OBJECT DRUGS

• Valproic Acid (Depakene, etc.)

PRECIPITANT DRUGS

Carbapenem Antibiotics:

• Doripenem (Doribax)
• Ertapenem (Invanz)
• Imipenem (Primaxin)
• Meropenem (Merrem)

Comment:

The administration of carbapenem antibiotics has been noted to markedly reduce the plasma concentrations of valproic acid. Reduction in seizure control may occur.

Class 2: Use Only if Benefit Felt to Outweigh Risk

• Use Alternative: It would be best to use an antibiotic other than a carbapenem in patients taking valproic acid.
• Monitor: If a carbapenem is used with valproic acid, monitor for altered valproic acid plasma concentrations and response if a carbapenem antibiotic is initiated, discontinued, or changed in dosage.