Decrease in serum valproic acid levels during treatment with ertapenem

American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
Fen-Fen LiaoChi-Yu Chen

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

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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

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