Any time a doctor suggests a new prescription, be sure to talk about what other medicines, supplements, herbs, and vitamins are already being taken. Sometimes one kind of medicine changes the way another kind of medicine works in the body. If two kinds of medicine affect each other, the doctor may prescribe something else or change the amount to be taken.

This is true not only for prescription medicines, but also for medicines you just pick up off the shelf at the store. For instance, aspirin (ASA) may increase the side effects from taking Depakote.

How does Depakote affect other medicines?
Depakote may increase the blood level of certain other seizure medicines, including

• Felbatol (felbamate)
• Lamictal (lamotrigine)
• Mysoline (primidone)
• phenobarbital

The levels of these medications in the blood may increase markedly-in some cases, more than double. If a person taking phenobarbital is also given Depakote, a rapid rise in phenobarbital levels can lead to extreme tiredness, slurred speech, and other signs of intoxication.

Depakote has similar but less significant effects on:

• Tegretol or Carbatrol (carbamazepine)
• Zarontin (ethosuximide)
• Ativan (lorazepam)
• Dilantin or Phenytek (phenytoin)

Adding Depakote may slightly increase side effects from each of these.

If combination therapy using Depakote and another seizure medicine is begun, the dosage of the first medicine may need to be adjusted. Similarly, if a seizure medicine previously used in combination therapy is to be stopped, the dosage of the remaining medicine may need to be changed.

How do other medicines affect Depakote?
Some other medicines do affect the way Depakote works in the body. Make sure that the doctor is aware of all the medicines being used.

Several other seizure medicines cause the medication in Depakote to leave the body much more quickly, so that higher doses may be needed to achieve the desired effect. These medicines include:

• Tegretol or Carbatrol (carbamazepine)
• Dilantin or Phenytek (phenytoin)
• phenobarbital
• Mysoline (primidone)

If Lamictal (lamotrigine) is given to someone already taking Depakote-especially a child-the chances of a potentially life-threatening rash will be increased. Adding the Lamictal slowly reduces this danger.

If a combination of Depakote and Klonopin (clonazepam) is given to a person who has been having absence seizures, prolonged absence seizures may occur.