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Combining-Valproic acid-Carbamazepine

454 bytes removed, 15:46, 22 April 2010
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| add = carbamazepine
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*A synergistic effect is suggested.<ref name="freeman">{{Pubmed|9433333|Freeman et al. Mood stabilizer Combinations: A Review of Safety and Efficacy. Am J Psychiatry 1998;155:12-21}}</ref> 
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* Valproate can increase carbamazepine-epoxide serum concentrations. Define valproate serum concentration before starting carbamazepine.
* Start carbamazepine according to the general dosing advice. Check valproate and carbamazepine serum concentration (+ epoxide) after 2 weeks of therapy and adapt dose if necessary. <ref name=”medicatiebewaking”> Schalekamp T. et al, Interacties met Psychofarmaca, Stichting Health Base, Houten, 2002. </ref>
| cave = * Valproate can inhibit carbamazepine metabolic pathways, resulting in raised carbamazepine-epoxide concentrations. <ref> {{Pubmed|9241092|Bernus et al. The mechanism of the carbamazepine-valproate interaction in humans. Br J Clin Pharmacol 1997;44:21CombiCaVa}}</ref>* Carefully monitoring for clinical and laboratory evidence of altered effects is recommended, particularly when the dosage of either drug is changed. <ref name=”medicatiebewaking”> Schalekamp T. et al, Interacties met Psychofarmaca, Stichting Health Base, Houten, 2002. </ref> <ref name=”bazire”> Bazire S, Psychotropic Drug Directory 2007, HealthComm UK Limited, Aberdeen, 2007. </ref>
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