Adding valproic acid to olanzapine.
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- Olanzapine is principally metabolized by CYP1A2 and CYP2D6.
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- Valproic acid is principally metabolized by CYP2C9, CYP2C19, CYP2A6 and UDP-glucuronosyltransferases. Valproic acid is an inhibitor of the enzymes CYP2C9, epoxide-hydroxylase and UDP-glucuronosyltransferases.
- This combination of drugs may have possible synergistic effects. However, this combination will also have additive side effects. Dose adaptation will be recommended for this combination.
Start valproic acid
- Start valproic acid according to the general dosing advice. Monitoring of the liver function every 3 to 4 months during the first year of treatment with either olanzapine or valproic acid is recommended.
Stop valproic acid
- Concurrent use of olanzapine and valproic acid may potentiate the risk of hepatotoxicity.
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