Severe anemia secondary to a probable drug interaction between zidovudine and valproic acid.
A 42-year-old man with human immunodeficiency virus (HIV) infection and a history of complex partial seizures developed severe anemia after the addition of valproic acid to his stable antiretroviral regimen of zidovudine, lamivudine, and abacavir. The inhibition of zidovudine glucuronidation by valproic acid and the resultant zidovudine hematologic toxicity is the proposed mechanism of the interaction.
Antoniou
Tony
T
Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada, tantoniou@smh.toronto.on.ca
Gough
Kevin
K
Yoong
Deborah
D
Arbess
Gordon
G
D000740:Anemia / Q000139:chemically induced*; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D015224:Dideoxynucleosides / Q000627:therapeutic use; D004347:Drug Interactions; D017029:Epilepsy, Complex Partial / Q000150:complications; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D014635:Valproic Acid / Q000009:adverse effects* / Q000627:therapeutic use; D015215:Zidovudine / Q000009:adverse effects* / Q000627:therapeutic use; D000099227:Abacavir
D019380:Anti-HIV Agents; D015224:Dideoxynucleosides; D019259:Lamivudine; D014635:Valproic Acid; D015215:Zidovudine; D000099227:Abacavir