Divalproex and Paliperidone Intramuscular

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.

Divalproex sodium may increase the blood levels of paliperidone (brand name Invega) when the medications are taken orally (as opposed to when given by injection). This may increase the risk of side effects such as drowsiness, Parkinson-like symptoms, abnormal muscle movements, high blood sugar, diabetes, cholesterol and lipid increases, weight gain, low white blood cell count, difficulty swallowing, and heat-related disorders such as heat intolerance or heat stroke. You may also be more likely to experience side effects associated with low blood pressure such as dizziness, lightheadedness, headache, flushing, fainting, and heart palpitations. 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 by your doctor to safely use both medications. You should avoid driving or operating hazardous machinery until you know how these medications affect you, and use caution when getting up from a sitting or lying position. 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: Coadministration with valproic acid may increase the plasma concentrations of orally administered paliperidone. The mechanism of interaction has not been established, but may involve increased gastrointestinal absorption of paliperidone. When a single 12 mg oral dose of extended-release (ER) paliperidone was coadministered with divalproex sodium ER at 1000 mg orally once daily, paliperidone peak plasma concentration (Cmax) and systemic exposure (AUC) increased by approximately 50%. No effect on the systemic clearance was observed; therefore, a clinically significant interaction would not be expected when paliperidone is administered by intramuscular injection. Conversely, coadministration of paliperidone ER (12 mg orally once daily for 5 days) with divalproex sodium ER (500 to 2000 mg orally once daily) did not affect the steady-state pharmacokinetics of valproate in 13 patients stabilized on valproate therapy. In a clinical study, subjects on stable doses of valproate had comparable valproate average plasma concentrations when oral paliperidone ER 3 to 15 mg/day was added to their existing valproate treatment.

MONITOR: Concomitant use of paliperidone and valproic acid may increase central nervous system depressant effects such as somnolence and impairment of cognitive and psychomotor skills.

MANAGEMENT: Caution is advised during concomitant use of oral paliperidone and valproate products. Pharmacologic response to paliperidone should be monitored more closely following the initiation or withdrawal of valproate therapy, and the paliperidone dosage adjusted as necessary. No dosage adjustment for paliperidone is required when it is administered by intramuscular injection. Additionally, no dosage adjustment is necessary for valproate when coadministered with paliperidone. Patients should be advised to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

Divalproex

Generic Name: divalproex sodium

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

Synonyms: Divalproex sodium

What is Divalproex?

Paliperidone Intramuscular

Generic Name: paliperidone

Brand name: Invega, Invega Sustenna, Invega Trinza

Synonyms: Paliperidone

What is Paliperidone Intramuscular?