Case reports describe reduced
valproate levels after
imipenem was given. This has led to seizures.
Although evidence is limited this is in line with the way other carbapenems interact. It would be prudent to monitor
valproate levels in any patient given carbapenems. The
valproate dosage may need to be increased. Consider using another antibacterial, or an alternative to
valproate. Limited evidence suggests that
carbamazepine and
phenytoin are not affected. Note that
imipenem should
be used with caution in patients with a history of seizures.