medications because of lower protein binding and no involvement of hepatic CYP isozymes [131,132]. LEV is rapidly absorbed in the digestive tract and mainly excreted in urine.…”

Section: New Generation Aedsmentioning

confidence: 99%

The Impact of Anti-Epileptic Drugs on Growth and Bone Metabolism

Fan

Lee

Chang

et al. 2016

IJMS

View full text Add to dashboard Cite

Epilepsy is a common neurological disorder worldwide and anti-epileptic drugs (AEDs) are always the first choice for treatment. However, more than 50% of patients with epilepsy who take AEDs have reported bone abnormalities. Cytochrome P450 (CYP450) isoenzymes are induced by AEDs, especially the classical AEDs, such as benzodiazepines (BZDs), carbamazepine (CBZ), phenytoin (PT), phenobarbital (PB), and valproic acid (VPA). The induction of CYP450 isoenzymes may cause vitamin D deficiency, hypocalcemia, increased fracture risks, and altered bone turnover, leading to impaired bone mineral density (BMD). Newer AEDs, such as levetiracetam (LEV), oxcarbazepine (OXC), lamotrigine (LTG), topiramate (TPM), gabapentin (GP), and vigabatrin (VB) have broader spectra, and are safer and better tolerated than the classical AEDs. The effects of AEDs on bone health are controversial. This review focuses on the impact of AEDs on growth and bone metabolism and emphasizes the need for caution and timely withdrawal of these medications to avoid serious disabilities.

show abstract

Section: New Generation Aedsmentioning

confidence: 99%

The Impact of Anti-Epileptic Drugs on Growth and Bone Metabolism

Fan

Lee

Chang

et al. 2016

IJMS

View full text Add to dashboard Cite

show abstract

“…1): LEV, which is the (S)‐enantiomer, and (R)‐α‐ethyl‐2‐oxo‐pyrrolidine acetamide (REV). Only the (S)‐enantiomer has anticonvulsant activity, and consequently, only this enantiomer has been developed and used as a new AED (3).…”

mentioning

confidence: 99%

Pharmacokinetics of Levetiracetam and Its Enantiomer (R)‐α‐ethyl‐2‐oxo‐pyrrolidine acetamide in Dogs

Isoherranen¹,

Yagen

Soback³

et al. 2001

Epilepsia

View full text Add to dashboard Cite

Summary: Purpose:The new antiepileptic drug, levetiracetam (LEV, ucb LO59), is a chiral molecule with one asymmetric carbon atom whose anticonvulsant activity is highly enantioselective. The purpose of this study was to evaluate and compare the pharmacokinetics (PK) of LEV [(S)-␣-ethyl-2-oxo-pyrrolidine acetamide] and its enantiomer (R)-␣-ethyl-2-oxo-pyrrolidine acetamide (REV) after i.v. administration to dogs. This is the first time that the pharmacokinetics of both enantiomers has been evaluated.Methods: Optically pure LEV and REV were synthesized, and 20 mg/kg of individual enantiomers was administered intravenously to six dogs. Plasma and urine samples were collected until 24 h, and the concentrations of LEV and REV were determined by an enantioselective assay. The levels of 2-pyrrolidone-N-butyric acid, an acid metabolite of LEV and REV, were determined by high-performance liquid chromatography (HPLC). The data were used for PK analysis of LEV and REV.Results: LEV and REV had similar mean ± SD values for clearance; 1.5 ± 0.3 ml/min/kg and volume of distribution; 0.5 ± 0.1 L/kg. The half-life (t 1/2 ) and mean residence time (MRT) of REV (t 1/2 , 4.3 ± 0.8 h, and MRT, 6.0 ± 1.1 h) were, however, significantly longer than those of LEV (t 1/2 , 3.6 ± 0.8 h, and MRT, 5.0 ± 1.2 h). The renal clearance and fraction excreted unchanged for LEV and REV were significantly different.Conclusions: In addition to the enantioselective pharmacodynamics, ␣-ethyl-2-oxo-pyrrolidine acetamide has enantioselective PK. The enantioselectivity was observed in renal clearance. Because REV has more favorable PK in dogs than LEV, the higher antiepileptic potency of LEV is more likely due to intrinsic pharmacodynamic activity rather than to enantioselective PK.

show abstract

“…It is chemically unrelated to other antiepileptic drugs and is the α-ethyl analogue of the nootropic agent piracetam. [1] It is postulated to act by binding to synaptic vesicle protein 2A (SV2A) and thereby modulation of one or more of its actions, ultimately affecting neural excitability. [2] It has been found to be well-tolerated and has a favorable pharmacokinetic profile that includes minimal protein binding, lack of hepatic metabolism and twice a day dosing.…”

Section: Introductionmentioning

confidence: 99%

Levetiracetam induced acute reversible psychosis in a patient with uncontrolled seizures

et al. 2014

View full text Add to dashboard Cite

Levetiracetam (LEV) is a relatively newer antiepileptic drug with novel mechanism of action. It was introduced to the market in the year 2000. Pre-marketing clinical trials of the drug reported good tolerability with a wide safety margin. On post-marketing updates, there are few reports of psychosis after treatment with the drug. Here, we report a case of 52-year-old epileptic man who developed acute, reversible psychosis within 3 days of initiation of treatment. The drug was prescribed at a dose of 500 mg per day. After 3 days of treatment, the patient developed visual hallucinations, mood swings, withdrawal and suspicious behavior. Delirium was ruled out as there was no fluctuation in his sensorium or focal neurological deficits. His lab investigations for electrolytes, renal function test, thyroid, liver function and other related tests levels were within normal limits. A diagnosis of LEV induced psychosis was reached based on clinical judgment and causality assessment.

show abstract

Levetiracetam

Cited by 44 publications

References 16 publications

The Impact of Anti-Epileptic Drugs on Growth and Bone Metabolism

The Impact of Anti-Epileptic Drugs on Growth and Bone Metabolism

Pharmacokinetics of Levetiracetam and Its Enantiomer (R)‐α‐ethyl‐2‐oxo‐pyrrolidine acetamide in Dogs

Levetiracetam induced acute reversible psychosis in a patient with uncontrolled seizures

Contact Info

Product

Resources

About