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NEUROLOGY 1980;30:94
© 1980 American Academy of Neurology

Valproic acid and plasma levels of phenobarbital

J. Bruni, M.D., B. J. Wilder, M. D., R. J. Perchalski, M.Sc., E. J. Hammond, Ph.D. and H. J. Villarreal, M. D.

Neurology Service, Veterans Administration Medical Center, and the University of Florida College of Medicine, Gainesville, FL

During concurrent administration of phenobarbital and valproic acid, phenobarbital plasma concentrations often increase. This often requires a reduction of phenobarbital dosage. In normal cats and patients with epilepsy, we found no evidence of decreased renal excretion of phenobarbital. Metabolic studies in four patients revealed a decrease in the conversion of phenobarbital to hydroxyphenylphenobarbital and decreased urinary ratios of hydroxyphenylphenobarbital to phenobarbital. These data suggest that phenobarbital metabolism is inhibited by therapeutic plasma levels of valproic acid.

Address reprint requests to Dr. Bruni, Neurology Service (127), Veterans Administration Medical Center, Gainesville, FL 32602.

Accepted for publication June 11, 1979.

This work was supported by the Medical Research Service of the Veterans Administration and the Epilepsy Research Foundation of Florida, Inc. Dr. Bruni is sponsored by the Ministry of Health, Ontario, Canada. Dr. Villarreal was sponsored by ANUIES, Mexico City, Mexico, and the Epilepsy Research Foundation of Florida, Inc.




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