Depakote and Imipenem and cilastatin

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.

Imipenem may significantly reduce the blood levels of divalproex sodium. This can cause loss of seizure control or changes in behavior. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use 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.

GENERALLY AVOID: Coadministration with carbapenem antibiotics may substantially decrease the serum concentrations of valproic acid (VPA) and increase the risk of breakthrough seizures. Approximately 50% to 90% reductions have been typically observed. The exact mechanism of interaction is unknown. In vitro and animal studies suggest that carbapenems may increase the metabolism of VPA to VPA glucuronide; inhibit the hydrolysis of VPA glucuronide in the liver; increase the renal clearance of VPA glucuronide; and inhibit the intestinal absorption of VPA. Carbapenems alone have also been associated with reports of seizures, primarily in patients with central nervous system disorders (e.g., brain lesions, history of seizures), bacterial meningitis, and/or compromised renal function. The interaction with VPA has been reported with various carbapenems including doripenem, ertapenem, imipenem, meropenem and panipenem, often resulting in subtherapeutic VPA levels promptly following initiation of the carbapenem and sometimes despite increases in the VPA dosage. Seizures have been reported in several cases. VPA levels typically begin to increase soon after discontinuation of the carbapenem.

MANAGEMENT: Concomitant use of valproic acid with carbapenem antibiotics is generally not recommended. Use of alternative antibiotics should be considered in patients whose seizures are well controlled on valproic acid therapy. If coadministration is required, supplemental anticonvulsant therapy may be advisable, since increasing the valproic acid dose alone may not be sufficient to overcome the interaction. Nevertheless, pharmacologic response and serum valproate levels should be monitored closely following the addition or withdrawal of carbapenem treatment, and the dosage adjusted as necessary.

Depakote

Generic Name: divalproex sodium

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

Synonyms: n.a.

What is Depakote?

Imipenem and cilastatin

Generic Name: cilastatin / imipenem

Brand name: Primaxin IV, Primaxin IM, Primaxin IV ADD-Vantage

Synonyms: Imipenem and Cilastatin

What is Imipenem and cilastatin?