Levetiracetam – epilepsy treatment, pharmacokinetics, mechanism of action, interaction and toxicity

Abstract

Kozłowski Piotr, Czępińska-Ćwik Wioleta, Kozłowska Magdalena, Kozłowska Karolina. Levetiracetam – epilepsy treatment, pharmacokinetics, mechanism of action, interaction and toxicity. Journal of Education, Health and Sport. 2015;5(4):143-150. ISSN 2391-8306. DOI: 10.5281/zenodo.16694

http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%284%29%3A143-150

https://pbn.nauka.gov.pl/works/553762

http://dx.doi.org/10.5281/zenodo.16694

Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011 – 2014 http://journal.rsw.edu.pl/index.php/JHS/issue/archive

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© The Author (s) 2015;

This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland and Radom University in Radom, Poland

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This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial

use, distribution and reproduction in any medium, provided the work is properly cited.

The authors declare that there is no conflict of interests regarding the publication of this paper.

Received: 20.01.2015. Revised 27.03.2015. Accepted: 27.03.2015.

LEVETIRACETAM – EPILEPSY TREATMENT, PHARMACOKINETICS, MECHANISM OF ACTION, INTERACTION AND TOXICITY

Piotr Kozłowski¹, Wioleta Czępińska-Ćwik², Magdalena Kozłowska³, Karolina Kozłowska⁴

¹ Katedra i Zakład Anatomii Prawidłowej Człowieka, UM w Lublinie

²  Klinika Chorób Wewnętrznych, 1 Wojskowy Szpital Kliniczny z Polikliniką w Lublinie

³ Katedra i Zakład Farmakologii doświadczalnej i Klinicznej, UM w Lublinie

⁴ Instytut Filologii Angielskiej, KUL

Uniwersytet Medyczny w Lublinie

ul. W. Chodźki 1, 20-093 Lublin

e-mail: piotr7176@gmail.com

Abstract

Epilepsy is a common chronic neurological disorder that requires a long-term antiepileptic drug therapy. Epilepsy affects approximately 1% of the world’s population, so about 50 million people worldwide have epilepsy. It more likely occurs among children and people over the age of 65. This chronic condition is characterized by recurrent, unprovoked epileptic seizures. Although there are many innovative methods of seizure control, such as neurosurgery, vagal nerve stimulations (VNS) and ketogenic diet, pharmacology is most forceful method of epilepsy treatment. Unfortunately, anticonvulsant drugs are not always effective; the number of non-responding patients is higher than 30% [2,25,29,31].

            Levetiracetam (LEV) is one of the newest AEDs, marketed worldwide only since 2000 [29]. This novel antiepileptic drug has a unique and non-standard mechanism of action. The structure of LEV is similar to the prototypical nootropic drug piracetam. Its novel mechanism of action is connected with the synaptic vesicle protein SV2A in the brain. The elimination plasma half-live of LEV is approximately from 6 to 8 hours among adults. About 66% of the drug is excreted unchanged and 27% as inactive hydrolysis product [12]. LEV is mainly removed by the kidneys so that elimination parallels kidney function (renal clearance: 0,6 ml/min/kg) [3,12,32]. LEV was found to be well tolerated and effective in all types of seizures in adults and children [18]. It can be also used in combinations with other AEDs. The drug may also be useful in treatment of Lennox-Gastaut syndrome [9].

            This article reviews available published data on LEV in the treatment of adults and children, including information about LEV`s pharmacokinetics, chemistry, mechanism of action, interactions and toxicity.

Key words: levetiracetam, antiepileptic drugs, seizures, epilepsy.