Population pharmacokinetics of levetiracetam in Chinese adult epilepsy patients with varying renal function

Levetiracetam is a first-line epilepsy treatment with a generally favorable pharmacokinetic profile, but individualized dosing guidance accounting for renal function in Chinese adult patients had not been established. This study used 148 plasma concentrations from 80 Chinese adult epilepsy patients to build a population pharmacokinetic model with Phoenix NLME, then used Monte Carlo simulation to generate renal-function-based dosing recommendations. Creatinine clearance was identified as the major covariate influencing levetiracetam clearance, with simulations indicating that patients with augmented renal function may require higher doses (up to 3.5 g twice daily) to achieve target exposure. The resulting model-based dosing guideline and individual predictive tool could help reduce the need for frequent drug concentration monitoring in this population.