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Drug Interactions between Depakote and Thorazine

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

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Interactions between your drugs

Moderate

chlorproMAZINE divalproex sodium

Applies to: Thorazine (chlorpromazine) and Depakote (divalproex sodium)

MONITOR: Chlorpromazine may decrease the plasma clearance of valproate and increase serum levels. Valproate toxicity may result. Cases of severe nephrotoxicity have been reported.

MANAGEMENT: Close clinical and laboratory monitoring for evidence of valproate toxicity is recommended during concomitant therapy. Patients should be advised to notify their physicians if they experience weakness, fatigue, confusion, ataxia, increased seizures, nausea, or vomiting.

References

  1. Peet M, Middlemiss D, Yates R (1980) "Pharmacokinetic interaction between propranolol and chlorpromazine in schizophrenic patients." Lancet, 2, p. 978
  2. Miller F, Rampling D (1982) "Adverse effects of combined propranolol and chlorpromazine therapy." Am J Psychiatry, 139, p. 1198-9
  3. Ishizaki T, Chiba K, Saito M, et al. (1984) "The effects of neuroleptics (haloperidol and chlorpromazine) on the pharmacokinetics of valproic acid in schizophrenic patients." J Clin Psychopharmacol, 4, p. 254-61
  4. Silver JM, Yudofsky SC, Kogan M, Katz BL (1986) "Elevation of thioridazine plasma levels by propranolol." Am J Psychiatry, 143, p. 1290-2
  5. Vestal RE, Kornhauser DM, Hollifield JW, Shand DG (1979) "Inhibition of propranolol metabolism by chlorpromazine." Clin Pharmacol Ther, 25, p. 19-24
  6. Bach N, Thung SN, Schaffner F, Tobias H (1989) "Exaggerated cholestasis and hepatic fibrosis following simultaneous administration of chlorpromazine and sodium valproate." Dig Dis Sci, 34, p. 1303-7
  7. Markowitz JS, Wells BG, Carson WH (1995) "Interactions between antipsychotic and antihypertensive drugs." Ann Pharmacother, 29, p. 603-9
View all 7 references

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Drug and food interactions

Moderate

divalproex sodium food

Applies to: Depakote (divalproex sodium)

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

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Moderate

chlorproMAZINE food

Applies to: Thorazine (chlorpromazine)

GENERALLY AVOID: Concurrent use of ethanol and phenothiazines may result in additive CNS depression and psychomotor impairment. Also, ethanol may precipitate dystonic reactions in patients who are taking phenothiazines. The two drugs probably act on different sites in the brain, although the exact mechanism of the interaction is not known.

MANAGEMENT: Patients should be advised to avoid alcohol during phenothiazine therapy.

References

  1. Lutz EG (1976) "Neuroleptic-induced akathisia and dystonia triggered by alcohol." JAMA, 236, p. 2422-3
  2. Freed E (1981) "Alcohol-triggered-neuroleptic-induced tremor, rigidity and dystonia." Med J Aust, 2, p. 44-5

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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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