Wechselwirkung zwischen Valproat-Seminatrium (Divalproex) und Valproinsäure
Valproat-Seminatrium (Divalproex) und Valproinsäure: Beide FDA-Fachinformationen versehen diese Kombination mit den stärksten Formulierungen, etwa einer Gegenanzeige, einem umrahmten Warnhinweis (Boxed Warning) oder der Anweisung, sie zu vermeiden.
Nicht ohne ärztliche Anleitung kombinieren. Die unten zitierten Formulierungen der Fachinformation sind die stärksten, die die FDA verwendet.
Was die FDA-Fachinformationen sagen
Aus der FDA-Fachinformation zu Valproat-Seminatrium (Divalproex) (Depakote ER) · Stand 2026-03-31
• with known hypersensitivity to divalproex sodium, sodium valproate, or valproic acid.
Children under the age of two years are at a considerably increased risk of developing fatal hepatotoxicity, especially those on multiple anticonvulsants, those with congenital metabolic disorders, those with severe seizure disorders accompanied by mental retardation, and those with organic brain disease.
In patients over two years of age who are clinically suspected of having a hereditary mitochondrial disease, Depakote ER should only be used after other anticonvulsants have failed.
The β-oxidation pathway consisting of 2-E-valproic acid, 3-OH-valproic acid, and 3-keto valproic acid was decreased from 25% of total metabolites excreted on valproate alone to 8.3% in the presence of aspirin.
Carbapenem Antibiotics A clinically significant reduction in serum valproic acid concentration has been reported in patients receiving carbapenem antibiotics (for example, ertapenem, imipenem, meropenem; this is not a complete list) and may result in loss of seizure control.
Aus der FDA-Fachinformation zu Valproinsäure (VALPROIC ACID) · Stand 2024-05-02
Children under the age of two years are at a considerably increased risk of developing fatal hepatotoxicity, especially those on multiple anticonvulsants, those with congenital metabolic disorders, those with severe seizure disorders accompanied by mental retardation, and those with organic brain disease.
In patients over two years of age who are clinically suspected of having a hereditary mitochondrial disease, valproic acid oral solution should only be used after other anticonvulsants have failed.
Patients on multiple anticonvulsants, children, those with congenital metabolic disorders, those with severe seizure disorders accompanied by mental retardation, and those with organic brain disease may be at particular risk.
Patients receiving valproate and ethosuximide, especially along with other anticonvulsants, should be monitored for alterations in serum concentrations of both drugs.
In a clinical trial of divalproex sodium as monotherapy in patients with epilepsy, 34/126 patients (27%) receiving approximately 50 mg/kg/day on average, had at least one value of platelets ≤ 75 x 10 9 /L.
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