Abstract
A possible interaction between valproic acid and ertapenem resulting in reduced serum valproic acid levels in two patients is reported. In the first case, a 47-year-old woman was brought to the emergency department (ED) with fever, pain, redness, swelling, and local heat in the tissue around her tracheostomy tube and left foot. One month prior she was hospitalized with pneumonia and had a generalized tonic-clonic seizure. She was given teicoplanin and amoxicillin-clavulanate potassium as empirical therapy for cellulitis. On day 3, the patient developed a fever. Amoxicillin-clavulanate potassium was discontinued and replaced by i.v. ertapenem. On day 5, due to a suspected drug-induced fever, carbamazepine was discontinued, and oral valproate sodium was initiated. On day 16, the patient was afebrile, so ertapenem was discontinued. Her serum valproic acid concentration was <1 mg/L, but seizures did not recur. Three days after ertapenem was discontinued, her serum valproic acid concentration increased to 33.6 mg/L. In the second case, a 72-year-old woman was brought to the ED after a sudden loss of consciousness and convulsive seizure. The patient was diagnosed with status epilepticus and admitted to the intensive care unit. A urin...Continue Reading
References
Dec 1, 1988·Clinical Pharmacokinetics·G ZaccaraF Moroni
Dec 1, 1982·Epilepsia·A CovanisP M Jeavons
Aug 1, 1981·Clinical Pharmacology and Therapeutics·C A NaranjoD J Greenblatt
Feb 1, 1997·The Journal of Antimicrobial Chemotherapy·K NagaiH Kato
Dec 3, 1998·Antimicrobial Agents and Chemotherapy·S KojimaT Hasegawa
Jun 24, 1999·Cellular and Molecular Neurobiology·T A KetterR M Post
Jun 29, 2001·The Journal of Pharmacy and Pharmacology·M ToriiM Yokota
Oct 31, 2001·Pharmaceutical Research·K YokogawaK Miyamoto
Mar 19, 2002·International Journal of Pharmaceutics·Mayumi ToriiMasayuki Yokota
Sep 4, 2004·Drug Metabolism and Disposition : the Biological Fate of Chemicals·Yoshitsugu NakajimaToshiro Yamaguchi
Feb 11, 2005·The Annals of Pharmacotherapy·Francisco Javier Coves-OrtsFrancisco Palacios-Ortega
Jun 30, 2005·Journal of Pharmaceutical Sciences·Kei OmodaMikihisa Takano
Feb 21, 2006·British Journal of Clinical Pharmacology·Emilio Perucca
Jun 30, 2006·Epilepsy Research·Kumiko OgawaMikihisa Takano
Mar 29, 2007·The Annals of Pharmacotherapy·John R HornLingtak-Neander Chan
Jul 5, 2007·The Annals of Pharmacotherapy·Isabel SprietWim Van Paesschen
Jul 28, 2007·Pharmacotherapy·Jesse L LundeHarrison F Storandt
Citations
Sep 25, 2015·Neurology·Raoul SutterSarah Tschudin-Sutter
Nov 20, 2016·The Annals of Pharmacotherapy·Hilary M TeibelKlepper A Garcia
Mar 4, 2017·The Kaohsiung Journal of Medical Sciences·Chi-Ren HuangYao-Chung Chuang
Jul 30, 2017·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Samuel DeshayesRenaud Verdon