A Case of Successful Levetiracetam Blood Concentration Control Using Non-Trough Sampling in Home Medical Care Following Renal Function Decline

Abstract

We report a case in which, based on the blood concentration immediately before taking levetiracetam (trough) at the time of hospitalization, blood samples were taken at non-trough times due to declining renal function that occurred during home medical care. The dosage was adjusted based on the predicted trough value calculated by analysis software, successfully maintaining blood concentration close to the trough level observed at admission. Although trough values are generally used to evaluate the blood concentration of levetiracetam, trough sampling is often difficult in home medical care, and blood samples may be taken after drug administration. This case suggests that even when blood samples are taken at non-trough times, dosage adjustment is possible in home medical care settings by taking into account drug characteristics such as blood concentration trends, predicted values, and linearity, and by setting parameters such as renal function, regular blood sampling, and the time elapsed since drug administration.