Brevicon and Depakote (Divalproex Long-Acting Tablets)

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using ethinyl estradiol together with divalproex sodium can cause loss of seizure control or symptoms such as tremors, poor muscle coordination, increased seizures, and changes in behavior. Talk with your doctor before using these medications together, and report any side effects promptly. You may need a dose adjustment or special tests to safely take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: A case report suggests that estrogens or progestins may decrease the serum concentrations and pharmacologic effects of valproic acid (VPA). The proposed mechanism is induction of hepatic glucuronidation by sex hormones. The case report involves a 26-year-old woman with a history of epilepsy since childhood. Petite mal seizures developed at age seven, which were treated with ethosuximide for approximately 2 years. She was seizure-free from age nine and did not require medication until age 13, when she had her first generalized convulsive seizure that corresponded with her first menstrual cycle. She continued to have one or two episodes each year under treatment with a variety of anticonvulsants, but had her last generalized convulsion at age 23 while taking VPA. Subsequently, she developed partial seizures that began around the time she was started on an oral contraceptive containing ethynodiol 1 mg and ethinyl estradiol 35 mcg. The patient's seizure charting indicated that her partial seizures occurred more frequently during the weeks she was taking active contraceptive pills than the weeks when she took the inactive pills. Specifically, over a 5-month period, she had 12 seizures during 105 days of active pill use and none during 35 days of inactive pill use. In two separate cycles, morning trough serum VPA level during the third week of active pill use was 39% and 64% of that between days 5 and 7 of inactive pill use. Conversely, VPA reportedly has no effects on the pharmacokinetics of contraceptive steroids. In one study, VPA given at a dosage of 200 mg twice daily for 2 months did not significantly affect the systemic exposure (AUC) of ethinyl estradiol or levonorgestrel in six women.

MANAGEMENT: Pharmacologic response and serum valproic levels should be monitored more closely whenever estrogen- and/or progestin-containing drugs are added to or withdrawn from therapy, and the valproic acid dosage adjusted as necessary. Patients should be advised to contact their physician if they experience loss of seizure control or symptoms of valproic acid toxicity such as tremors, ataxia, nystagmus, increased seizures, and changes in mental status. In patients receiving oral contraceptives, gradual transient increases in valproic acid levels will likely occur during the pill-free week for women not also taking an enzyme-inducing drug (e.g., carbamazepine, phenytoin, phenobarbital, primidone, rifampin). The increase in valproic acid levels will be greater if the dose of valproic acid is increased in the few days before or during the pill-free week.

Brevicon

Generic Name: ethinyl estradiol / norethindrone

Brand name: Blisovi 24 Fe, Estrostep Fe, Femcon Fe, Kaitlib FE, Lo Minastrin Fe, Microgestin 24 Fe, Norinyl 1+35, Ortho-Novum 7/7/7, Taytulla, Tri-Norinyl, Zenchent, Blisovi 24 Fe, Blisovi Fe 15/30, Blisovi Fe 1/20, Gildess 24 Fe, Gildess Fe 15/30, Gildess Fe 1/20, Junel Fe 15/30, Junel Fe 1/20, Junel Fe 24, Larin 24 Fe, Larin Fe 15/30, Larin Fe 1/20, Lo Loestrin Fe, Loestrin 24 Fe, Loestrin Fe 15/30, Loestrin Fe 1/20, Lomedia 24 Fe, Microgestin 24 Fe, Microgestin Fe 15/30, Microgestin Fe 1/20, Tarina Fe 1/20, Tilia Fe, Tri-Legest Fe, femhrt 05 mg/25 mcg, Fyavolv, Jevantique Lo, Jinteli, Femcon Fe, Generess FE, Loestrin 1/20, Ovcon 35, Brevicon

Synonyms: n.a.

What is Brevicon?

Depakote (Divalproex Long-Acting Tablets)

Generic Name: divalproex sodium

Brand name: Depakene, Depacon, Depakote ER, Depakote Sprinkles, Depakote

Synonyms: Depakote

What is Depakote (Divalproex Long-Acting Tablets)?