Divalproex Delayed Release and Sinequan (Doxepin Oral Concentrate)
Determining the interaction of Divalproex Delayed Release and Sinequan (Doxepin Oral Concentrate) and the possibility of their joint administration.
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:Before using doxepin, tell your doctor if you also use divalproex sodium. This combination may cause uneven heartbeats, extreme drowsiness, dizziness, confusion, blurred vision, and seizures. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or special tests 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: The concomitant administration of valproic acid or its derivatives may increase serum concentrations of tricyclic antidepressants. In one study, the amitriptyline area under the curve was increased 31% in subjects taking divalproex sodium (n=15). A case report has described increased nortriptyline levels and toxicity after sodium valproate was added to the regimen. The proposed mechanism is inhibition of CYP450 hepatic metabolism. CNS and/or respiratory depressant effects may be additively or synergistically increased in patients taking multiple drugs which cause these effects. Other tricyclic antidepressants may exhibit a similar interaction. Additionally, tricyclic antidepressants may counteract the anticonvulsive effects of valproic acid and divalproex by lowering the seizure threshold.
MANAGEMENT: It may be advisable to monitor patients for altered efficacy and safety. Dose adjustments or alternate therapy may be necessary if an interaction is suspected.
- Fu C, Katzman M, Goldbloom DS "Valproate/nortriptyline interaction." J Clin Psychopharmacol 14 (1994): 205-6
- Wong SL, Cavanaugh J, Shi H, Awni WM, Granneman GR "Effects of divalproex sodium on amitriptyline and nortriptyline pharmacokinetics." Clin Pharmacol Ther 60 (1996): 48-53
Generic Name: divalproex sodium
Brand name: Depakote ER, Depakote Sprinkles, Depakote, Depakene, Depacon
Synonyms: Divalproex sodium, Divalproex
Generic Name: doxepin
Brand name: Sinequan, Sinequan, Silenor
Synonyms: Sinequan Capsules, Sinequan
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.
- Divalproex Delayed Release-Sinex Long-Acting
- Divalproex Delayed Release-Sinex Nasal Spray
- Divalproex Delayed Release-Singulair
- Divalproex Delayed Release-Singulair (Montelukast Chewable Tablets)
- Divalproex Delayed Release-Singulair (Montelukast Oral Granules)
- Divalproex Delayed Release-Singulair (Montelukast Tablets)
- Sinequan (Doxepin Oral Concentrate)-Divalproex Delayed Release Tablets
- Sinequan (Doxepin Oral Concentrate)-Divalproex Extended Release
- Sinequan (Doxepin Oral Concentrate)-Divalproex Long-Acting Tablets
- Sinequan (Doxepin Oral Concentrate)-Divalproex sodium
- Sinequan (Doxepin Oral Concentrate)-Divalproex Sprinkle
- Sinequan (Doxepin Oral Concentrate)-Divalproex Sprinkle Capsules