Keppra blood test

[travel bug]

Last week my Dr's office called and said I needed to have a blood test before they could refill my prescription. No biggie; I got other things tested while I was at it, but I don't remember anyone talking about getting a test for Keppra levels here. It's been almost exactly 5 years since I've been on Keppra so I guess I was due.

So questions: How often has anyone here been tested? Does anyone know what they are looking for?

 

[Silat]

Never. As far as I know there's not an established blood level for a theraputic dose of Keppra, so most likely they're checking your kidney/liver functions to ensure the medicine isn't placing strain upon them. Some meds can be harsh, especially if you've been on them a while, on your liver and kidneys, since they're the organs who have to constantly filter it out of your system. It may also be that they're testing to make sure you're not retaining the keppra in your system for too long, causing it to slowly add up over time. If that were the case, you could go toxic from it because it's not being filtered out of your system at the normal rate.

I'm pretty sure the blood test is to check for one of those two possibilities, if not both, as you said you had other things tested as well. An ounce of precaution is worth a lot!

 

[Hand of Blood]

i only ever get levels for my tegretol but not for keppra!

 

[Cint]

I'm taking 3000 mgs. of Keppra and have been for 12 years now. My neurologist never does blood levels, but when I go to my endocrinologist for diabetes, I always have blood levels checked. Maybe they're looking for kidney, liver issues. My endocrinologist does think the Keppra does effect my glucose levels, making it harder to keep glucose lower and my A1c level under 7.

 

[epileric]

I'd think they're looking to check that the levels are at their optimum. They do know what levels it can work best at. It's the toxic levels they aren't aware of yet.

Most individuals display optimal response to levetiracetam with serum levels 12 to 46 mcg/mL. Some individuals may respond well outside of this range, or may display toxicity within the therapeutic range, thus interpretation should include clinical evaluation. Toxic levels have not been well established. Therapeutic ranges are based on specimen drawn at trough (ie, immediately before the next dose).

http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/83140

 

[travel bug]

Thanks everyone for your input! I received a readout of the results of the lipid screen which included liver function; everything was within normal range. Then today my Dr's nurse called to tell me my Keppra test came back normal. So, I guess it's for actual Keppra levels as the liver function level test was part of the lipid screen. I didn't know it was possible for Keppra to build up over time and become toxic; it's good my doc is keeping tabs I wish I had asked for the actual numbers, I like to keep track of things like this myself.

 

[epileric]

I received a readout of the results of the lipid screen which included liver function; everything was within normal range. Then today my Dr's nurse called to tell me my Keppra test came back normal. So, I guess it's for actual Keppra levels as the liver function level test was part of the lipid screen.

That's great that your liver function is normal but my understanding of keppra is that it is processed in the kidneys instead of the liver. Were any of the tests renal (kidney) tests?

Keppra is not protein bound (<10 percent bound) and its metabolism is not liver cytochrome P450 dependent, with sixty-six percent (66 percent) of the dose renally excreted unchanged. Plasma half-life of the medication is approximately 6 to 8 hours but is increased in the elderly (due to age-related decrease in renal function) and in patients with renal impairment.

http://www.medilexicon.com/drugs/keppra.php

I didn't know it was possible for Keppra to build up over time and become toxic; it's good my doc is keeping tabs I wish I had asked for the actual numbers, I like to keep track of things like this myself.

I didn't see anywhere that it builds up over time, just that we can all react toxically (is there a such word?) to different doses. I see that as safer because if someone does react to it as a toxin it can exit the system much faster than if it did build up over time.

 

[Sheripark]

My neuro test me three times already since I have been on Keppra 7monts now. There is a therapeutic level to check. They ask you your dose and time and it takes 2 days. My levels were low so it was good information to increase my Keppra. I think if you are at a good level (and there is a high end too) and your not symptomatic then your Keppra is working. If your maxed out at 3000mg and not at a therapeutic level that's a problem. On the other end as well. If our blowing off the charts why is your dose so high? Getting levels checked is so important and I think a sign of a good doctor (my personal opinion). Your GP should be checking your liver and kidneys as well as vit d. Good luck

 

[travel bug]

That's great that your liver function is normal but my understanding of keppra is that it is processed in the kidneys instead of the liver. Were any of the tests renal (kidney) tests?

I think the liver function test was just part of that particular screen -just checking cholesterol and all that while we were about it. I don't know that my doc was thinking about liver function in connection with the Keppra. He is pretty young and I don't think he's that experienced with epilepsy etc, but he's very caring and takes an active interest in my case so stick with him over someone who may be more experienced but who doesn't give a rat's you-know-what I'm only on 1000 mg so I'm not too worried, but I'll keep the fact that Keppra is processed through the kidneys in mind.

Thanks, Eric

 

[epileric]

You're very welcome.

One of the best neurologists I"ve had was very young & new. Like you, he still had to learn a bit but he had no problem saying that he was wrong or that he didn't know things & wasn't scared to look things up.

Actually, he's the guy that sent me to the neurologist who found the lesion in my brain.

Just make sure you know what questions to ask. That shouldn't be hard if you're comfortable with him.

 

[travel bug]

Thanks Sheripark

Now I really wish I had asked for the exact level. I do have strange foot flapping at night that is not restless leg syndrome that may or may not be seizure activity. I hate bringing it up because it seems so trivial, but if my levels are on the low side, that may be causing the flapping. I had discovered that vit D helped a lot, but it only does so much.

But compared to others, I have very little to complain about; if the foot flapping is seizure activity, then it's very, very minor.

 

[Sheripark]

Ok so yes keppra is "eliminated" through the kidneys but it is still processed through the liver. So yes it is "easier" on the liver than other drugs but don't be fooled to think your liver is sitting pretty. Liver tests need to be done too. The other E drug eliminated through the kidney is lamicatal. These are the only two I'm aware of.

 

[Bobbi]

I have been on Keppra since 12/12 and the keppra blood tests have been done mostly annually. The test results don't seem to help the docs adjust meds, seems more the EEG and the guessing game. I also take lamictal since 4/14(?) and I was just looking at my blood tests from 2014 compared to 2016 - both my AST and ALT have increased. 22 to 32 and 20 to 42. These are still considered normal but I would like to know why the increase and if I should be tested every 6 months. I will ask my doc who will prob tell me 'nothing to be concerned about' since it still in the normal range. Any ideas or experience with this?

 

[acshuman]

Blood Tests

travel bug,
I have to say that for me it is the pharmacy that requires a renewed prescription each year. They want that and the only way I can get this prescription from my doctor is to come to his clinic for an appointment.
I am happy to do this. As far as I am concerned my E is something that can't be handled over the phone or email! This also lets me get a physical and find out if anything new has tried to take over my body!

ACsHuman