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Depakene and Zyprexa Intramuscular

Determining the interaction of Depakene and Zyprexa Intramuscular and the possibility of their joint administration.

Check result:
Depakene <> Zyprexa Intramuscular
Relevance: 20.07.2023 Reviewer: Shkutko P.M., M.D., in

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.

Consumer:

Using valproic acid together with OLANZapine can increase the risk of liver problems. Talk with your doctor before using these medications together. This can cause fever, rash, loss of appetite, nausea, vomiting, fatigue, right upper abdomianal pain, dark urine, and yellowish skin. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or special test if you 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.

Professional:

MONITOR: Concurrent use of olanzapine and valproic acid may potentiate the risk of hepatotoxicity. The exact mechanism of interaction is unknown. In a retrospective study of 52 children, combined treatment with olanzapine and divalproex was associated with more frequent elevations of hepatic enzymes than either agent alone, and mean and peak hepatic enzyme levels during the observed course of treatment were also higher. All 12 patients who received combined treatment had at least one peak enzyme elevation above the normal range, versus 10 of 17 who received olanzapine alone and 6 of 23 who received divalproex alone. With the exception of 2 patients who required discontinuation of combination treatment (due to development of pancreatitis in one and steatohepatitis in the other), the observed peak and mean enzyme levels were less than 3 times the upper limit of normal (ULN) and were asymptomatic. The long-term significance of these findings is unknown.

MANAGEMENT: The authors of the study recommend monitoring liver function tests every 3 to 4 months during the first year of treatment with either olanzapine or valproic acid, at least in pediatric patients. If no elevations of liver enzymes or marked weight gain occur after one year, a decrease in frequency of monitoring to every 6 months can be considered. Patients should be advised to notify their physician if they experience signs and symptoms of hepatotoxicity such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice.

References
  • Gonzalez-Heydrich J, Raches D, Wilens TE, Leichtner A, Mezzacappa E "Retrospective study of hepatic enzyme elevations in children treated with olanzapine, divalproex, and their combination." J Am Acad Child Adolesc Psychiatry 42 (2003): 1227-33
Depakene

Generic Name: valproic acid

Brand name: Depakene, Depacon, Stavzor, Valproate Sodium

Synonyms: n.a.

Zyprexa Intramuscular

Generic Name: olanzapine

Brand name: Zyprexa Intramuscular, Zyprexa, Zyprexa Zydis, Zyprexa Relprevv

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

Interaction with food and lifestyle
Disease interaction