Key result
Concomitant levetiracetam shows no association with altered apixaban concentrations versus apixaban alone.
Why the study?
Some professional organizations have advised caution coadministering apixaban and levetiracetam, despite the lack of evidence of a mechanism-based drug interaction.
Does concomitant levetiracetam alter apixaban plasma concentrations in hospitalized adults taking apixaban?
Observational (n=77)
No
Does concomitant levetiracetam alter apixaban plasma concentrations in hospitalized adults taking apixaban?
Answers are grounded in this paper and cite their sources.
Concomitant administration of levetiracetam does not appear to significantly alter apixaban plasma concentrations, suggesting no clinically significant pharmacokinetic interaction.
Despite the lack of evidence of a mechanism‐based drug interaction, some professional organizations have advised caution coadministering apixaban and levetiracetam. Eligible patients taking apixaban with or without levetiracetam for any indication for at least 72 h were screened from the electronic medical records. Plasma samples from 77 patients were retrieved from salvaged clinical blood collections. Apixaban minimum and maximum concentrations ( C min and C max ) were compared using descriptive statistics in R. While the median C min and C max appear to be marginally elevated, there were no apparent differences relative to apixaban alone. These findings suggest no apparent interaction of levetiracetam and support the current lack of labeled warning of concomitant apixaban dosing.
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Riley et al. (2026) conducted an observational in Patients taking apixaban for any indication (n=77). Levetiracetam coadministration vs. Apixaban alone was evaluated on Apixaban minimum and maximum concentrations (Cmin and Cmax). Coadministration of levetiracetam with apixaban resulted in no apparent differences in apixaban minimum and maximum concentrations compared to apixaban alone in a real-world hospital cohort.
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