From the Research
Routine laboratory monitoring is generally not required for patients taking Keppra (levetiracetam), but kidney function should be monitored closely in patients with known kidney impairment or those receiving high doses of the medication, as suggested by the most recent study 1. When considering the monitoring of patients on Keppra, several factors come into play, including the potential for kidney injury, as highlighted in cases where levetiracetam has been implicated in acute kidney injury 2, 1.
- The pharmacokinetics of levetiracetam are not significantly altered in patients with mild to moderate liver cirrhosis, but dose adjustments may be necessary in those with severe cirrhosis due to reduced renal function 3.
- Levetiracetam has been found to be safe and effective in patients with epilepsy and chronic liver disease, with some patients even showing improvement in liver function tests during treatment 4.
- In critically ill patients, levetiracetam appears to be a safe option for seizure management, with no reported adverse hemodynamic events or cardiac arrhythmias, although dosing should be adjusted for renal function 5. Given the potential for kidney injury and the importance of renal function in the clearance of levetiracetam, baseline and periodic monitoring of kidney function is recommended, especially in patients with pre-existing kidney disease or those at risk for kidney injury. However, for the majority of patients on Keppra, routine laboratory monitoring of complete blood counts, liver function tests, and kidney function tests is not necessary unless clinically indicated by symptoms or other risk factors. Patients should be advised to report any unusual symptoms promptly, and clinicians should remain vigilant for signs of kidney injury or other adverse effects, adjusting treatment as necessary to minimize risks and optimize outcomes.