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Created page with '{{Drugcombi | base = Lamotrigine | add = valproic acid | info = * Lamoptrigine is principally metabolised by UDP-glucuronosyltransferases. * Valproic acid is principally metabol...'
{{Drugcombi
| base = Lamotrigine
| add = valproic acid
| info =
* Lamoptrigine is principally metabolised by 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.
* 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 =
* Reduce the lamotrigine dose by 50% of the general dose when combined with valproate. Start valproate at low dose and increase dose based on serum concentration slowly. <ref name=”medicatiebewaking”> Schalekamp T. et al, Interacties met Psychofarmaca, Stichting Health Base, Houten, 2002. </ref> <ref> {{Pubmed|8098122|Pisani at al, Interaction of lamotrigine with sodium valproate. Lancet. 1993 May 8;341(8854):1224.}}</ref>
| cave =
* Valproate can increase lamotrigine plasma levels significantly by inhibiting lamotrigine’s glucuronidation. This effect of valproate is dose-dependent.
}}
| base = Lamotrigine
| add = valproic acid
| info =
* Lamoptrigine is principally metabolised by 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.
* 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 =
* Reduce the lamotrigine dose by 50% of the general dose when combined with valproate. Start valproate at low dose and increase dose based on serum concentration slowly. <ref name=”medicatiebewaking”> Schalekamp T. et al, Interacties met Psychofarmaca, Stichting Health Base, Houten, 2002. </ref> <ref> {{Pubmed|8098122|Pisani at al, Interaction of lamotrigine with sodium valproate. Lancet. 1993 May 8;341(8854):1224.}}</ref>
| cave =
* Valproate can increase lamotrigine plasma levels significantly by inhibiting lamotrigine’s glucuronidation. This effect of valproate is dose-dependent.
}}