Impact of levetiracetam on direct oral anticoagulant level and outcomes among older Asian patients with atrial fibrillation
Journal
Frontiers in Pharmacology
Journal Volume
16
Start Page
1505665
ISSN
1663-9812
Date Issued
2025
Author(s)
Chen, Tzu-Ling
Huang, Yun-Lin
Peng, Yu-Fong
Abstract
Objective: This purpose of this study is to analyze the influence of levetiracetam (LEV) on direct oral anticoagulant (DOAC) exposure and its implications for clinical outcomes. Methods: This investigation comprised a retrospective cohort study utilizing the integrated medical database and a prospective observational study conducted in a tertiary hospital. Patients aged >65 years with atrial fibrillation and undergoing DOAC therapy were included and were categorized as LEV users and non-users based on LEV exposure status. In retrospective cohort, clinical outcomes between LEV users and non-users were compared, included ischemic stroke or transient ischemic attack (IS/TIA), systemic thromboembolism (STE) and major bleeding. In prospective cohort, DOAC trough concentration was measured. Results: = 0.53). High DOAC concentration were observed in 10.5% of LEV-users and 11.8% LEV non-users (P = 0.57). The association between LEV therapy and low or high DOAC concentration was non-significant. Conclusion: Concurrent use of LEV and DOAC did not significantly affect DOAC exposure or clinical outcomes. LEV may be a safe anti-seizure medication for patients receiving DOAC therapy.
Subjects
bleeding
direct oral anticoagulants
drug interaction
elderly
levetiracetam
thromboembolism
Type
journal article