About two-thirds of administered levetiracetam is cleared by the kidney via glomerular filtration.55 Clearance of levetiracetam decreases in proportion to the decrease in creatinine clearance in patients with renal insufficiency.56 The following table lists the dosing of levetiracetam as a function of creatinine clearance:
|Creatinine clearance |
|>80||500–1,500||Every 12 hrs|
|50–80||500–1,000||Every 12 hrs|
|30–50||250–750||Every 12 hrs|
|<30||250–500||Every 12 hrs|
Levetiracetam is water soluble, has low protein binding, and has a low volume of distribution.55 Approximately 50% of the body pool of levetiracetam is removed during a 4-hour hemodialysis session.56 A supplemental dose of 250 to 500 mg of levetiracetam following dialysis is recommended.57
Reviewed and revised February 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.
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