Pharmaceuticals API List 4 >>
Probenecid competes with meropenem for active tubular secretion and thus
inhibits the renal excretion of meropenem. This led to statistically
significant increases in the elimination half-life (38%) and in the extent
of systemic exposure (56%). Therefore, the coadministration of probenecid
with meropenem is not recommended.
A clinically significant reduction in serum valproic acid concentration has
been reported in patients receiving carbapenem antibiotics and may result in
loss of seizure control.
Although the mechanism of this interaction is not fully understood, data
from in vitro and animal studies suggest that carbapenem antibiotics may
inhibit valproic acid glucuronide hydrolysis.
Valproic acid concentrations should be monitored frequently after initiating
carbapenem therapy. Alternative antibacterial or anticonvulsant therapy
should be considered if serum valproic acid concentrations drop below the
therapeutic range or a seizure occurs