Drug interactions
Imipenem / cilastatin / relebactam + Valproic acid
Severity: Contraindicated
Imipenem / cilastatin / relebactam and Valproic acid: contraindicated interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Imipenem-containing regimens rapidly lower valproate concentrations and can cause loss of seizure control. The reduction can persist after the carbapenem is stopped and is hard to counter with valproate dose increases.
What this interaction means in plain words
Imipenem / cilastatin / relebactam and Valproic acid are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Carbapenems inhibit acylpeptide hydrolase, blocking hydrolysis of valproate glucuronide back to valproate, and possibly reduce its absorption or increase its distribution into red cells.
What to do
Avoid the combination and choose a non-carbapenem antibiotic. If unavoidable, give alternative anticonvulsant cover and monitor valproate levels and seizures.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Imipenem / cilastatin / relebactam and Valproic acid, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Valproic acid
- Ertapenem + Valproic acid Contraindicated
- Imipenem / cilastatin + Valproic acid Contraindicated
- Meropenem / vaborbactam + Valproic acid Contraindicated
- Meropenem + Valproic acid Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Valproic acid Major
- Cilastatin-imipenem + Valproic acid Major
Frequently asked questions
Can I take Imipenem / cilastatin / relebactam with Valproic acid?
MediHelp rates the interaction as contraindicated. Imipenem / cilastatin / relebactam and Valproic acid are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Imipenem-containing regimens rapidly lower valproate concentrations and can cause loss of seizure control. The reduction can persist after the carbapenem is stopped and is hard to counter with valproate dose increases.
How serious is the interaction between Imipenem / cilastatin / relebactam and Valproic acid?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and choose a non-carbapenem antibiotic. If unavoidable, give alternative anticonvulsant cover and monitor valproate levels and seizures.
What other medicines interact with Valproic acid?
MediHelp also lists interactions of Valproic acid with, for example, Ertapenem, Imipenem / cilastatin, Meropenem / vaborbactam. The full list is on the Valproic acid page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
