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Depakene®
Diagnosis & Treatment > Seizure Medications > Depakene® > Interactions of Depakene with other medications
 

Interactions of Depakene with other medications

Sometimes medications affect the way others are absorbed or excreted, or how effectively they work. The fact that Depakene is often added to a regimen of other antiepileptic drugs makes the question of interactions especially important. When prescribing Depakene, question patients or family members extensively about the use of prescription and OTC medications, herbal products, vitamins, alcohol, and other substances. Usually all necessary medications can be used, but the dosages may need to be adjusted to achieve therapeutic levels.

Effects of Depakene (valproic acid) on other drugs
Depakene inhibits certain liver enzymes and can cause the levels of Felbatol (felbamate), Lamictal (lamotrigine), Mysoline (primidone), and phenobarbital to increase markedly—in some cases, more than double. If a person taking phenobarbital is also given Depakene, a rapid rise in phenobarbital levels can lead to extreme tiredness, slurred speech, and other signs of intoxication.

Depakene has more complex, variable, and less significant effects on Tegretol (carbamazepine), Zarontin (ethosuximide), Ativan (lorazepam), and Dilantin (phenytoin). Depakene inhibits epoxide hydrolase, thereby increasing levels of the epoxide metabolite of carbamazepine. It can inhibit metabolism of Zarontin and Ativan, leading to higher levels of these medications. It also can displace Dilantin from protein binding sites and slightly increase the free Dilantin level. In each case, side effects may increase slightly.

Coagulation tests should be carefully checked if patients taking anticoagulants such as Coumadin (warfarin) begin taking Depakene.

Effects of other drugs on Depakene (valproic acid)
Enzyme-inducing antiepileptic drugs, including carbamazepine, phenytoin, phenobarbital, and primidone, will markedly increase the metabolism (and thus the clearance) of Depakene.

Moderate or rapid introduction of Lamictal in a patient taking Depakene, especially a child, can significantly increase the chances of a potentially life-threatening rash (Stevens-Johnson syndrome).

If Depakene and Klonopin (clonazepam) are given together to a patient with a history of absence seizures, prolonged absence seizures (absence status) may occur.

Aspirin (acetylsalicylic acid, ASA) can increase some metabolites of Depakene that may contribute to side effects.

Patients taking Depakene along with testosterone-type androgens should be regularly checked for liver problems.

AED Interaction Sheets:
Seizure drugs are often affected by drug-drug interactions. Print these informative sheets for practical help.