Divalproex (valproate) and Imipenem and cilastatin interaction
Divalproex (valproate) and Imipenem and cilastatin: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Imipenem and cilastatin (PRIMAXIN IV) label · effective 2024-07-05
The concomitant use of PRIMAXIN and valproic acid/divalproex sodium is generally not recommended ( 5.3 , 7.3 ).
The concomitant use of PRIMAXIN and valproic acid/divalproex sodium is generally not recommended.
Valproic acid/divalproex sodium: Concomitant use with PRIMAXIN is generally not recommended.
Increased Seizure Potential Due to Interaction with Valproic Acid: Co-administration of PRIMAXIN, to patients receiving valproic acid or divalproex sodium results in a reduction in valproic acid concentrations.
Increased Seizure Potential Due to Interaction with Valproic Acid Case reports in the literature have shown that co-administration of carbapenems, including PRIMAXIN, to patients receiving valproic acid or divalproex sodium results in a reduction in valproic acid concentrations.
From the Divalproex (valproate) (Depakote ER) label · effective 2026-03-31
Interaction with Carbapenem Antibiotics Carbapenem antibiotics (for example, ertapenem, imipenem, meropenem; this is not a complete list) may reduce serum valproate concentrations to subtherapeutic levels, resulting in loss of seizure control.
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.
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Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.