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{{Drugcombi
| base = Topiramatetopiramate| add = Valproic 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.{{PossibleSynergisticEffects}}
| 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. {{MonitorChange}}
| cave =
* Topiramate plasma levels are increased by about 15% by valproate, which could be important if valproate is withdrawn.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>
}}
