Epileptic seizures caused by low valproic acid levels from an interaction with meropenem.
A 55-year-old woman was diagnosed with pneumonia and was treated with meropenem; 5 days later she developed epileptic seizures. She had been treated with valproic acid for 16 years to control her epileptic seizures. Her serum valproic acid concentration was low during treatment with meropenem than previously recorded despite an increase of valproic dose. As soon as administration of meropenem was withdrawn, valproic acid concentration increased to previous levels and her seizures stopped. Meropenem decreases valproic acid concentration, and may promote the development of epileptic seizures in previously controlled epileptic patients. The acute lowering of serum valproate produced by meropenem probably precludes their concomitant use.
Fudio
S
S
Servicio de Farmacología Clínica, Hospital Universitario La Paz, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain. acarcas.hulp@salud.madrid.org
Carcas
A
A
Piñana
E
E
Ortega
R
R
D000927:Anticonvulsants / Q000097:blood* / Q000627:therapeutic use; D004347:Drug Interactions; D004827:Epilepsy / Q000097:blood* / Q000139:chemically induced / Q000188:drug therapy; D005260:Female; D006801:Humans; D000077731:Meropenem; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy; D013845:Thienamycins / Q000009:adverse effects*; D014635:Valproic Acid / Q000097:blood* / Q000627:therapeutic use
D000927:Anticonvulsants; D013845:Thienamycins; D014635:Valproic Acid; D000077731:Meropenem