Levetiracetam: Safety Considerations across the Lifespan

00:00 used. In this part of our discussion, we're going to take a look at potential safety issues with levetiracetam.

00:07 First up, let's talk about some examples of sound alike look alike issues.

00:11 Now I've listed several of those there for you on the screen, but let's just do one.

00:16 Keppra may be confused with Keflex or Keppra XR.

00:20 That is one example, and we've listed some others on the screen for you.

00:24 Now what about older adults? This is considered a high risk medication.

00:29 Levetiracetam is identified in the screening tool of older persons prescription, STOPP for short.

00:36 Now this is the criteria that tells us it's potentially inappropriate medication in older adults greater than or equal to 65 years of age, who have a history of recurrent falls due to an increased risk of falls if they take levetiracetam. Now when it comes to levetiracetam in pregnancy, I've got a fair bit of information for you now.

00:58 First up, I want you to know that there's the FDA PLLR narrative summary. There's a registry available for women exposed to levetiracetam during pregnancy. Pregnant women can enroll themselves in the North American Anti Drug Pregnancy Registry.

01:15 We've got the most current information on the screen for you there.

01:19 Now the reason for this is levetiracetam crosses the placental barrier.

01:23 And that's why it requires careful monitoring during pregnancy due to decreasing plasma levels. Now this is particularly important during the third trimester.

01:33 Also you're going to monitor that's extended into the postpartum period to make dose adjustments. Now the human data the prospective pregnancy exposure data show really no substantial increases in major congenital malformations.

01:47 But studies are limited and we cannot determine specific birth defect risks.

01:52 The animal data shows developmental toxicity studies that show evidence of skeletal variations at clinically relevant doses.

02:00 Now, monotherapy is preferred over polytherapy, and clinicians should monitor for potential complications, including small for gestational age (SGA) infants and low Apgar scores like less than seven at one minute.

02:15 Now, the clinical considerations is seizures during pregnancy pose risks to both the mother and the fetus. So as in anything else, the risks and the benefits will have to be weighed.

02:26 And you'll have a therapeutic discussion in collaboration with your client.