IMIPENEM AND VALPROATE

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.
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