Drug interactions
Pretomanid + Valproic acid
Severity: Major
Pretomanid and Valproic acid: major 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
Pretomanid-containing regimens carry a risk of liver injury, and valproic acid is itself a recognised cause of hepatotoxicity. Using them together may add to the risk of serious liver damage.
What this interaction means in plain words
Pretomanid and Valproic acid can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Pretomanid belongs to Anti Bacterial; Valproic acid belongs to Central Nervous System.
Why it happens
Additive hepatotoxicity from two drugs that can each injure the liver.
What to do
Avoid valproic acid during pretomanid therapy where an alternative anticonvulsant or mood stabiliser is possible. If it cannot be avoided, check liver enzymes and bilirubin at baseline and regularly during treatment, and stop the offending drug if liver injury appears.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Valproic acid
- Ertapenem + Valproic acid Contraindicated
- Imipenem / cilastatin / relebactam + 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
Other interactions of Pretomanid
Frequently asked questions
Can I take Pretomanid with Valproic acid?
MediHelp rates the interaction as major. Pretomanid and Valproic acid can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Pretomanid-containing regimens carry a risk of liver injury, and valproic acid is itself a recognised cause of hepatotoxicity. Using them together may add to the risk of serious liver damage.
How serious is the interaction between Pretomanid and Valproic acid?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid valproic acid during pretomanid therapy where an alternative anticonvulsant or mood stabiliser is possible. If it cannot be avoided, check liver enzymes and bilirubin at baseline and regularly during treatment, and stop the offending drug if liver injury appears.
What other medicines interact with Valproic acid?
MediHelp also lists interactions of Valproic acid with, for example, Ertapenem, Imipenem / cilastatin / relebactam, Imipenem / cilastatin. The full list is on the Valproic acid page.
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