Pharmacokinetic interaction between valproic acid and meropenem

Meropenem –valproic acid interaction in patients with cefepime-associated status epilepticus

“…Recovery of plasma valproic acid levels after discontinuation of meropenem varied in the literature from a few days 18,19,22,23 to more than two Am J Health-Syst Pharm-Vol 64 Jan 1, 2007 weeks. 16,18,21 In our reports, therapeutic serum valproic acid levels were not achieved after meropenem was discontinued; however, both patients died within two weeks of the onset of the drug-drug interaction.…”

“…Several other reports have since confi rmed the decrease of plasma valproic acid levels after concurrent treatment with carbapenem antibiotics. [17][18][19][20][21][22][23] The mechanism of the interaction between valproic acid and meropenem has not been fully elucidated. In a series of animal studies, the interaction was confi rmed by a signifi cantly decreased area under the curve and peak plasma concentration of valproic acid after meropenem administration.…”

Antibiotic Drug Interactions

“…An increased risk for seizures has also been noted with use of valproic acid and carbapenems. This interaction is associated with a rapid reduction in valproic acid concentrations, so therapeutic drug monitoring and dosage increment of valproic acid should be performed when concomitant use of a carbapenem is necessary [7,13].…”

Drug interaction between valproic acid and carbapenems in patients with epileptic seizures

“…The mechanisms of the interaction between VPA and carbapenems are complex and have still not been fully investigated [17]. However, the reduction in serum VPA levels induced by carbapenems may lead to the aggravation of seizures, and it has been advised that the combined use of these medications is best avoided [8–12,15].…”