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藥物交互作用

Imipenem / cilastatin + Valproic acid

嚴重程度: 禁忌併用

Imipenem / cilastatin and Valproic acid: contraindicated interaction.

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僅供醫療專業人員參考。本頁為簡要摘要,並非醫療建議,亦不能取代官方仿單或臨床判斷。開立處方或調劑前請務必核實。

本頁的臨床內容僅提供英文版。

摘要

Carbapenems rapidly and substantially lower serum valproate concentrations, often within a day, and can precipitate breakthrough seizures. The effect may persist for days after the carbapenem is stopped and is not reliably overcome by raising the valproate dose.

用白話說明這項交互作用的意義

Imipenem / cilastatin 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.

證據等級: High

為什麼會發生

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

處置方式

Avoid the combination and use a non-carbapenem antibiotic. If a carbapenem is essential, add alternative anticonvulsant cover and monitor valproate levels and seizure activity.

可向藥師詢問的問題

  • 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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建立帳號並開始 Pro+ 試用,即可解鎖 Imipenem / cilastatin 與 Valproic acid 的完整臨床處置建議、補充說明、證據詳情及整張處方的交互作用檢查工具。

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  • Additional notes
  • Evidence detail
  • Interaction checker for a whole prescription

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常見問題

Can I take Imipenem / cilastatin with Valproic acid?

MediHelp rates the interaction as contraindicated. Imipenem / cilastatin 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. Carbapenems rapidly and substantially lower serum valproate concentrations, often within a day, and can precipitate breakthrough seizures. The effect may persist for days after the carbapenem is stopped and is not reliably overcome by raising the valproate dose.

How serious is the interaction between Imipenem / cilastatin 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 use a non-carbapenem antibiotic. If a carbapenem is essential, add alternative anticonvulsant cover and monitor valproate levels and seizure activity.

What other medicines interact with Valproic acid?

MediHelp also lists interactions of Valproic acid with, for example, Ertapenem, Imipenem / cilastatin / relebactam, Meropenem / vaborbactam. The full list is on the Valproic acid page.

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