title: No kinetic interaction between levetiracetam and cyclosporine: a case report.
abstract: Levetiracetam is a new antiepileptic drug reported to be effective and well-tolerated in adults and children affected by epilepsy. Its lack of hepatic cytochrome metabolism is the theoretic basis for the absence of interactions with other drugs that follow this pathway. We present a 14-year-old girl who underwent orthotopic heart transplantation, followed by antirejection therapy including cyclosporine. Symptomatic occipital lobe epilepsy developed that was successfully treated with oxcarbazepine, but cyclosporine plasma levels decreased to below the antirejection threshold. Oxcarbazepine was replaced by levetiracetam. Levetiracetam did not affect the metabolism of cyclosporine, and cyclosporine plasma levels have remained in the therapeutic range up to now. The patient is still seizure-free and does not complain of any side effects after a 1-year follow-up. Further studies are necessary to confirm the lack of interactions between these drugs, which would make levetiracetam a useful therapeutic option in managing seizure control during antirejection therapy with cyclosporine.
authors.affiliation: Child Neuropsychiatry, University of Bologna, Bologna, Italy. emilio.franzoni@unibo.it
authors.forename: Emilio
authors.initials: E
authors.lastname: Franzoni
authors.forename: Jasenka
authors.initials: J
authors.lastname: Sarajlija
authors.forename: Caterina
authors.initials: C
authors.lastname: Garone
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Malaspina
authors.forename: Valentina
authors.initials: V
authors.lastname: Marchiani
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D002311:Cardiomyopathy, Dilated / Q000601:surgery; D016572:Cyclosporine / Q000627:therapeutic use*; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D004827:Epilepsy / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects; D006801:Humans; D000077287:Levetiracetam; D010889:Piracetam / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D004791:Enzyme Inhibitors; D000077287:Levetiracetam; D016572:Cyclosporine; D010889:Piracetam