{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:49:44Z","timestamp":1787849384916,"version":"build-2784847793"},"reference-count":8,"publisher":"American Association of Psychiatric Pharmacists (AAPP)","issue":"1","license":[{"start":{"date-parts":[[2021,1,8]],"date-time":"2021-01-08T00:00:00Z","timestamp":1610064000000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The divalproex (DVP) package insert states that rifampin may increase the oral clearance of valproate by 40% and that valproic acid derivative dose adjustments may be required when starting or stopping rifampin. However, the overall clinical significance of this drug-drug interaction remains unclear given that limited clinical outcome data has been published. This case describes a 52-year-old female with bipolar disorder, borderline personality disorder, and PTSD who was previously stable on a medication regimen consisting of DVP delayed-release 500 mg every morning and 1500 mg every evening (baseline steady-state trough 99.8 mcg\/mL). Throughout rifampin therapy for latent tuberculosis treatment, she required an increase in both the frequency of DVP administration, from 2 to 3 times daily, and DVP dose by 75% to maintain clinical stability. Valproic acid trough concentrations ranged from 56.4 to 75.9 mcg\/mL during the 4-month course of rifampin. This report supports that the DVP-rifampin interaction may be clinically significant and of a greater magnitude than suggested by the package insert.<\/jats:p>","DOI":"10.9740\/mhc.2021.01.019","type":"journal-article","created":{"date-parts":[[2021,1,14]],"date-time":"2021-01-14T00:49:12Z","timestamp":1610585352000},"page":"19-22","source":"Crossref","is-referenced-by-count":3,"title":["Rifampin-divalproex drug-drug interaction in an adult patient: A case report"],"prefix":"10.9740","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1461-6634","authenticated-orcid":true,"given":"Christine","family":"Doran","sequence":"first","affiliation":[{"name":"PGY-2 Ambulatory Care Pharmacy Resident, Kaiser Permanente Colorado, Denver, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3067-4260","authenticated-orcid":true,"given":"Michael","family":"Moro","sequence":"additional","affiliation":[{"name":"Doctor of Pharmacy Candidate 2019, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Denver, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1686-5511","authenticated-orcid":true,"given":"Jennifer","family":"Green","sequence":"additional","affiliation":[{"name":"Adult Psychiatrist, Kaiser Permanente Colorado, Denver, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4016-4731","authenticated-orcid":true,"given":"Kristen N.","family":"Gardner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4719","published-online":{"date-parts":[[2021,1,8]]},"reference":[{"key":"2021012100103003700_i2168-9709-11-1-19-b01","doi-asserted-by":"crossref","unstructured":"Sterling\n              TR,\n            \n            \n              Njie\n              G,\n            \n            \n              Zenner\n              D,\n            \n            \n              Cohn\n              DL,\n            \n            \n              Reves\n              R,\n            \n            \n              Ahmed\n              A,\n            \n            et al.\n\t\t\t\t\t\n          Guidelines for the treatment of latent tuberculosis infection: recommendations from the National Tuberculosis Controllers Association and CDC, 2020. MMWR Recomm\n          Rep.\n\t\t\t\t\t2020;69(1):1-11.\n\t\t\t\t\tDOI: 10.15585\/mmwr.rr6901a1. PubMed PMID: 32053584; PubMed Central PMCID: PMC7041302.","DOI":"10.15585\/mmwr.rr6901a1"},{"key":"2021012100103003700_i2168-9709-11-1-19-b02","unstructured":"Eon Labs, Inc.\n          RIFAMPIN (rifampin) capsule [updated 2018 Feb; cited 2018 Nov 18].\n\t\t\t\t\tDailyMed [Internet].\n\t\t\t\t\tBethesda (MD):\n\t\t\t\t\tNational Library of Medicine (US).Available from: https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=55816042-946d-4bec-9461-bd998628ff45"},{"key":"2021012100103003700_i2168-9709-11-1-19-b03","unstructured":"Orchid Chemicals and Pharmaceuticals Ltd. 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PubMed PMID: 28413090.","DOI":"10.1016\/j.psym.2017.02.009"},{"key":"2021012100103003700_i2168-9709-11-1-19-b05","unstructured":"Hanrath\n              MA,\n            \n            \n              Swart\n              EL.\n            \n          \n          Insulten door interactie van anti-epileptica met rifampicine [Convulsions due to an interaction between anti-epileptic drugs and rifampicin].\n\t\t\t\t\tNed Tijdschr Geneeskd.\n\t\t\t\t\t2014;158:A7707.\n\t\t\t\t\tPubMed PMID: 25315327."},{"key":"2021012100103003700_i2168-9709-11-1-19-b06","unstructured":"Pharmacy Quality Alliance [Internet].\n          PQA adherence measures\n          [cited\n          2020\n          Aug 15]. 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PubMed PMID: 21191377.","DOI":"10.1038\/clpt.2010.271"},{"key":"2021012100103003700_i2168-9709-11-1-19-b08","doi-asserted-by":"crossref","unstructured":"Horn\n              JR,\n            \n            \n              Hansten\n              PD,\n            \n            \n              Chan\n              L-N.\n            \n          \n          Proposal for a new tool to evaluate drug interaction cases.\n\t\t\t\t\tAnn Pharmacother.\n\t\t\t\t\t2007;41(4):674-80.\n\t\t\t\t\tDOI: 10.1345\/aph.1H423. 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