藥物交互作用
Cilastatin-imipenem + Valproic acid
嚴重程度: 嚴重
Cilastatin-imipenem and Valproic acid: major interaction.
最後更新
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摘要
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.
用白話說明這項交互作用的意義
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.
為什麼會發生
Carbapenems inhibit hydrolysis of valproate glucuronide and may reduce its absorption and distribution, lowering valproate levels.
處置方式
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.
可向藥師詢問的問題
- 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?
Cilastatin-imipenem 的其他交互作用
Valproic acid 的其他交互作用
常見問題
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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