Open main menu

Psychiatrienet β

Changes

Combining-Valproic acid-Topiramate

413 bytes removed, 12:53, 4 May 2010
no edit summary
| add = topiramate
| info =
* 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 =
* 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. <ref name="drugscom">{{DRUGSCOMdrugscominteract|olanzapinetopiramate-with-valproic-acid-2216-0-2286-0|valproic acid|topiramate}}</ref>
| 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plasma levels are increased by about 15% by valproate, which could be important if valproare valproic acid is withdrawn. <ref name=”bazire”"bazire"> Bazire S, Psychotropic Drug Directory 2007, HealthComm UK Limited, Aberdeen, 2007. </ref>
}}
editor, reviewer
1,499
edits