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Interactions médicamenteuses

Cilastatin-imipenem + Valproic acid

Gravité: Majeure

Cilastatin-imipenem and Valproic acid: major interaction.

Dernière mise à jour

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Résumé

Carbapenems, including imipenem, rapidly and markedly lower serum valproate concentrations, which can lead to loss of seizure control. The effect begins within a day or two and may persist for some days after stopping the carbapenem.

Ce que signifie cette interaction, en termes simples

Cilastatin-imipenem 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.

Cilastatin-imipenem belongs to Anti Bacterial; Valproic acid belongs to Central Nervous System.

Niveau de preuve: High

Pourquoi elle survient

Carbapenems inhibit hydrolysis of valproate glucuronide and may reduce its absorption and distribution, lowering valproate levels.

Conduite à tenir

Avoid the combination and use a non-carbapenem antibiotic. Increasing the valproate dose is usually ineffective, so add or switch to another anticonvulsant if a carbapenem is unavoidable.

Questions à poser à votre pharmacien

  • 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Questions fréquentes

Can I take Cilastatin-imipenem with Valproic acid?

MediHelp rates the interaction as major. Cilastatin-imipenem 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. Carbapenems, including imipenem, rapidly and markedly lower serum valproate concentrations, which can lead to loss of seizure control. The effect begins within a day or two and may persist for some days after stopping the carbapenem.

How serious is the interaction between Cilastatin-imipenem 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 the combination and use a non-carbapenem antibiotic. Increasing the valproate dose is usually ineffective, so add or switch to another anticonvulsant if a carbapenem is unavoidable.

What other medicines interact with Cilastatin-imipenem?

MediHelp also lists interactions of Cilastatin-imipenem with, for example, Divalproex, Ganciclovir, Bcg intravesical live. The full list is on the Cilastatin-imipenem page.

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Ouvrez le référentiel complet, vérifiez les interactions entre plusieurs médicaments et utilisez les outils de posologie dans l'application MediHelp.

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