Optimization of levetiracetam maintenance regimen in Chinese epileptic children based upon Monte Carlo simulation
OBJECTIVE To optimize maintenance regimen of levetiracetam(LEV)in Chinese epileptic children based upon Monte Carlo simulation(MCS).METHODS According to the published pharmacokinetic data of LEV population in Chinese epileptic children,MCS was utilized for predicting the steady-state blood concentration(Css)of LEV under different dosing regi-mens and the probability distribution of Css within the therapeutic concentration reference range of 10 to 40 mg·L-1.RESULTS For LEV dosing in epileptic children aged 0-17 years,the maximal PT A value(97.4％)of Css distributed in 10-40 mg·L-1 was obtained with a dose of Lev at 15 mg·kg-1 bid.At a target concentration of 0-10 mg·L-1,PT A value peaked(69.3％)at a dose of 5 mg·kg-1 bid;at a target concentration of 10-20 mg·L-1,maximal PT A value was 66％at a dose of 8 mg·kg-1 bid;at a target concentration of 20-30 mg·L-1,PTA value peaked(43.5％)with a dose of 12.5 mg·kg-1 bid;at a target concentration of 30-40 mg·L-1,PTA value peaked(31.1％)at a dose of 17.5 mg·kg-1 bid.CONCLUSION MCS simulation may predict the reaching probability of Css at different LEV maintenance doses and reveal its distribution in different reference concentration ranges in Chinese epileptic children.It provides references for optimizing LEV dosing regimen.
levetiracetamtherapeutic drug monitoringinfluencing factors,reference rangeMonte Carlo simulationopti-mizing dose
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