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Adding topiramate to valproic acid.
General information- 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 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 inhibitor of CYP2C19.
- 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 topiramate- Start topiramate according to general dosing advice. Pharmacologic response to the drugs should be monitored more closely following addition or withdrawal of one or the other drug. [4]
Cave- Topiramate has been shown to produce a small but significant increase in valproate clearance, reducing plasma levels.
- Topiramate plasma levels are increased by about 15% by valproate, which could be important if valproic acid is withdrawn.[5]
- ↑ Farmacotherapeutisch Kompas; Toxicologie (dutch)
- ↑ 2.0 2.1 2.2 Farmacotherapeutisch Kompas - valproinezuur (dutch)
Cite error: Invalid
<ref>tag; name "ftk" defined multiple times with different content Cite error: Invalid<ref>tag; name "ftk" defined multiple times with different content - ↑ KNMP; Informatorium Medicamentorum 2023; Monografie "valproaat" (Dutch)
- ↑ Interactions between valproic acid and topiramate on drugs.com
- ↑ Bazire S, Psychotropic Drug Directory 2007, HealthComm UK Limited, Aberdeen, 2007.
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