Drug Interactions between divalproex sodium and rufinamide
This report displays the potential drug interactions for the following 2 drugs:
- divalproex sodium
- rufinamide
Interactions between your drugs
divalproex sodium rufinamide
Applies to: divalproex sodium and rufinamide
ADJUST DOSE: Coadministration with valproate may increase the plasma concentrations of rufinamide. The mechanism of interaction has not been established. According to a population pharmacokinetic analysis, rufinamide steady-state concentrations increased by less than 16% up to 70% depending on concomitant plasma valproate concentration. The largest increases were reported in pediatric patients or patients of low body weight (<30 kg) at high dosages or drug concentrations. Valproate steady-state concentrations were not affected by rufinamide.
MANAGEMENT: Patients already stabilized on rufinamide should begin valproate therapy at a low dosage, which may then be titrated according to clinical response and tolerability. Likewise, patients already receiving valproate therapy should begin rufinamide at a dosage lower than 10 mg/kg/day (pediatric) or 400 mg/day (adult).
References (3)
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Cerner Multum, Inc. "Australian Product Information."
- (2008) "Product Information. Banzel (rufinamide)." Eisai Inc
Drug and food interactions
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)
- Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
- 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.
- (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
- (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
rufinamide food
Applies to: rufinamide
GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of rufinamide. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.
ADJUST DOSING INTERVAL: Food enhances the oral absorption and bioavailability of rufinamide. In healthy volunteers, administration of a single 400 mg dose of rufinamide with food resulted in an approximately 56% increase in mean peak plasma concentration (Cmax) and a 34% increase in systemic exposure (AUC) compared to administration during a fasting state.
MANAGEMENT: To ensure maximal oral absorption, it is preferable to administer rufinamide with food. Patients receiving rufinamide should be advised to avoid consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how rufinamide affects them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
References (1)
- (2008) "Product Information. Banzel (rufinamide)." Eisai 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
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
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