Interaction Checker
Potential Interaction
Lopinavir/ritonavir (LPV/r)
Sodium valproate
Quality of Evidence: Very Low
Summary:
Coadministration with sodium valproate has not been studied. Sodium valproate circulates in plasma as the valproate ion. Valproate is mainly glucuronidated by UGTs 1A6, 1A9 and 2B7 and metabolized by CYP2C9 and CYP2C19. Coadministration of lopinavir/ritonavir (400/100 mg twice daily) and valproic acid (250 mg twice daily) to 8 HIV+ subjects increased lopinavir AUC by ~38%. No apparent effect of lopinavir/ritonavir on valproate concentrations was observed. A retrospective analysis of a TDM registry showed no significant effect of valproic acid on lopinavir trough concentrations (n=4). However, there is a case report of a 48% decrease in valproate concentration in previously stable patient who developed exacerbated mania on starting lopinavir/ritonavir; dose increase of valproic acid was required.
Description:
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