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Combining-Carbamazepine-Valproic acid

927 bytes added, 11:41, 4 March 2010
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*Carbamazepine is principally metabolized by CYP3A4 (also CYP2C8), but is also a potent inducer of CYP1A2, CYP3A4 and UDP-glucuronosyltransferases.*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.
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*Define carbamazepine serum concentration (+ epoxide) before starting valproate. Check carbamazepine serum concentration (+ epoxide) again after 2 weeks 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;44:21}}</ref>
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