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Drug Interactions between divalproex sodium and sodium phenylbutyrate

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

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Interactions between your drugs

Major

divalproex sodium sodium phenylbutyrate

Applies to: divalproex sodium and sodium 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: 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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Moderate

sodium phenylbutyrate food

Applies to: sodium phenylbutyrate

ADJUST DOSING INTERVAL: Coadministration with a high-fat meal may reduce the rate and extent of absorption of sodium phenylbutyrate. When a single 3 g-1 g dose of sodium phenylbutyrate-taurursodiol (sodium phenylbutyrate-ursodoxicoltaurine) was administered to healthy volunteers in the presence of a high-fat, high-calorie meal (approximately 800 to 1000 calories; 500 to 600 calories from fat, 250 calories from carbohydrate, 150 calories from protein), sodium phenylbutyrate peak plasma concentration (Cmax) decreased by 75% and systemic exposure (AUC) decreased by 55%. The Cmax for taurursodiol was not significantly affected, but AUC was increased by 46%. The clinical significance of these changes has not been established. In premarketing studies, patients were advised to take the drug before a meal.

MANAGEMENT: The prescribing information recommends administration of sodium phenylbutyrate-taurursodiol before a meal or snack, particularly in patients of low body weight (less than 70 kg).

References

  1. "Product Information. Relyvrio (sodium phenylbutyrate-taurursodiol)." Amylyx Pharmaceuticals 1 (2022):
  2. "Product Information. Albrioza (sodium phenylbutyrate-ursodoxicoltaurine)." Innomar Strategies Inc. (2022):

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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.

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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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