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Clinical Pharmacokinetics
Published in: Clinical Pharmacokinetics 3/2021

01-03-2021 | Pharmacokinetics | Systematic Review

Population Pharmacokinetics of Levetiracetam: A Systematic Review

Authors: Zi-ran Li, Chen-yu Wang, Xiao Zhu, Zheng Jiao

Published in: Clinical Pharmacokinetics | Issue 3/2021

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Abstract

Background

Levetiracetam has been widely used as a treatment option for different types of epilepsy in both adults and children. Because of its large between-subject variability, several population pharmacokinetic studies have been performed to identify its pharmacokinetic covariates, and thus facilitate individualised therapy.

Objective

The aim of this review was to provide a synopsis for population pharmacokinetic studies of levetiracetam and explore the identified influencing covariates.

Methods

We systematically searched the PubMed and Embase databases from inception to 30 June 2020. The information on study designs, target population, model characteristics, and identified covariates was summarised. Moreover, the pharmacokinetic profiles were compared among neonates, children, and adults.

Results

Fourteen studies were included, among which two involved neonates, four involved children, two involved both children and adults, and six involved adults only. The median value of apparent clearance for children (0.074 L/h/kg [range 0.038–0.079]) was higher than that for adults (0.054 L/h/kg [range 0.039–0.061]). Body weight was found to significantly influence the apparent clearance and volume of distribution, whereas renal function influenced the clearance. Likewise, coadministration with enzyme-inducing antiepileptic drugs (such as carbamazepine and phenytoin) increased the drug clearance by 9–22%, whereas coadministration with valproate acid decreased it by 18.8%.

Conclusion

Levetiracetam dose regimen is dependent on the body size and renal function of patients. Further studies are needed to evaluate levetiracetam pharmacokinetics in neonates and pregnant women.
Appendix
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Metadata
Title
Population Pharmacokinetics of Levetiracetam: A Systematic Review
Authors
Zi-ran Li
Chen-yu Wang
Xiao Zhu
Zheng Jiao
Publication date
01-03-2021
Publisher
Springer International Publishing
Published in
Clinical Pharmacokinetics / Issue 3/2021
Print ISSN: 0312-5963
Electronic ISSN: 1179-1926
DOI
https://doi.org/10.1007/s40262-020-00963-2

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