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Drug Interactions between Depakote ER and glycerol phenylbutyrate

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

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Interactions between your drugs

Major

divalproex sodium glycerol phenylbutyrate

Applies to: Depakote ER (divalproex sodium) and glycerol phenylbutyrate

CONTRAINDICATED: Valproic acid can increase plasma ammonia levels and may interfere with the therapeutic effects of phenylbutyrate therapy in the management of urea cycle disorders. Hyperammonemic encephalopathy, sometimes fatal, has been reported following initiation of valproate therapy in patients with urea cycle disorders, particularly ornithine transcarbamylase deficiency.

MANAGEMENT: Valproic acid should generally not be given to patients receiving phenylbutyrate therapy, as the use of valproic acid is considered contraindicated in patients with urea cycle disorders.

References

  1. "Product Information. Depakene (valproic acid)." Abbott Pharmaceutical PROD (2001):
  2. "Product Information. Depakote (divalproex sodium)." Abbott Pharmaceutical PROD (2001):
  3. "Product Information. Buphenyl (sodium phenylbutyrate)." Horizon Therapeutics USA Inc PROD (2001):
  4. "Product Information. Ravicti (glycerol phenylbutyrate)." Hyperion Therapeutics Inc (2013):
View all 4 references

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Drug and food interactions

Moderate

divalproex sodium food

Applies to: Depakote ER (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 "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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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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