Seizures from valproate-carbapenem interaction.
BACKGROUND
Antiepileptic medication interactions can complicate the management of epilepsy, by either increasing or reducing the effective serum concentrations thereby causing adverse effects or loss of seizure control.


RESULTS
A 14-year-old girl with well-controlled juvenile absence epilepsy lost control of her seizures acutely following the administration of carbapenem for pneumonia. Serum valproate concentrations fell by 90% within 48 hours following carbapenem and returned to baseline following its discontinuation.


CONCLUSIONS
Awareness of this clinically significant interaction alters clinical practice by avoiding carbapenem or temporary use of adjunctive medication to prevent the clinical consequences of this significant drug interaction.
Division of Pediatric Neurology, Nemour's Children's Clinic, and the Department of Neurology, Mayo Clinic, Jacksonville, Florida.
Firas A
FA
Taha
David N
DN
Hammond
Raj D
RD
Sheth
D000293:Adolescent; D000927:Anticonvulsants / Q000009:adverse effects / Q000097:blood*; D015780:Carbapenems / Q000009:adverse effects / Q000097:blood*; D004347:Drug Interactions / Q000502:physiology*; D005260:Female; D006801:Humans; D012640:Seizures / Q000097:blood* / Q000139:chemically induced / Q000175:diagnosis*; D014635:Valproic Acid / Q000009:adverse effects / Q000097:blood*
D000927:Anticonvulsants; D015780:Carbapenems; D014635:Valproic Acid
Valproate; carbapenem; drug interaction