Therapeutic Drug Monitoring of Levetiracetam by High - Performance Liquid Chromatography in Paediatric Epileptic Patients

Levetiracetam is a second generation anticonvulsant drug used as adjunctive therapy or monotherapy with high efficacy and tolerability in the treatment of partial seizures, myoclonic seizures and generalized tonic-clonic seizures in children. We aimed to correlate the serum drug concentration with seizure control status, complaints and liver enzymes (Alanine aminotransferase, Aspartate aminotransferase) in pediatric epileptic population. We prospectively evaluated 36 levetiracetam monotherapy patients, the dose was administrated based on their body mass index. A rapid and specific method by high-performance liquid chromatography (HPLC) UV detection was developed to determine serum drug concentrations, observations made and analyzed. Out of 36 patients, 24 patients drug concentration was within therapeutic range (12-46µg/ml) have shown good seizure control, 8 patients were in the sub-therapeutic range, of these subjects 4 had good seizure control and another 4 poor seizure control. Remaining 4 patients were in the supra-therapeutic range. This drug has no effect on liver enzymes. There is no significant correlation between serum drug concentration levels and subjective complaints. Levetiracetam can be used as a first-line broad-spectrum antiepileptic drug which is well tolerated and achieves good seizure control.