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Drug interactions between Depakote and Invega Sustenna

Results for the following 2 drugs:
Depakote (divalproex sodium)
Invega Sustenna (paliperidone)

Interactions between your drugs


divalproex sodium ↔ paliperidone

Applies to:Depakote (divalproex sodium) and Invega Sustenna (paliperidone)

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with valproic acid may increase the plasma concentrations of orally administered paliperidone. The mechanism of interaction has not been established, but may involve increased gastrointestinal absorption of paliperidone. When a single 12 mg oral dose of extended-release (ER) paliperidone was coadministered with divalproex sodium ER at 1000 mg orally once daily, paliperidone peak plasma concentration (Cmax) and systemic exposure (AUC) increased by approximately 50%. No effect on the systemic clearance was observed; therefore, a clinically significant interaction would not be expected when paliperidone is administered by intramuscular injection. Conversely, coadministration of paliperidone ER (12 mg orally once daily for 5 days) with divalproex sodium ER (500 to 2000 mg orally once daily) did not affect the steady-state pharmacokinetics of valproate in 13 patients stabilized on valproate therapy. In a clinical study, subjects on stable doses of valproate had comparable valproate average plasma concentrations when oral paliperidone ER 3 to 15 mg/day was added to their existing valproate treatment.

MONITOR: Concomitant use of paliperidone and valproic acid may increase central nervous system depressant effects such as somnolence and impairment of cognitive and psychomotor skills.

MANAGEMENT: Caution is advised during concomitant use of oral paliperidone and valproate products. Pharmacologic response to paliperidone should be monitored more closely following the initiation or withdrawal of valproate therapy, and the paliperidone dosage adjusted as necessary. No dosage adjustment for paliperidone is required when it is administered by intramuscular injection. Additionally, no dosage adjustment is necessary for valproate when coadministered with paliperidone. Patients should be advised to avoid hazardous activities requiring 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.


  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. "Product Information. Invega Trinza (paliperidone)." Janssen Pharmaceuticals, Titusville, NJ.
  3. "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals, Titusville, NJ.
  4. "Product Information. Invega Sustenna (paliperidone)." Janssen Pharmaceuticals, Titusville, NJ.
View all 4 references

Drug and food interactions


divalproex sodium food

Applies to: Depakote (divalproex sodium)

Alcohol can increase the nervous system side effects of divalproex sodium such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with divalproex sodium. Do not use more than the recommended dose of divalproex sodium, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

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paliperidone food

Applies to: Invega Sustenna (paliperidone)

You should avoid the use of alcohol while being treated with paliperidone. Alcohol can increase the nervous system side effects of paliperidone such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. Paliperidone may be taken with or without food. Talk to your doctor or pharmacist if you have any questions or concerns.

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Therapeutic duplication warnings

No therapeutic duplications were found for your selected drugs.

Drug Interaction Classification

The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
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 information available.

Do not stop taking any medications without consulting your healthcare provider.

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