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

Minimizing drug-drug interactions between dabigatran and levetiracetam through clinical... BackgroundDirect 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 summaryWe 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 ischaemic or haemorrhagic events occurred.DiscussionThe evaluation of DOACs concentration could be helpful to start a tailored therapy in frailty patients. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Heart Journal - Case Reports Oxford University Press

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

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Publisher
Oxford University Press
Copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.
eISSN
2514-2119
DOI
10.1093/ehjcr/ytad006
Publisher site
See Article on Publisher Site

Abstract

BackgroundDirect 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 summaryWe 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 ischaemic or haemorrhagic events occurred.DiscussionThe evaluation of DOACs concentration could be helpful to start a tailored therapy in frailty patients.

Journal

European Heart Journal - Case Reports – Oxford University Press

Published: Jan 6, 2023

Keywords: Dabigatran; Levetiracetam; DOAC serum level; Drug interaction; Atrial fibrillation; Case report

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