Background Direct oral anticoagulants (DOACs) are useful for stroke prevention in atrial fibrillation (AF) patients. However, the concomitant administration of Levetiracetam limited their use in clinical practice, although some authors raise doubts about clinical relevance of the interaction. Case summary We report a case of a 54-year-old male with AF, cirrhosis and seizures, in which the assessment of Dabigatran plasma concentration was needed due to the concomitant use of Levetiracetam. In this case no relevant reduction of trough Dabigatran plasma concentration was found. An increased peak serum level of dabigatran may be obtained delaying levetiracetam administration. The patient was then followed in our clinic and during 32 months of follow up no ischemic or haemorrhagic events occurred. Discussion The evaluation of DOACs concentration could be helpful to start a tailored therapy in frailty patients.

Minimizing drug-drug interactions between dabigatran and levetiracetam through clinical management. a case report / Menichelli, Danilo; Pastori, Daniele; Pignatelli, Pasquale; Pani, Arianna. - In: EUROPEAN HEART JOURNAL. CASE REPORTS. - ISSN 2514-2119. - 7:1(2023). [10.1093/ehjcr/ytad006]

Minimizing drug-drug interactions between dabigatran and levetiracetam through clinical management. a case report

Danilo Menichelli;Daniele Pastori
;
Pasquale Pignatelli;
2023

Abstract

Background Direct oral anticoagulants (DOACs) are useful for stroke prevention in atrial fibrillation (AF) patients. However, the concomitant administration of Levetiracetam limited their use in clinical practice, although some authors raise doubts about clinical relevance of the interaction. Case summary We report a case of a 54-year-old male with AF, cirrhosis and seizures, in which the assessment of Dabigatran plasma concentration was needed due to the concomitant use of Levetiracetam. In this case no relevant reduction of trough Dabigatran plasma concentration was found. An increased peak serum level of dabigatran may be obtained delaying levetiracetam administration. The patient was then followed in our clinic and during 32 months of follow up no ischemic or haemorrhagic events occurred. Discussion The evaluation of DOACs concentration could be helpful to start a tailored therapy in frailty patients.
2023
dabigatran; levetiracetam: DOAC serum level; drug interaction,; atrial fibrillation; case report
01 Pubblicazione su rivista::01i Case report
Minimizing drug-drug interactions between dabigatran and levetiracetam through clinical management. a case report / Menichelli, Danilo; Pastori, Daniele; Pignatelli, Pasquale; Pani, Arianna. - In: EUROPEAN HEART JOURNAL. CASE REPORTS. - ISSN 2514-2119. - 7:1(2023). [10.1093/ehjcr/ytad006]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1671228
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