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Generalized seizures have been reported in patients who received ganciclovir and imipenem/cilastatin. These drugs should not be used concomitantly unless the potential benefits outweigh the risks. (See Storage.)
Case reports in the literature have shown that co-administration of carbapenems, including imipenem, to patients receiving valproic acid or divaproex sodium results in a reduction of valproic acid concentrations. The valproic acid concentrations may drop below the therapeutic range as a result of this interaction, therefore increasing the risk of breakthrough seizures. Although the mechanism of this interaction is unknown, data from in vitro and animal studies suggest that carbapenems may inhibit the hydrolysis of valproic acid's glucuronide metabolite (VPA-g) back to valproic acid, thus decreasing the serum concentrations of valproic acid. (See Precautions.)
