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Drug Interactions between CMT and Depakene

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

valproic acid choline salicylate

Applies to: Depakene (valproic acid) and CMT (choline salicylate / magnesium salicylate)

MONITOR: Salicylates, particularly aspirin, may displace valproate from protein binding sites and inhibit its clearance. Four-fold increases in the free fraction of valproate have been reported in children. Increased therapeutic and toxic effects may be expected to occur. This interaction is more likely with large or prolonged doses of salicylates.

MANAGEMENT: Small single doses of salicylates are unlikely to cause significant effects. However, patients who take large doses of salicylates or over a prolonged period of time should be closely monitored for clinical and laboratory evidence of valproate toxicity and hepatotoxicity. Free fraction of valproate may be particularly helpful in detecting this interaction. Patients should be advised to notify their physician if they experience possible symptoms of toxicity (e.g., malaise, weakness, lethargy, drowsiness, nausea, vomiting, or abdominal pain).

References

  1. Orr JM, Abbott FS, Farrell K, Ferguson S, Sheppard I, Godolphin W "Interaction between valproic acid and aspirin in epileptic children: serum protein binding and metabolic effects." Clin Pharmacol Ther 31 (1982): 642-9
  2. Farrell K, Orr JM, Abbott FS, et al. "The effect of acetylsalicylic acid on serum free valproate concentrations and valproate clearance in children." J Pediatr 101 (1982): 142-4
  3. Abbott FS, Kassam J, Orr JM, Farrell K "The effect of aspirin on valproic acid metabolism." Clin Pharmacol Ther 40 (1986): 94-100
  4. Dasgupta A, Jacques M "Reduced in vitro displacement of valproic acid from protein binding by salicylate in uremic sera compared with normal sera - role of uremic compounds." Am J Clin Pathol 101 (1994): 349-53
View all 4 references

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Moderate

valproic acid magnesium salicylate

Applies to: Depakene (valproic acid) and CMT (choline salicylate / magnesium salicylate)

MONITOR: Salicylates, particularly aspirin, may displace valproate from protein binding sites and inhibit its clearance. Four-fold increases in the free fraction of valproate have been reported in children. Increased therapeutic and toxic effects may be expected to occur. This interaction is more likely with large or prolonged doses of salicylates.

MANAGEMENT: Small single doses of salicylates are unlikely to cause significant effects. However, patients who take large doses of salicylates or over a prolonged period of time should be closely monitored for clinical and laboratory evidence of valproate toxicity and hepatotoxicity. Free fraction of valproate may be particularly helpful in detecting this interaction. Patients should be advised to notify their physician if they experience possible symptoms of toxicity (e.g., malaise, weakness, lethargy, drowsiness, nausea, vomiting, or abdominal pain).

References

  1. Orr JM, Abbott FS, Farrell K, Ferguson S, Sheppard I, Godolphin W "Interaction between valproic acid and aspirin in epileptic children: serum protein binding and metabolic effects." Clin Pharmacol Ther 31 (1982): 642-9
  2. Farrell K, Orr JM, Abbott FS, et al. "The effect of acetylsalicylic acid on serum free valproate concentrations and valproate clearance in children." J Pediatr 101 (1982): 142-4
  3. Abbott FS, Kassam J, Orr JM, Farrell K "The effect of aspirin on valproic acid metabolism." Clin Pharmacol Ther 40 (1986): 94-100
  4. Dasgupta A, Jacques M "Reduced in vitro displacement of valproic acid from protein binding by salicylate in uremic sera compared with normal sera - role of uremic compounds." Am J Clin Pathol 101 (1994): 349-53
View all 4 references

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Moderate

choline salicylate magnesium salicylate

Applies to: CMT (choline salicylate / magnesium salicylate) and CMT (choline salicylate / magnesium salicylate)

GENERALLY AVOID: Concomitant use of more than one salicylate at a time may increase the potential for gastrointestinal adverse effects (e.g., inflammation, pain, bleeding, ulceration) and bruising or bleeding.

MANAGEMENT: Concomitant use of more than one salicylate at a time should generally be avoided. Patients treated with a salicylate should be advised to take it with food and to immediately report signs and symptoms of GI ulceration and bleeding such as severe abdominal pain, dizziness, lightheadedness, and the appearance of black, tarry stools.

References

  1. "Product Information. Pepto-Bismol (bismuth subsalicylate)." Procter and Gamble Pharmaceuticals PROD (2001):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

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Drug and food interactions

Moderate

valproic acid food

Applies to: Depakene (valproic acid)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc. (1990):
  3. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  4. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
View all 4 references

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Moderate

magnesium salicylate food

Applies to: CMT (choline salicylate / magnesium salicylate)

GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.

References

  1. "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn PROD (2002):

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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