Levetiracetam is an antiepileptic drug that is used as monotherapy for partial seizures as well as an adjunct in partial, myoclonic and generalised tonic-clonic seizures. It shows a rapid absorption after oral administration and has linear pharmacokinetics. It is renally excreted (the majority unchanged and about ¼ as an inactive metabolite). The serum half life in adults is 6 to 8 hours. For therapeutic drug monitoring a trough level is recommended.
Previously a therapeutic range from 12 to 46 mg/L has been recommended (1). Newer data from New South Wales recommend a therapeutic range 20 to 40 mg/L based on freedom from epileptic fits both in patients on monotherapy as well as in patients where multiple antiepileptic medications are used (2).
Suggested therapeutic range: 20 to 40 mg/L
- Krasowski MD Therapeutic Drug Monitoring of the Newer Anti-Epilepsy Medications Pharmaceuticals (Basel). 2010 Jun 11;3(6):1909-1935. doi: 10.3390/ph3061909.
- Stepanova D, Beran RG. Measurement of levetiracetam drug levels to assist with seizure control and monitoring of drug interactions with other anti-epileptic medications (AEMs) Seizure. 2014 May;23(5):371-6.