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Created page with '{{Drugcombi | base = Topiramate | add = Valproic acid | info = * Topiramate induces CYP3A4 and is an inhibiter of CYP2C19. * Valproic acid is principally metabolized by CYP2C9, ...'
{{Drugcombi
| base = Topiramate
| add = Valproic acid
| info =
* 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 =
* 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* Topiramate plasma levels are increased by about 15% by valproate, which could be important if valproate is withdrawn. <ref name=”bazire”> Bazire S, Psychotropic Drug Directory 2007, HealthComm UK Limited, Aberdeen, 2007. </ref>
}}
| base = Topiramate
| add = Valproic acid
| info =
* 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 =
* 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. <ref name=”bazire”> Bazire S, Psychotropic Drug Directory 2007, HealthComm UK Limited, Aberdeen, 2007. </ref>
}}