{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:40:03Z","timestamp":1790368803573,"version":"4.1.0"},"reference-count":14,"publisher":"American Association of Psychiatric Pharmacists (AAPP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Background: Valproic acid (VPA) and its derivatives are highly protein bound. Certain highly protein bound medications (eg, phenytoin) have specific administration instructions for patients on enteral nutrition supplements to optimize absorption of the medication. Pharmacokinetic interactions between VPA and enteral nutrition or protein supplements demonstrating impaired absorption have not been published to date.<\/jats:p>\n               <jats:p>Case Report: A patient receiving enteral VPA syrup via percutaneous endoscopic gastrostomy tube experienced a clinically significant decrease in serum concentration when enteral protein supplement was initiated. Other sources of interactions were ruled out, and VPA serum concentration increased when doses were separated from protein supplement by 2 hours.<\/jats:p>\n               <jats:p>Discussion: This is the first published case of enteral protein supplementation affecting absorption of enteral VPA. Enteral feeds are known to interact with other highly protein bound medications, and clinical practice for these medications may be used to guide administration when an interaction with VPA is suspected.<\/jats:p>\n               <jats:p>Conclusion: When using enteral protein supplements concomitantly with enteral VPA, clinicians may consider separating doses to avoid potential interaction or impaired absorption.<\/jats:p>","DOI":"10.9740\/mhc.2017.01.010","type":"journal-article","created":{"date-parts":[[2017,1,3]],"date-time":"2017-01-03T19:05:44Z","timestamp":1483470344000},"page":"10-12","source":"Crossref","is-referenced-by-count":8,"title":["Enteral administration of protein supplement and valproate: A potential pharmacokinetic interaction"],"prefix":"10.9740","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2294-2694","authenticated-orcid":false,"given":"Amy","family":"VandenBerg","sequence":"first","affiliation":[{"name":"(Corresponding author), Adjunct Assistant Professor, Department of Clinical Pharmacy and Outcomes Sciences, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, a2vandena@gmail.com"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8920-0719","authenticated-orcid":false,"given":"Jessica","family":"Broadway","sequence":"first","affiliation":[{"name":"Assistant Professor, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4719","reference":[{"key":"2020060307303527000_i2168-9709-7-1-10-b01","unstructured":"Depakene [package insert]. Abbott Park (IL): Abbott Laboratories;2009."},{"issue":"10","key":"2020060307303527000_i2168-9709-7-1-10-b02","doi-asserted-by":"publisher","first-page":"695","DOI":"10.2165\/00023210-200216100-00004","article-title":"Pharmacological and therapeutic properties of valproate: a summary after 35 years of clinical experience","volume":"16","author":"Perucca","year":"2002","journal-title":"CNS Drugs"},{"issue":"5","key":"2020060307303527000_i2168-9709-7-1-10-b03","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1097\/JCP.0b013e3181b4b07c","article-title":"Valproic acid toxicity associated with low dose of aspirin and low total valproic acid levels: a case report","volume":"29","author":"de Leon","year":"2009","journal-title":"J Clin Psychopharmacol"},{"issue":"4","key":"2020060307303527000_i2168-9709-7-1-10-b04","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1254\/jphs.FPE04007X","article-title":"A theoretical method for normalizing total serum valproic acid concentration in hypoalbuminemic patients","volume":"97","author":"Hermida","year":"2005","journal-title":"J Pharmacol Sci"},{"issue":"10","key":"2020060307303527000_i2168-9709-7-1-10-b05","first-page":"1490","article-title":"Effects of food on valproic acid absorption","volume":"38","author":"Hamilton","year":"1981","journal-title":"Am J Hosp Pharm"},{"issue":"6","key":"2020060307303527000_i2168-9709-7-1-10-b06","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1002\/bdd.2510140607","article-title":"Influence of food intake on the pharmacokinetics of a sustained release formulation of sodium valproate","volume":"14","author":"Royer-Morrot","year":"1993","journal-title":"Biopharm Drug Dispos"},{"issue":"8","key":"2020060307303527000_i2168-9709-7-1-10-b07","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1212\/WNL.38.8.1319","article-title":"Effect of food on the serum concentration profile of enteric-coated valproic acid","volume":"38","author":"Fischer","year":"1988","journal-title":"Neurology"},{"issue":"8","key":"2020060307303527000_i2168-9709-7-1-10-b08","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1002\/j.1552-4604.1990.tb03637.x","article-title":"Absorption characteristics of a new valproate formulation: divalproex sodium-coated particles in capsules (Depakote Sprinkle)","volume":"30","author":"Carrigan","year":"1990","journal-title":"J Clin Pharmacol"},{"issue":"12","key":"2020060307303527000_i2168-9709-7-1-10-b09","first-page":"1347","article-title":"Influence of food on the pharmacokinetics of a new multiple unit sustained release sodium valproate formulation","volume":"47","author":"Retzow","year":"1997","journal-title":"Arzneimittelforschung"},{"issue":"6","key":"2020060307303527000_i2168-9709-7-1-10-b10","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1002\/bdd.2510140607","article-title":"Influence of food intake on the pharmacokinetics of a sustained release formulation of sodium valproate","volume":"14","author":"Royer-Morrot","year":"1993","journal-title":"Biopharm Drug Dispos"},{"key":"2020060307303527000_i2168-9709-7-1-10-b11","unstructured":"Dilantin [package insert]. New York: Pfizer;2011."},{"issue":"24","key":"2020060307303527000_i2168-9709-7-1-10-b12","doi-asserted-by":"publisher","first-page":"2347","DOI":"10.2146\/ajhp080155","article-title":"Medication administration through enteral feeding tubes","volume":"65","author":"Williams","year":"2008","journal-title":"Am J Health Syst Pharm"},{"issue":"18","key":"2020060307303527000_i2168-9709-7-1-10-b13","doi-asserted-by":"crossref","first-page":"1850","DOI":"10.1093\/ajhp\/60.18.1850","article-title":"Recovery of phenytoin from feeding formulas and protein mixtures","volume":"60","author":"Hennessy","year":"2003","journal-title":"Am J Health Syst Pharm"},{"key":"2020060307303527000_i2168-9709-7-1-10-b14","unstructured":"Medical Nutrition USA [Internet]. Rockville (MD): Nutricia North America [cited2011Jul 15]. Available from: http:\/\/www.specializedadultnutrition.com\/."}],"container-title":["Mental Health Clinician"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/mhc\/article-pdf\/7\/1\/10\/2095409\/mhc_2017_01_010.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/mhc\/article-pdf\/7\/1\/10\/2095409\/mhc_2017_01_010.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T16:22:04Z","timestamp":1731687724000},"score":1,"resource":{"primary":{"URL":"https:\/\/mhc.kglmeridian.com\/view\/journals\/mhcl\/7\/1\/article-p10.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1,1]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,1,1]]}},"URL":"https:\/\/doi.org\/10.9740\/mhc.2017.01.010","relation":{},"ISSN":["2168-9709"],"issn-type":[{"value":"2168-9709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,1,1]]}}}