Hi Everyone!

Our Pharmacy told us, that there is an rising shortage of phenobarbital. Being 1st line treatment for neonatal seizures again, this brings some problems with it.

What would you prefer as 1st line treatment instead?

- Guidelines are kind of favouring Phenytoin as an alternative - but has more significant sideefects.

- Levetiracetam? Not that promising, right?

Any alternatives?

 

Best wishes, Bernhard

We use Levetiracetam as a first line after cutting the seizure with benzodiazepines. 

Works very well for us. Levetiracetam does not impair the vigilance and Eeg as much as phenobarbital

Levetiracetam is a good alternative

We dont have  intravenous phenobarbital since I remember at least 15 years, so we have to use it orally, but in the acute phase we use leviteracetam

Thanks you for your answers.

 

we used LEV for 1st line therapy for some years, but often ended up with a co-therap with phenobarbital, so we switched back to pheno as 1st line at the time the new ILAE Recomendatilns came out.

 

so now we will do LEV as 1st line after temesta for acute therapy and Phenytoin as 2nd line, in case phenobarbital really is getting non available.

 

thank you for your reply