This panel provides information on interacting drugs and their ADRs along with references
| Interacting drug |
Toxicity |
Interaction Type |
Mechanism |
Reference |
|---|
| Carbamazepine (298-46-4) | Nystagmus | Antagonistic | carbamazepine metabolism appear to be inhibited by both valproate and its amide derivative, valpromide.The levels of the metabolite carbamazepine-,10,11-epoxide increase during concurrent use,
probably by inhibition of its metabolism to carbamazepine-10,11-trans-diol, by epoxide hydrolase | Effect of valpromide on the pharmacokinetics of carbamazepine-10, 11-epoxide
|
| Amdinocillin Pivoxil (32886-97-8) | Hyperammonaemic Encephalopathy | Antagonistic | Not fully understood | Hyperammonemic encephalopathy induced by a combination of valproate and pivmecillinam
|
| Pivampicillin (33817-20-8) | Increased Risk Of Carnitine Deficiency | Antagonistic | Not fully understood | Differential excretion of xenobiotic acyl-esters of carnitine due to administration of pivampicillin and valproate
|
| Phenytoin (57-41-0) | Hepatotoxicity | Antagonistic | The initial fall in total serum phenytoin levels appears to result from the displacement of phenytoin from its protein binding sites by valproate, the extent being subject to the diurnal variation in valproate levels. This allows more of the unbound drug to be exposed to metabolism by the liver and the total phenytoin levels fall | Valproic acid in epilepsy: clinical and pharmacological effects
|
| Lamotrigine (84057-84-1) | Ataxia | Synergistic | valproate reduces lamotrigine glucuronidation
by competitive inhibition, which results in a decreased lamotrigine
clearance | Sodium valproate acutely inhibits lamotrigine metabolism
|
| Acetylsalicylic acid (50-78-2) | Ataxia | Synergistic | Aspirin displaces valproate from its protein binding sites and also alters its metabolism by the liver so that the levels of free (and pharmacologically active) valproate rise | Interaction between valproic acid and aspirin in epileptic children: serum protein binding and metabolic effects
|
| Acetylsalicylic acid (50-78-2) | Drowsiness | Synergistic | Aspirin displaces valproate from its protein binding sites and also alters its metabolism by the liver so that the levels of free (and pharmacologically active) valproate rise | Interaction between valproic acid and aspirin in epileptic children: serum protein binding and metabolic effects
|
| Acetylsalicylic acid (50-78-2) | Nystagmus | Synergistic | Aspirin displaces valproate from its protein binding sites and also alters its metabolism by the liver so that the levels of free (and pharmacologically active) valproate rise | Interaction between valproic acid and aspirin in epileptic children: serum protein binding and metabolic effects
|
| Acetylsalicylic acid (50-78-2) | Tremor | Synergistic | Aspirin displaces valproate from its protein binding sites and also alters its metabolism by the liver so that the levels of free (and pharmacologically active) valproate rise | Interaction between valproic acid and aspirin in epileptic children: serum protein binding and metabolic effects
|
| Aciclovir (59277-89-3) | Seizures | Antagonistic | not known | Possible interaction between acyclovir and antiepileptic treatment
|
| Chlorpromazine (50-53-3) | Hepatotoxicity | Synergistic | reduction in liver metabolism | The effects of neuroleptics (haloperidol and chlorpromazine) on the pharmacokinetics of valproic acid in schizophrenic patients
|
| Cholestyramine (11041-12-6) | Valproate Auc Fell By 15% And The Maximum Serum Levels Fell By 21% | Antagonistic | Colestyramine is an ion-exchange resin intended to bind with bile acids in the gut, but it can also bind with drugs as well, leading to a reduction in their absorption | Effect of cholestyramine resin on single dose valproate pharmacokinetics
|
| Erythromycin (114-07-8) | Confusion | Synergistic | Unclear | Erythromycin and valproate interaction
|
| Erythromycin (114-07-8) | Slurred Speech | Synergistic | Unclear | Erythromycin and valproate interaction
|
| Erythromycin (114-07-8) | Worsening Gait | Synergistic | Unclear | Erythromycin and valproate interaction
|
| Felbamate (25451-15-4) | Cognitive Disturbances | Synergistic | Uncertain,Felbamate may cause inhibition of the oxidative pathway of valproate metabolism | The effect of felbamate on valproic acid disposition
|
| Felbamate (25451-15-4) | Drowsiness | Synergistic | Uncertain,Felbamate may cause inhibition of the oxidative pathway of valproate metabolism | The effect of felbamate on valproic acid disposition
|
| Felbamate (25451-15-4) | Headaches | Synergistic | Uncertain,Felbamate may cause inhibition of the oxidative pathway of valproate metabolism | The effect of felbamate on valproic acid disposition
|
| Felbamate (25451-15-4) | Lethargy | Synergistic | Uncertain,Felbamate may cause inhibition of the oxidative pathway of valproate metabolism | The effect of felbamate on valproic acid disposition
|
| Felbamate (25451-15-4) | Low Platelet Counts | Synergistic | Uncertain,Felbamate may cause inhibition of the oxidative pathway of valproate metabolism | The effect of felbamate on valproic acid disposition
|
| Isoniazid (54-85-3) | Asthenia | Synergistic | isoniazid inhibited the metabolism (oxidation) of valproate by the liver so that it accumulated | Interaction between isoniazid and valproate: a case of valproate overdosage
|
| Isoniazid (54-85-3) | Drowsiness | Synergistic | isoniazid inhibited the metabolism (oxidation) of valproate by the liver so that it accumulated | Interaction between isoniazid and valproate: a case of valproate overdosage
|
| Mefloquine (53230-10-7) | Seizures | Antagonistic | not clear | Suspected convulsive side-effect of mefloquine
|
| Meropenem (119478-56-7) | Seizures | Antagonistic | Unknown | Pharmacokinetic interaction between valproic acid and meropenem
|
| Methylphenidate (113-45-1) | Bruxism | Additives | Not understood | Adverse response to methylphenidate in combination with valproic acid
|