O31 Levetiracetam monitoring in breast-milk: high inter-individual variability

BackgroundAnti-epileptic drug therapy is a great challenge for the practitioners during pregnancy and lactation. Levetiracetam (LEV) is commonly prescribed to pregnant women, however, there are only few publications on its use during lactation with small number of participants.ObjectiveTo monitor LE...

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Bibliographic Details
Published in:Archives of disease in childhood 2019-06, Vol.104 (6), p.e14-e14
Main Authors: Dinavitser, N, Kohn, E, Berlin, M, Livne, A, Keidar, R, Ben-Nun, L, Agajani, N, Sheinberg, R, Gamsu, S, Flor-Hirsch, H, Brandriss, N, Bar-Chaim, A, Stepenski, D, Berkovitch, M
Format: Article
Language:English
Subjects:
Babies
Breast feeding
Breast milk
Breastfeeding & lactation
Drug dosages
Drug therapy
Epilepsy
Etiracetam
Excretion
Females
High-performance liquid chromatography
Infants
Lactation
Liquid chromatography
Milk
Pregnancy
Side effects
Young Children
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Summary:BackgroundAnti-epileptic drug therapy is a great challenge for the practitioners during pregnancy and lactation. Levetiracetam (LEV) is commonly prescribed to pregnant women, however, there are only few publications on its use during lactation with small number of participants.ObjectiveTo monitor LEV levels in breast-milk of epileptic mothers treated with LEV.MethodsBreastfeeding women treated with LEV during pregnancy and after delivery were recruited. Milk sample was collected before administration of the drug and other samples were collected at time points of 1,3,6,9, and 12 hours after drug administration. Breastmilk and blood LEV levels were measured using HPLC.ResultsFourteen breastfeeding women participated in the study: 9 infants were fully breastfed whereas 5 were partially breastfed. Maternal average daily dose of LEV was 2517 mg. Average infant´s age was 8 weeks (3–22w). Average infant´s weight 4368 gr (3300–7000 gr). Milk/Plasma LEV concentration ratio was 0.88 (0.23–1.1). Relative Infant Dose (RID) was 40% in partial breast feeding, and 61% in full breastfeeding. Estimated average daily dose that all infants received through milk was 158 mg/d (83–250 mg). The normalized dose for the average infant weight per day was 36 mg, which is 15% less than the maximal daily dose of LEV in infants (max. daily dose in infants 1–6 months in 42 mg/d). No adverse reactions were observed in the breastfeed infants.ConclusionsAlthough the RID of LEV were found to be high, no adverse reactions were observed in the infants; Nevertheless, further studies are needed to elucidate the high variability of LEV excretion into breastmilk.Disclosure(s)Nothing to disclose
ISSN:0003-9888
1468-2044
DOI:10.1136/archdischild-2019-esdppp.31