Antiepileptic Drug Level Monitoring
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Routine monitoring of antiepileptic drug levels does not alter seizure or side effect rates. (Strength of Recommendation [SOR]: B, based on a single randomized controlled trial [RCT] with less than 80 percent follow-up). Antiepileptic drug level monitoring may be clinically useful in special populations, including patients with suspected drug toxicity or noncompliance, pregnant patients, and patients with renal failure. Monitoring dosage increases of drugs with nonlinear kinetics, such as phenytoin (Dilantin), may be useful. (SOR: C, based on expert opinion). Therapeutic drug level monitoring of newer antiepileptic drugs has not been shown to be clinically useful. (SOR: C, based on expert opinion).
American Family Physician, 78(3) 2008: 385+