Levetiracetam
Antiepileptic approved in an injectable formulation
Keppra
Levetiracetam injection
UCBAntiepileptic approved in an injectable formulation
This antiepileptic is hypothesized to exert its effect by selectively preventing hypersynchronization of epileptiform burst firing and propagation of seizure activity. Levetiracetam injection was approved on July 31, 2006, as adjunctive therapy in the treatment of partial onset seizures in adults with epilepsy. The formulation is an alternative for patients when oral administration is temporarily not feasible.
Efficacy. The efficacy of levetiracetam as adjunctive therapy for adults with epilepsy was assessed in 3 multicenter, randomized, double-blind, placebo-controlled clinical studies in patients who had refractory partial onset seizures with or without secondary generalization. Patients in all 3 studies (N=904) were randomized to placebo or 1,000, 2,000, or 3,000 mg/d of levetiracetam in the tablet formulation. Enrollees in Studies 1 and 2 had refractory partial onset seizures for at least 2 years and had taken 2 or more classical antiepileptic drugs (AEDs). Enrollees in Study 3 had refractory partial onset seizures for at least 1 year and had taken 1 classical AED. In Study 1, levetiracetam 1,000 mg/d demonstrated a 26.1% reduction in partial seizure frequency over placebo, while the 3,000 mg/d dosing regimen demonstrated a 30.1% reduction (P<.001). In Study 2, levetiracetam 1,000 mg/d demonstrated a 17.1% reduction in partial seizure frequency over placebo, while the 2,000 mg/d dosing regimen demonstrated a 21.4% reduction (P#.001). In Study 3, levetiracetam 3,000 mg/d demonstrated a 23.0% reduction in partial seizure frequency over placebo (P<.001).
Dosing. The recommended initial dose of levetiracetam injection is 1,000 mg/d, given as 2 doses of 500 mg. Additional dosing increments may be given (1,000 mg/d additional every 2 weeks) to a maximum recommended dose of 3,000 mg/d.
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
