Peer-reviewed veterinary case report
How phenobarbital and bromide affect seizure drug levels in dogs
By Muñana, K R et al.·Published in Journal of veterinary internal medicine·2015·Department of Clinical Sciences·View original on PubMed →
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Original publication title: Effect of chronic administration of phenobarbital, or bromide, on pharmacokinetics of levetiracetam in dogs with epilepsy.
- Species:
- dog
Plain-English summary
A group of dogs with epilepsy were treated with levetiracetam, a common medication for seizures, alongside either phenobarbital or bromide. The study found that dogs receiving bromide alone had higher levels of levetiracetam in their system compared to those on phenobarbital or both medications. This suggests that when levetiracetam is given with phenobarbital, the body clears it more quickly, which might mean that higher doses of levetiracetam are needed for effective seizure control in those dogs. Adjusting the dosage could help improve treatment outcomes for dogs on phenobarbital.
People also search for: dog epilepsy treatment · levetiracetam dosage for dogs · phenobarbital side effects in dogs
Abstract
BACKGROUND: Levetiracetam (LEV) is a common add-on antiepileptic drug (AED) in dogs with refractory seizures. Concurrent phenobarbital administration alters the disposition of LEV in healthy dogs. HYPOTHESIS/OBJECTIVES: To evaluate the pharmacokinetics of LEV in dogs with epilepsy when administered concurrently with conventional AEDs. ANIMALS: Eighteen client-owned dogs on maintenance treatment with LEV and phenobarbital (PB group, n = 6), LEV and bromide (BR group, n = 6) or LEV, phenobarbital and bromide (PB-BR group, n = 6). METHODS: Prospective pharmacokinetic study. Blood samples were collected at 0, 1, 2, 4, and 6 hours after LEV administration. Plasma LEV concentrations were determined by high-pressure liquid chromatography. To account for dose differences among dogs, LEV concentrations were normalized to the mean study dose (26.4 mg/kg). Pharmacokinetic analysis was performed on adjusted concentrations, using a noncompartmental method, and area-under-the-curve (AUC) calculated to the last measured time point. RESULTS: Compared to the PB and PB-BR groups, the BR group had significantly higher peak concentration (Cmax ) (73.4 ± 24.0 versus 37.5 ± 13.7 and 26.5 ± 8.96 μg/mL, respectively, P < .001) and AUC (329 ± 114 versus 140 ± 64.7 and 98.7 ± 42.2 h*μg/mL, respectively, P < .001), and significantly lower clearance (CL/F) (71.8 ± 22.1 versus 187 ± 81.9 and 269 ± 127 mL/h/kg, respectively, P = .028). CONCLUSIONS AND CLINICAL IMPORTANCE: Concurrent administration of PB alone or in combination with bromide increases LEV clearance in epileptic dogs compared to concurrent administration of bromide alone. Dosage increases might be indicated when utilizing LEV as add-on treatment with phenobarbital in dogs.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/25711374/