Massive price rise for levetiracetam

RE: Massive price rise for levetiracetam

Bob Russell — Tue, 31 Oct 2017 16:16:46 GMT

I would struggle to be in the same room as someone waxing lyrical about cascade. It can be a sensible guide or a ridiculous straight jacket.

We have one success on Pexion. Others are settled on phenobarb +/- KBr. One is topped up with Keppra following some nightmare episodes.

I would rarely if ever start medication at the first seizure (other than clusters) and blood test rarely unless there are problems. The new VetScan phenobarb rota is pretty inexpensive and includes liver enzymes. Good correlation with external lab figures. May do a few more now we have this convenience.

Edit: the problem with Keppra seems to be the poor availability of the generic version which was much cheaper. No reason why it should not return but may not be at the right price of course.

RE: Massive price rise for levetiracetam

grumpyoldman — Tue, 31 Oct 2017 13:47:20 GMT

My own dogs seizures are and have been managed on this alone at 500mg bid for 2 years now ,pre Keppra he was having several clusters and partial seizures a month. I have also used it in a similar way in many clients dogs very successfully for several years. At a recent PSS inspection the RCVS inspector was waxing lyrical on the joys of the cascade and how we must all nod along to the tune and admire the kings new clothes. Had to bite my lip and walk away from this blithering fool. Never liked phenobarb even with KBr in the bad ones the dosage just goes up and up and compliance is very poor on the bloods. I have also seen loads of single seizure patients on 60mg epiphen bid for several years, prescribed after a single seizure who's levels were 10-15, so we take them off it and nothing happens. , Pexion seems very variable in activity and expensive. Epanutin had reappeared on the human market but at some vastly inflated price and it was in any event a pro drug. Diligent owners maybe able to use levitiracetam just in the pre or post ictal phases along with the rectal diazepam to quickly arrest seizure activity before too much damage from exitotoxicity occurs.

You maybe better dropping the phenobarb and carrying on with the levitiracetam.

RE: Massive price rise for levetiracetam

Braden Collins — Sat, 28 Oct 2017 10:53:39 GMT

https://www.rvc.ac.uk/small-animal-referrals/news-events/clinical-podcasts

Great podcast on here (scroll down 5-6 weeks ago). Its got some good tips on how it can be used sparingly.