Levetiracetam Serum Concentrations in Pediatric Patients: Is There a Role in Clinical Decision Making?

Monitoring of levetiracetam is not frequently used in clinical practice. This study evaluated the LEV blood level concentrations, correlation with dose, and co-medication effect to decide the need for blood concentration monitoring in pediatric patients. The children with epileptic seizures on levetiracetam therapy, aged one month-18 years, were enrolled and evaluated for gender, age, body weight, daily drug dose, comedication, and drug concentration records. 57.9% of one hundred and forty patients were on monotherapy. The mean dose of LEV was 35.40 mg/kg/day, while the mean drug concentration was 14.06 μg/ mL. The correlation between the dose and the serum concentration in the polytherapy group was poorly significant, whereas it was positive and highly significant in the monotherapy group. The mean drug concentration was within the established reference range, but concentration monitoring revealed children with serum concentrations below and above the therapeutic range. All cases in our study had the typical range of drug dose per body weight with no side effects. Conclusion: We point out that monitoring is not practical for most patients. Due to its tolerability over an extensive concentration range, the clinical assessment remains the monitoring strategy for patients with epilepsy on LEV therapy.