Frågedatum: 1997-07-21
RELIS database 1997; id.nr. 14062, DRUGLINE
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Is there any interaction between chloroquine and sodium valproate?/nA 12-year-old boy with epilepsy



Fråga: Is there any interaction between chloroquine and sodium valproate?

A 12-year-old boy with epilepsy is treated with sodium valproate 600 mg per day. A trip is planned and chloroquine is suggested as a malaria prophylaxis.

Sammanfattning: There are no data available on possible interactions between sodium valproate and chloroquine in the literature. If chloroquine prophylaxis increases the risk for epileptic seizures is not well established but considering the wide use of chloroquine for malaria prophylaxis and the very limited number of reported cases, the risk must be very small.

Svar: According to FASS, chloroquine is contraindicated in patients with epilepsy (1). Chloroquine has been reported to provoke tonic-clonic seizures in patients with a history of epilepsy (2). In one publication four cases of seizures were described in patients using chloroquine for malaria prophylaxis; all these patients were women. The chloroquine dose was 300 mg once weekly, but three patients also took dapsone/pyrimethamine or sulphadoxine/pyrimethamine. Three of the patients had no history of seizures, and none experienced seizures after discontinuing prophylaxis (3). In a subsequent comment it was argued that the likelihood of a causal relationship between the seizures and antimalarial prophylaxis could not be estimated from this report (4).

In SADRAC, two cases of seizures have been reported in patients treated with chloroquine and paludrine for malaria prophylaxis. The relationship between treatment and event were judged as possible (5,6).

No reports on the interaction between sodium valproate and chloroquine could be found in the literature. 1 FASS 1996, The Swedish Catalogue of Approved Medical Products, page 602 2 Dollery, Therapeutic drugs. 1991; 1: C192 3 Fish DR, Espir MLE: Convulsions associated with prophylactic antimalarial drugs: implications for people with epilepsy. Br Med J 1988; 297: 526-527 4 Hellgren U, Rombo L: Malaria prophylaxis and epilepsy. Br Med J 1988; 297: 1267 5 SADRAC, 933388 (Swedish Adverse Drug Reactions Advisory Committee) 6 SADRAC, 960166 (Swedish Adverse Drug Reactions Advisory Committee)

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