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Drug Interactions between divalproex sodium and propofol

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

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Interactions between your drugs

Moderate

propofol divalproex sodium

Applies to: propofol and divalproex sodium

MONITOR: Coadministration with valproate may increase the blood levels and effects of propofol. The proposed mechanism may involve valproate-mediated inhibition of propofol metabolism via CYP450 2C9 and UDP-glucuronosyltransferase (UGT)1A9. In vitro, UGT1A9 is responsible for glucuronic acid conjugation, the main metabolic pathway of propofol. Furthermore, since both valproate and propofol target gamma-aminobutyric acid (GABA) receptors, their synergistic effects may lead to a reduction in the dosage of propofol needed for sedation.

MANAGEMENT: Dosage reduction of propofol may be required when coadministered with valproate. Patients should be closely monitored for signs of increased sedation and cardiorespiratory depression.

References (10)
  1. (2001) "Product Information. Depakene (valproic acid)." Abbott Pharmaceutical
  2. (2001) "Product Information. Depakote (divalproex sodium)." Abbott Pharmaceutical
  3. (2001) "Product Information. Diprivan (propofol)." Astra-Zeneca Pharmaceuticals
  4. (2001) "Product Information. Depacon (valproic acid)." Abbott Pharmaceutical
  5. (2024) "Product Information. propOFol Lipuro (B Braun) (propOFol)." B Braun Australia Pty Ltd, 3
  6. (2023) "Product Information. Diprivan (propofol)." Aspen Pharmacare Canada Inc
  7. (2024) "Product Information. Propofol (Lipuro) (propofol)." B.Braun Medical Ltd
  8. (2024) "Product Information. Propofol (propofol)." Hospira Inc
  9. Hizli SG, Eryilmaz G, Semieoglu S, Ozten E, Gogcegoz GI (2014) "Influence of valproate on the required dose of propofol for anesthesia during electroconvulsive therapy of bipolar affective disorder patients." Neuropsychiatr Dis Treat, 10, p. 433-8
  10. Ishii M, Higuchi H, Maeda S, Tomoyasu Y, Egusa M, Miyawaki T (2012) "The influence of oral VPA on the required dose of propofol for sedation during dental treatment in patients with mental retardation: a prospective observer-blinded cohort study." Epilepsia, 53, e13-6

Drug and food interactions

Moderate

propofol food

Applies to: propofol

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

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