Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Experience and pharmacokinetics of Levetiracetam in Korean neonates with neonatal seizures

  • Shin, Jae Won (Department of Pediatrics, Pharmacology, Yonsei University College of Medicine) ;
  • Jung, Yun Seob (Department of Pharmacology, Yonsei University College of Medicine) ;
  • Park, Kyungsoo (Department of Pharmacology, Yonsei University College of Medicine) ;
  • Lee, Soon Min (Department of Pediatrics, Pharmacology, Yonsei University College of Medicine) ;
  • Eun, Ho Seon (Department of Pediatrics, Pharmacology, Yonsei University College of Medicine) ;
  • Park, Min Soo (Department of Pediatrics, Pharmacology, Yonsei University College of Medicine) ;
  • Park, Kook In (Department of Pediatrics, Pharmacology, Yonsei University College of Medicine) ;
  • Namgung, Ran (Department of Pediatrics, Pharmacology, Yonsei University College of Medicine)
  • Received : 2016.08.19
  • Accepted : 2016.10.25
  • Published : 2017.02.15
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Abstract

Purpose: The aims of this study were to evaluate the safety and pharmacokinetics of levetiracetam (LEV) in neonates with seizures and to establish a population pharmacokinetics (PPK) model by using the software NONMEM. Methods: A retrospective analysis of 18 neonatal patients with seizures, who were treated with LEV, including 151 serum samples, was performed. The mean loading dose was 20 mg/kg, followed by a mean maintenance dose of 29 mg/kg/day. Results: Seventeen neonates (94%) had seizure cessation within 1 week and 16 (84%) remained seizure-free at 30 days under the LEV therapy. The mean serum concentration of LEV was $8.7{\mu}g/mL$. Eight samples (5%) were found above the therapeutic range. No serious adverse effects were detected. In the PPK analysis for Korean neonates, the half-life was 9.6 hours; clearance, 0.357 L/hr; and volume of distribution, 4.947 L, showing differences from those in adults. Conclusion: LEV is a safe and effective option for the treatment of neonatal seizures with careful therapeutic drug monitoring.

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References

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