Clinical Pharmacist on LinkedIn 💊✨️ | Delivering Quality Patient Care through Expert Medication Management 💉 | Clinical Preceptor ✨️
💉 𝑫𝒓𝒖𝒈-𝑫𝒓𝒖𝒈 𝑰𝒏𝒕𝒆𝒓𝒂𝒄𝒕𝒊𝒐𝒏 💉 🥊 One significant interaction to consider is between meropenem, a broad-spectrum antibiotic, and valproic acid, a medication commonly used to treat epilepsy and bipolar disorder. 𝑯𝒐𝒘 𝒅𝒐𝒆𝒔 𝒊𝒕 𝒉𝒂𝒑𝒑𝒆𝒏? ⬆️ Meropenem significantly reduces the serum levels of valproic acid. ❕️This occurs because meropenem increases the clearance of valproic acid from the body, thereby decreasing its concentration in the blood. 💊 𝑪𝒍𝒊𝒏𝒊𝒄𝒂𝒍 𝑷𝒉𝒂𝒓𝒎𝒂𝒄𝒊𝒔𝒕 𝑻𝒉𝒐𝒖𝒈𝒉𝒕𝒔 🌟 For patients relying on valproic acid for seizure control, this interaction can lead to subtherapeutic levels of the drug, resulting in increased seizure activity or loss of seizure control, we can consider changing thr antibiotic to another agent as per the culture and susceptibility results of the microorganism.
Jordan Moss
3mo
Love this! I will say, most of my patients in the hospital have multimodal seizure control (eg, concurrent levitriacitam), and the interaction with VPA rarely induces a seizure. I typically recommend close monitoring during the course if no alternative agent is available for the infection, such as in the setting of an ESBL. Which begs the question, was VPA controlling the seizures to begin with? 🤔
If the meropenem is replaced by imipenem then we can reduce the problem at some extent .
Stanley Zhou
3mo
It can also induce seizures/convulsions in its own right.
Usman Raza
3mo
Very informative
Very helpful!
Sterile Compounding Specialist & Consultant, Clinical Pharmacist
3moA good strategy to manage valproic acid overdose is to give meropenem 1 gram q8h due to this known interaction. Caution if the patient was using VPA for seizure control as the rapid drop in VPA would cause seizures. Instead then rely on the usual reversal agent L-carnitine.