Combining-Topiramate-Valproic acid

Topiramate
Type moodstabilizer
Group anticonvulsant
links
ATC-code N03AX11
PubChem 5284627
PubMed Topiramate
Drugs.com topiramate
Kompas (Dutch) Topiramate
Wikipedia Topiramate
Valproic acid
Type moodstabilizer
Group anticonvulsant
links
ATC-code N03AG01
PubChem 3121
PubMed acid%22 Valproic acid
Drugs.com valproic-acid
Kompas (Dutch) Valproic acid
Wikipedia Valproic acid

Adding valproic acid to topiramate.

Infobord.png General information
  • Topiramate induces CYP3A4 and is an inhibitor of CYP2C19.
  • Valproic acid is principally metabolized by CYP2C9, CYP2C19, CYP2A6 and UDP-glucuronosyltransferases. Valproic acid is an inhibitor of the enzymes CYP2C9, epoxide-hydroxylase and UDP-glucuronosyltransferases.
  • This combination of drugs may have possible synergistic effects. However, the pharmacokinetic drug interactions will influence the plasma levels. Dose adaptation will be recommended for this combination.
Eenrichtingbord.png Start valproic acid
  • Start valproic acid according to the general dosing advice.
  • Pharmacologic response to the drugs should be monitored more closely following addition or withdrawal of one or the other drug. Dose adjustments may be required if an interaction is suspected.
Letopbord.png Cave
  • Topiramate plasma levels are increased by about 15% by valproate, which could be important if valproate is withdrawn. [1]


  1. Bazire S, Psychotropic Drug Directory 2007, HealthComm UK Limited, Aberdeen, 2007.
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