Difference between revisions of "Combining-Topiramate-Valproic acid"
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Adding Valproic acid to Topiramate.
General information- Topiramate induces CYP3A4 and is an inhibitor of CYP2C19.
- 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.
- Topiramate induces CYP3A4 and is an inhibiter of CYP2C19.
- 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, the pharmacokinetic drug interactions will influence the plasma levels. Dose adaptation will be recommended for this combination.
Start Valproic acid- Start valproic acid according to the general dosing advice.
- Pharmacologic response to the drugs should be monitored more closely following addition or withdrawal of one or the other drug. Dose adjustments may be required if an interaction is suspected.
Cave- Topiramate has been shown to produce a small but significant increase in valproate clearance, reducing plasma levels, although enhanced valproate side-effects.
- Topiramate plasma levels are increased by about 15% by valproate, which could be important if valproate is withdrawn. [4]
- ↑ 1.0 1.1 1.2 Farmacotherapeutisch Kompas - topiramaat (dutch)
Cite error: Invalid
<ref>tag; name "ftk" defined multiple times with different content - ↑ Farmacotherapeutisch Kompas; Toxicologie (dutch)
- ↑ KNMP; Informatorium Medicamentorum 2023; Monografie "valproaat" (Dutch)
- ↑ Bazire S, Psychotropic Drug Directory 2007, HealthComm UK Limited, Aberdeen, 2007.
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