| Valproic acid-carbapenem interaction: report of six cases and a review of the literature. | |
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MedLine Citation:
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PMID: 20408498 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: To evaluate the drug interactions between valproic acid (VPA) and carbapenem antibiotics. METHODS: The effects of concurrent use of VPA and carbapenem antibiotics were evaluated in a retrospective observational study of hospitalized adults. Patients receiving both VPA and a carbapenem with at least two plasma VPA concentrations serially measured prior to, during, and/or after this combined treatment were included. RESULTS: Six critically ill VPA-treated patients were identified who concurrently received meropenem (n=4), imipenem (n=1), or ertapenem (n=1). As compared with values obtained while not receiving treatment with the carbapenem, mean plasma VPA trough concentrations decreased by 58% (from 51.7 [95% confidence interval {CI} 28.0-75.4] to 21.8 [95% CI 11.1-32.5] mg/L; p = 0.025). Estimated mean VPA clearance increased by 191% (from 0.0158 [95% CI 0.0041-0.0275] to 0.0302 [95% CI 0.0169-0.0591] L/h/kg; p = 0.007). All VPA concentrations measured during concurrent VPA-carbapenem treatment were below the lower boundary of the usual therapeutic range. Five patients (83%) experienced generalized seizures during concurrent VPA-carbapenem treatment, including two with no prior history of seizures or epilepsy. CONCLUSIONS: All recipients showed evidence of a complex pharmacokinetic and pharmacodynamic drug interaction between VPA and a carbapenem. Concurrent use of these medications should be avoided. |
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Authors:
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Jennifer K Tobin; Larry K Golightly; Steven D Kick; Michael A Jones |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Drug metabolism and drug interactions Volume: 24 ISSN: 0792-5077 ISO Abbreviation: Drug Metabol Drug Interact Publication Date: 2009 |
Date Detail:
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Created Date: 2010-04-22 Completed Date: 2010-07-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8904736 Medline TA: Drug Metabol Drug Interact Country: England |
Other Details:
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Languages: eng Pagination: 153-82 Citation Subset: IM |
Affiliation:
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University of Colorado Denver School of Pharmacy, Denver, CO, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anticonvulsants / adverse effects, blood* Antimanic Agents / adverse effects, blood* Carbapenems / adverse effects, pharmacology* Drug Interactions Female Humans Male Middle Aged Recurrence Retrospective Studies Seizures / chemically induced Valproic Acid / adverse effects, blood* |
| Chemical | |
Reg. No./Substance:
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0/Anticonvulsants; 0/Antimanic Agents; 0/Carbapenems; 99-66-1/Valproic Acid |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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