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Interactions médicamenteuses

Imipenem / cilastatin / relebactam + Valproic acid

Gravité: Contre-indiquée

Imipenem / cilastatin / relebactam and Valproic acid: contraindicated interaction.

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Résumé

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.

Ce que signifie cette interaction, en termes simples

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.

Niveau de preuve: High

Pourquoi elle survient

Carbapenems inhibit acylpeptide hydrolase, blocking hydrolysis of valproate glucuronide back to valproate, and possibly reduce its absorption or increase its distribution into red cells.

Conduite à tenir

Avoid the combination and choose a non-carbapenem antibiotic. If unavoidable, give alternative anticonvulsant cover and monitor valproate levels and seizures.

Questions à poser à votre pharmacien

  • 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?

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 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.

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