<unk>  can reduce the concentrations of valproic acid, an epilepsy medication, by 70% and perhaps up to 95% within 24 hours; this can result in inadequate control of seizures. The effect is described for other carbapenem antibiotics as well, but seems to be most pronounced for<unk>  and meropenem. This is likely caused by several mechanisms: carbapenems inhibit transport of valproic acid from the gut into the body; they may increase metabolization of valproic acid to its glucuronide; they may reduce enterohepatic circulation and recycling of valproic acid glucuronide by acting against gut bacteria; and they may block transporter proteins that pump valproic acid out of red blood cells into the blood plasma. The effect is also seen in reverse: in cases where<unk>  has been withdrawn blood concentrations of valproate have been reported to rise. Drug interactions via the cytochrome P450 enzyme system or the P-glycoprotein transporter are considered unlikely, as these proteins are not involved in the metabolism of<unk> .
Ertapenem
Meropenem
Vancomycin
Resistin
Colistin
Imipenem
Linezolid
Ceftazidime