Adding valproic acid to gabapentin.
- Gabapentin is eliminated unchanged by the kidney for 100%.
- 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. There are no reports for pharmacokinetic drug interactions. However, the combination will have additional side effects. 
- Start valproic acid according to the general dosing advice.
- Farmacotherapeutisch Kompas - gabapentine (dutch)
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- Farmacotherapeutisch Kompas; Toxicologie (dutch)
- KNMP; Informatorium Medicamentorum 2015; Monografie "valproaat" (Dutch)
- Freeman et al. Mood stabilizer Combinations: A Review of Safety and Efficacy. Am J Psychiatry 1998;155:12-21
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