Difference between revisions of "Combining-Valproic acid-Lamotrigine"
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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. | * 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. | ||
* Lamotrigine is principally metabolised by UDP-glucuronosyltransferases. | * Lamotrigine is principally metabolised by UDP-glucuronosyltransferases. | ||
− | * | + | * {{PossibleSynergisticEffects}} |
| start = | | start = | ||
* Lamotrigine generally has no significant effect on valproate levels, however caution is recommended. | * Lamotrigine generally has no significant effect on valproate levels, however caution is recommended. |
Revision as of 13:29, 5 March 2010
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Adding lamotrigine to valproic acid.
- 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.
- Lamotrigine is principally metabolised by UDP-glucuronosyltransferases.
- 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.
- Lamotrigine is principally metabolised by 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.
- Lamotrigine generally has no significant effect on valproate levels, however caution is recommended.
- Start lamotrigine at low dose and check valproate plasma level after 1 week. Change valproate dose if necessary. [5]
- Very slow titration of lamotrigine is recommended because reports of lamotrigine-related skin rashes. [6]
- ↑ 1.0 1.1 Farmacotherapeutisch Kompas; Toxicologie (dutch)
- ↑ 2.0 2.1 Farmacotherapeutisch Kompas - valproinezuur (dutch)
Cite error: Invalid
<ref>
tag; name "ftk" defined multiple times with different content - ↑ KNMP; Informatorium Medicamentorum 2023; Monografie "valproaat" (Dutch)
- ↑ Drugs.com lamotrigine
- ↑ Schalekamp T. et al, Interacties met Psychofarmaca, Stichting Health Base, Houten, 2002.
- ↑ Chang CC at al, Toxic epidermal necrolysis with combination lamotrigine and valproate in bipolar disorder. Prog Neuropsych. Biol Psychiatry. 2006 Jan;30(1):147-50
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