Ahmet ÇAKIR, Hasan MEMİŞ, Nesligül ÖZDEMİR, Zeynep Ülkü GÜN

A clinical pharmacist's intervention on interaction between meropenem and valproic acid in paediatric inpatient clinic: A case report

Background and Aims: Drug-drug interactions cause many complex drug events, especially adverse drug effects. It is known that drug interactions occur when meropenem and valproic acid are used together. It was aimed to back up existing research on the interaction of valproic acid. Methods: After an interaction had been suspected by the ward pharmacists, all of the patient’s drugs were assessed via Up- ToDate® and Micromedex® databases and the interaction management was shared with the physician in charge. Results: The patient’s serum valproic acid through level was in therapeutic range before meropenem administration. After the administration of meropenem, the patient's number of seizures increased and the serum trough level of valproic acid de- creased to 4.3 µg/ml. The valproic acid levels turned back to normal range after switching to a carbapenem antibiotic. Conclusion: Drug interactions are often encountered in paediatric patients and it is of critical importance in terms of seizure control. Because of the drug interaction between valproic acid and meropenem, one should avoid using these medications concomitantly. If that is impossible, daily serum valproic acid levels should be monitored with caution. Clinical pharmacists could increase the clinicians’ awareness about drug-drug interactions.

Keywords:

drug interactions hospitalized child, meropenem, pharmacists, valproic acid,

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