Depakote Sprinkles and Xyrem

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 sodium oxybate together with other medications that can affect the central nervous system such as divalproex sodium may increase side effects like drowsiness, dizziness, lightheadedness, confusion, depression, low blood pressure, and slow or shallow breathing. Occasionally, severe reactions may result in coma and even death. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Do not drive, operate machinery, or perform other hazardous activities for at least six hours after taking sodium oxybate and until you know how these medications affect you. You should also avoid the use of alcohol during treatment with these 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: The central nervous system and respiratory depressant effects of sodium oxybate, which is the sodium salt of gamma hydroxybutyrate (GHB), may be potentiated by concomitant use of other agents with CNS depressant effects including anticonvulsants. An increased risk of serious adverse reactions such as respiratory depression, hypotension, profound sedation, syncope, coma, and even death should be considered.

ADJUST DOSE: Animal data suggest a possible pharmacokinetic interaction between sodium oxybate and certain anticonvulsants like valproate, phenytoin, ethosuximide, and trimethadione that can inhibit the enzyme GHB dehydrogenase, which converts GHB to succinic semialdehyde. In humans, coadministration of sodium oxybate (6 gm/day in two equal doses 4 hours apart) with divalproex sodium (1250 mg valproic acid per day) has been associated with a 25% mean increase in systemic exposure to sodium oxybate and a greater impairment on some tests of attention and working memory. Pharmacokinetic data are not available for other anticonvulsants.

MANAGEMENT: Concomitant use of sodium oxybate with other CNS depressants should be avoided whenever possible. Otherwise, close monitoring and/or dosage reductions should be considered. For patients already stabilized on sodium oxybate who are prescribed divalproex sodium, the manufacturer recommends that the nightly dosage of sodium oxybate be reduced initially by at least 20%. Conversely, for patients already taking divalproex sodium, it is recommended that prescribers use a lower starting dosage of sodium oxybate upon initiation of treatment. Further dosage adjustments should be made according to patient response and tolerance. No specific dosage recommendations are available for use with other anticonvulsants. All patients treated with sodium oxybate should be advised not to drive, operate machinery, or engage in hazardous activities requiring mental alertness and motor coordination for at least 6 hours after taking the second nightly dose of sodium oxybate and until they know how the medication affects them.

Depakote Sprinkles

Generic Name: divalproex sodium

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

Synonyms: Depakote Capsules

What is Depakote Sprinkles?

Xyrem

Generic Name: sodium oxybate

Brand name: Xyrem

Synonyms: n.a.

What is Xyrem?