Valproic Acid with Rufinamide Interaction Details
Brand Names Associated with Valproic Acid
- Depakene®
- Depakote®
- Depakote® ER
- Depakote® Sprinkle
- Divalproex sodium
- Valproate sodium
- Valproic Acid
Brand Names Associated with Rufinamide
- Banzel®
- Rufinamide
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 08, 2023
Interaction Effect
Increased rufinamide exposure
Interaction Summary
Concomitant administration of rufinamide and valproate may increase rufinamide concentrations up to 70% and result in more rufinamide side effects than usual. Larger increases in rufinamide plasma concentrations were observed in children with higher valproate doses or concentrations. Patients taking rufinamide should begin valproate at a low dose, and titrate to a clinically effective dose. Patients taking valproate should begin rufinamide at a dose lower than 10 mg/kg/day (children) or 400 mg/day (adults).
Severity
Major
Onset
Unspecified
Evidence
Established
How To Manage Interaction
Caution is advised if rufinamide and valproate are coadministered as this may result in increased rufinamide plasma concentrations. Risk is increased in children with higher valproate doses/concentrations. Patients taking rufinamide should begin valproate at a low dose, and titrate to a clinically effective dose. Patients taking valproate should begin rufinamide at a dose lower than 10 mg/kg/day (children) or 400 mg/day (adults).
Mechanism Of Interaction
Unknown
Literature Reports
A) A pharmacokinetic analysis revealed rufinamide clearance was decreased by valproate, increasing the exposure to rufinamide. In children, valproate administration increased rufinamide concentrations by up to 70%; the most dramatic effects were noted in children with higher valproate doses or concentrations .
Valproic Acid Overview
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Valproic acid is used alone or with other medications to treat certain types of seizures. Valproic acid is also used to treat mania (episodes of frenzied, abnormally excited mood) in people with bipolar disorder (manic-depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). It is also used to prevent migraine headaches but not to relieve headaches that have already begun. Valproic acid is in a class of medications called anticonvulsants. It works by increasing the amount of a certain natural substance in the brain.
Rufinamide Overview
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Rufinamide is used with other medication(s) to control seizures in people who have Lennox-Gastaut syndrome (a severe form of epilepsy that begins during childhood and causes several types of seizures, behavioral disturbances, and developmental delays). Rufinamide is in a class of medications called anticonvulsants. It works by decreasing abnormal excitement in the brain.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.