CARBAMAZEPINE AND VALPROATE
The serum levels of carbamazepine are usually only slightly affected by sodium valproate, valproic acid or valpromide although a moderate to marked rise in the levels of its active epoxide metabolite may occur. Carbamazepine may reduce the serum levels of sodium valproate by 60% or more. Concurrent use may possibly increase the incidence of sodium valproate-induced hepatotoxicity.
Monitor valproate levels, and adjust the dose if necessary. Also monitor for carbamazepine toxicity (due to raised carbamazepine-epoxide levels), which may present as nausea, vomiting, ataxia or drowsiness.
Monitor valproate levels, and adjust the dose if necessary. Also monitor for carbamazepine toxicity (due to raised carbamazepine-epoxide levels), which may present as nausea, vomiting, ataxia or drowsiness.