Thursday February 4, 2010


Q: It is well known that Keppra (levetiracetam) is eliminated via renal route. Approximately how much of levetiracetam is removed during a standard 4-hour hemodialysis procedure?


Answer: Approximately 50% of the pool of levetiracetam in the body is removed during a standard 4-hour hemodialysis procedure. Supplemental doses should be given to patients after dialysis.

Clearance of levetiracetam is correlated with creatinine clearance. Total body clearance of levetiracetam is reduced in patients with impaired renal function by 40% in the mild group (CLcr = 50-80 mL/min), 50% in the moderate group (CLcr = 30-50 mL/min) and 60% in the severe renal impairment group (CLcr less than 30 mL/min). In anuric (end stage renal disease) patients, the total body clearance decreased 70% compared to normal subjects.