Divalproex and Phenobarbital Elixir

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.

Before taking divalproex sodium, tell your doctor if you also use PHENobarbital. You may need dose adjustments or special tests in order to safely take both medications together. This combination may increase the levels of PHENobarbital in your body. You should notify your doctor if you have symptoms of excessive sedation or lethargy. You should avoid driving until you know how these medications will affect you. It is important that you tell your healthcare provider about all other medications that you are using including vitamins and herbs. Do not stop using your medications without first talking to your doctor first.

MONITOR: Valproate may increase the plasma levels of phenobarbital. The proposed mechanism may involve valproate inhibition of CYP450-mediated metabolism of the barbiturate. In healthy subjects, coadministration of valproate (250 mg twice daily for 14 days) with phenobarbital (60 mg once) resulted in a 50% increase in half-life and a 30% reduction in the plasma clearance of phenobarbital. In addition, the fraction of phenobarbital dose excreted unchanged increased by 50% when administered with valproate. In contrast, phenobarbital may cause a decrease in valproate plasma concentrations by inducing the enzymatic metabolism of valproate. Central nervous system- and/or respiratory-depressant effects may also be additively or synergistically increased in patients taking valproate and phenobarbital concomitantly, especially in elderly or debilitated patients.

MANAGEMENT: Patients started on combination therapy should be closely monitored for clinical and laboratory evidence of phenobarbital toxicity. They should be advised to notify their doctor if they experience excessive sedation or lethargy. Reductions in the phenobarbital dosage may be required; some authorities recommend reducing the phenobarbital dose by one-third to one-half when administered with valproate. Monitoring of the plasma concentrations of both drugs when starting, stopping, or changing the dose of either drug is recommended. During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression.

Divalproex

Generic Name: divalproex sodium

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

Synonyms: Divalproex sodium

What is Divalproex?

Phenobarbital Elixir

Generic Name: phenobarbital

Brand name: Solfoton, Luminal

Synonyms: Phenobarbital, PHENobarbital

What is Phenobarbital Elixir?