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Drug Interactions between divalproex sodium and felbamate

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

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Interactions between your drugs

Moderate

felbamate divalproex sodium

Applies to: felbamate and divalproex sodium

ADJUST DOSE: Felbamate may increase steady-state plasma concentrations of valproate by decreasing its plasma clearance. In a study involving 10 patients with epilepsy, valproate mean peak concentrations increased by 34% and 55% when coadministered with felbamate at doses of 1200 mg/day and 2400 mg/day, respectively. In another study involving 4 patients with epilepsy, valproate steady-state minimum concentrations increased by 24% and 52% when coadministered with felbamate at doses of 1200 mg/day and 2400 mg/day, respectively. Valproate protein binding did not change significantly with increasing doses of felbamate.

MANAGEMENT: When combination therapy involving felbamate and valproic acid or its derivatives is initiated, valproate dosage generally should be decreased 20% to 30%. Lower felbamate dosages may also be required. Close observation for clinical and laboratory evidence of altered effects is indicated, especially when changing the dose or discontinuing felbamate. Patients should be advised to report possible symptoms of valproate toxicity to their physician, including nausea, confusion, irritability, nervousness, restlessness, tremor, insomnia, headache, or somnolence.

References (3)
  1. Ward DL, Wagner ML, Perhach JL, et al. (1991) "Felbamate steady-state pharmacokinetics during coadministration of valproate." Epilepsia, 32, p. 8
  2. (2001) "Product Information. Felbatol (felbamate)." Wallace Laboratories
  3. (2001) "Product Information. Depacon (valproic acid)." Abbott Pharmaceutical

Drug and food interactions

Moderate

felbamate food

Applies to: felbamate

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 (4)
  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
Moderate

divalproex sodium food

Applies to: 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 (4)
  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

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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