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Created page with '{{Drugcombi | base = valproic acid | add = lamotrigine | info = * Valproic acid is principally metabolized by CYP2C9, CYP2C19, CYP2A6 and UDP-glucuronosyltransferases. Valproic ...'
{{Drugcombi
| base = valproic acid
| add = lamotrigine
| 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.
* Lamotrigine is principally metabolised by 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 =
* Lamotrigine generally has no significant effect on valproate levels, however caution is recommended.
* Start lamotrigine at low dose and check valproate plasma level after 1 week. Change valproate dose if necessary. <ref name=”medicatiebewaking”> Schalekamp T. et al, Interacties met Psychofarmaca, Stichting Health Base, Houten, 2002. </ref>
| cave =
* Very slow titration of lamotrigine is recommended because reports of lamotrigine-related skin rashes. <ref> {{Pubmed|16225978|Chang CC at al, Toxic epidermal necrolysis with combination lamotrigine and valproate in bipolar disorder. Prog Neuropsych. Biol Psychiatry. 2006 Jan;30(1):147-50}}</ref>
}}
| base = valproic acid
| add = lamotrigine
| 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.
* Lamotrigine is principally metabolised by 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 =
* Lamotrigine generally has no significant effect on valproate levels, however caution is recommended.
* Start lamotrigine at low dose and check valproate plasma level after 1 week. Change valproate dose if necessary. <ref name=”medicatiebewaking”> Schalekamp T. et al, Interacties met Psychofarmaca, Stichting Health Base, Houten, 2002. </ref>
| cave =
* Very slow titration of lamotrigine is recommended because reports of lamotrigine-related skin rashes. <ref> {{Pubmed|16225978|Chang CC at al, Toxic epidermal necrolysis with combination lamotrigine and valproate in bipolar disorder. Prog Neuropsych. Biol Psychiatry. 2006 Jan;30(1):147-50}}</ref>
}}
