Avoid routine testing for antiepileptic drug levels in people with epilepsy.
|Rationale and Comments:||Antiepileptic drug level testing should not be routinely ordered when seizures are well controlled, and no adverse effect is suspected. The reference ranges should not be used as a rigid framework. The effectiveness and tolerability of treatments should be determined by the clinical responses. Antiepileptic drug levels should be ordered to address a specific question. Some examples include weight-based dosing adjustments in young children, adherence, suspected toxicity, and pregnant women.|
|References:||• Eadie MJ Therapeutic drug monitoring – antiepileptic drugs. Br J Clin Pharmacol. 1998;46:185-193.
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• St. Louis EK Monitoring Antiepileptic Drugs: A Level-Headed Approach. Current Neuropharmacology, 2009;7:115-119.
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