Stiripentol Valproate

Levy RH, Rettenmeier AW, Anderson GD, Wilensky AJ, Friel PN, Baillie TA, Acheampong A, Tor J, Guyot M, Loiseau P. Effects of poly therapy with phenytoin, carbama-zepine, and stiripentol on formation of 4-ene-valproate, a hepatotoxic metabolite of valproic acid. Qin Pharmacol Ther 1990 48(3) 225-35. 

Stiripentol causes marked rises in the serum levels of carbamazepine, phenobarbital and phenytoin. Stiripentol causes only a small rise In the serum levels of valproate. 

Valproate 1 g daily was given to 8 subjects with or without stiripentol 1.2 g daily. The stiripentol caused a 14% increase in the peak semm levels of valproate. In another 11 patients no adverse effects on motor, perceptual or attention tests were seen when stiripentol was given with other antiepileptic drugs, but the doses of phenobarbital, phenytoin and carbamazepine were reduced before the combination was taken. ... 

Levy RH, LoiseauP, Gi otM, Acheampoi A, Tor J, Rettenmeier AW. Effects of stiripentol on valproate plasma level and metabolism. Epilepsia (1987) 28,605. 

Stiripentol was given marketing authorization in the European Union on 4 January 2007 for use in conjunction with clobazam and valproate as adjunctive therapy of refractory generalized tonic-clonic seizures in patients with severe myoclonic epilepsy in infancy (Dravet s syndrome) whose seizures are not adequately controlled with clobazam and valproate [284 ]. 

Drag-drag interactions Care must be taken in using stiripentol as add-on therapy with carbamazepine, clobazam, pheno-barbital, phenytoin, and valproate, because stiripentol inhibits the metabolism of these drugs and/or their metabolites [286 ]. 

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