Medication · antiepileptic

Supplements and Sodium valproate.

Every documented pair, every citation. Below: 1 documented pair grouped by mechanism.

Sodium valproate, sold under the brand names Epilim, Episenta, is an antiepileptic drug. Several agents in this class are strong CYP inducers or inhibitors.

Sodium valproate is an antiepileptic medicine. The class is heterogeneous. Enzyme inducers (carbamazepine, phenytoin, phenobarbital) drop plasma levels of many medicines given alongside. Enzyme inhibitors (valproate) raise them. The newer agents (levetiracetam, lacosamide) have quieter interaction profiles. The supplement interactions of greatest clinical importance. St John's Wort is excluded with the inducer antiepileptics on top of an already complex CYP picture. Folate at high doses competes with the folate depletion that antiepileptics drive, in a way that needs neurology team input rather than community pharmacy. Calcium and vitamin D status matter because inducer antiepileptics drive bone density loss over years; the SANAD bone substudy data is the relevant evidence base. Pregnancy planning on an antiepileptic regimen always runs through the neurology team, because of folate timing and the teratogenicity profile specific to each agent (valproate carries the highest, levetiracetam much lower).

Below are the 1 documented pair we have explicitly assessed against Sodium valproate in the Distil database: 1 amber. The pairs cluster around 1 mechanism: CYP induction. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.

Documented interactions

CYP induction

Amber Ginkgo Biloba

There is a report of seizures returning in a person on valproate and phenytoin who was also taking ginkgo, with low blood levels of both seizure medicines. Ginkgo may lower the levels of these medicines, and ginkgo seeds also contain a natural compound that can trigger seizures. If you take valproate for epilepsy, it is safer not to add ginkgo without discussing it with the team managing your epilepsy.

PMID 16419414 · PMID 15608563 · BNF: Valproate

Reviewer-flagged: awaiting clinical-reviewer sign-off.

What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.

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How we decide

How we grade severity, choose what's in scope, and what we exclude.

Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.

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Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.