ArticlePharmaceutical research2025
Population Pharmacokinetics of Intravenous Levetiracetam in Neurosurgical Patients: Dosage Optimization Based on CrCl and Mannitol Use.
Article in Pharmaceutical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveConventional low-dose levetiracetam (LEV) for post-neurosurgical seizure prophylaxis often yields subtherapeutic serum levels. This study characterized the population pharmacokinetics (PPK) of intravenous LEV to optimize dosing in neurosurgical patients.
methodsWe conducted a retrospective PPK analysis in 87 neurosurgical patients (131 concentrations). Nonlinear mixed-effects modeling was used. Monte Carlo simulations identified regimens achieving ≥ 90% probability of target attainment (PTA) for trough concentrations (C
resultsLEV median daily dose was 15.4 (7.7-43.5) mg/kg. A median of 1.5 (1-6) concentration samples were collected per patient. The LEV concentrations was 9.11 (1.39-33.79) μg/mL. Importantly, 78 random concentrations and C
conclusionStandard LEV prophylaxis dosing often yields inadequate exposure in neurosurgical patients. LEV clearance is influenced by CrCl and mannitol use, higher doses is required for patients with concurrent mannitol therapy.
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