Levetiracetam drug interactions

Geriatric Considerations-Summary Levetiracetam is associated with few drug interactions and low incidence of cognitive impairment. Tremor and headache are more prevalent in older adults as compared to adults < 65 years of age. Hemodialysis reduces plasma concentrations. 

Side effects. Detailed safety studies show that levetiracetam is well tolerated, the most frequent side effects reported being somnolence, asthenia and dizziness. To date, levetiracetam would appear to be a highly effective new antiepileptic drug with an excellent safety and tolerability profile. Few drug interactions have been reported so far. The efficacy and safety of the drug have been established as add-on therapy for refractory partial onset seizures with or without secondary generalization and there is now evidence of its efficacy in monotherapy. 

Because levetiracetam is not metabolized by CYP450 enzymes and does not inhibit or induce CYP450 enzymes, it is unlikely to have significant pharmacokinetic drug interactions... 

Levetiracetam. Levetiracetam is a new anticonvulsant agent that does not as yet present any drug interactions. Dizziness and somnolence occurred to a statistically significant extent (14.8% versus 8.4% of the placebo patients) (18). This side effect occurred more frequently with patients receiving levetiracetam in combination with other anticonvulsant agents. 

Drug Interactions. Levetiracetam neither inhibits nor indnces the CYP450, UGT, or epoxide hydrolase enzyme systems, and in vitro data predict a low potential for pharmacokinetic interactions. Levetiracetam does not appear to interact with other AEDs, warfarin, digoxin, or oral contraceptive drngs. ° ... 

The risk of clinically relevant drug interactions is minimal with S-(-)-levetiracetam, because it does not alter the pharmacokinetics of coadministered drugs by inhibition or induction of hepatic enzymes (84). Toxic effects include mild to moderate somnolence, asthenia, ataxia, and dizziness these effects seldom require discontinuance. An increase in the incidence of behavioral abnormalities in children and in adults having a previous history of neuropsychiatric problems has been noted (85). Its use in the elderly or in patients with renal Impairment will require an individualization of dose, and an additional dose is needed after renal dialysis. Levetiracetam was associated with developmental toxicity in the offspring of pregnant animals. 

Nicolas, J.-M. et al.. In vitro evaluation of potential drug interactions with levetiracetam, a new antiepileptic agent, Drug Metab. Dispos., 27 250-254, 1999. 

Drug/Food Interactions Food does not affect the extent of absorption of levetiracetam, but it decreases C ax by 20% and delays T ax by 1 -5 hours. 

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