Alcohol, CNS depressants Enhanced CNS depression.
Amitriptyline/Nortriptyline, barbiturates, diazepam, ethosuximide, hydantoins (eg, phenytoin), phenobarbital, primidone, zidovudine Plasma levels of these drugs may be increased.
Carbamazepine Carbamazepine plasma levels may be decreased while carbamazepine-10,11-epoxide levels may be increased; decreased valproic acid levels.
Charcoal, cholestyramine, meropenem, rifampin May decrease valproic acid levels.
Chlorpromazine, cimetidine, erythromycin, felbamate, fluoxetine, salicylates May increase valproic acid levels.
Clonazepam Absence status may be induced in patients with a history of absence type seizures.
Lamotrigine Decreased valproic acid levels; increased lamotrigine levels.
Lorazepam Lorazepam plasma levels may be increased.
Olanzapine Risk of hepatic adverse reactions may be increased; olanzapine levels may be decreased.
Topiramate Coadministration with valproic acid has been associated with hyperammonemia with and without encephalopathy. Plasma levels of both drugs may be decreased.
Warfarin Warfarin may be displaced from its protein binding site, transiently increasing the anticoagulant effect.
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