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This review describes, compares, and contrasts the PK and PD differences of IR AEDs and their respective U.S. Food and Drug Administration (FDA)–approved ER formulations.IR AEDs may be associated with wide ranges of peak‐to‐trough plasma concentrations.

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In order to calculate the dose recommended for patients with renal impairment, creatinine clearance adjusted for body surface area must be calculated.

Controlled studies in pregnant women show no evidence of fetal risk.Antiepileptic mechanism unknown; may inhibit voltage-depedent N-type calcium channels; may bind to synaptic proteins that modulate neurotransmitter release; through displacement of negative modulators may facilitate GABA-ergic inhibitory transmissionPeak plasma time: 1 hr (immediate release); 4 hr (extended release)Half-life: 6-8 hr (increased in elderly or renal disease)Renal clearance: 0.6 mL/min/kg; 4 mL/min/kg (metabolite)IV preparation: Dilute IV solution in 100 mL compatible solutionElepsia XR, Keppra XR: Swallow tablet whole; do not chew, split, crush, or cut tabletsUnused vials: Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F)May store diluted IV solution in PVC bags at 15-30°C (59-86°F) for up to 24 hrExtended-release or immediate release tablets: Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F)Adding plans allows you to compare formulary status to other drugs in the same class.To view formulary information first create a list of plans.





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Improved AE profiles may permit the administration of higher doses in patients who require them.

My doctor is putting me on 3 brand only keppra xr 500 mgs a day & caremark/cvs has quoted me $877.00 for a 90 day supply!

Despite having longer half‐lives, some IR AEDs (i.e., lamotrigine and topiramate) continue to be administered twice daily (Various innovative drug delivery technologies (e.g., Microtrol technology, OROS, DiffCore, hydrophilic matrix) have been developed to minimize the fluctuations in plasma drug levels seen with IR products (Ideally, an ER formulation should be bioequivalent to the corresponding IR form of the medication when given as directed.

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