Valproic Acid
Severe
Database
Carbapenems markedly reduce valproate levels → breakthrough seizures
Avoid combination; if unavoidable use alternative anticonvulsant + monitor levels
Source: Kimi deep-research + Cla
Drug reference
Doripenem
Carbapenem beta-lactam antibiotic · Antibiotic
Also known as Doribax, Finibax
START
500 mg IV q8h (1-h infusion; prolonged infusion for less-susceptible organisms)
TYPICAL MAX
1.5 g/day
STOP IF
Anaphylaxis, severe CDI, seizures
WATCH
Renal function (dose-adjust), hypersensitivity, diarrhoea/CDI; not for VAP
CDSCO approvedSchedule HATC J01DH04
KDIGO 2024 + manufacturer label
- ONSET
- 30min · IV onset
- PEAK
- 1h · end of infusion
- t½
- 1h · plasma t½
- DURATION
- 8h · q8h interval
EXCRETION
~70% renal unchanged; minimal metabolism
route + CYP
INTERACTIONS
1 major
SEVERE in our sources
PREGNANCY
Use only if clearly needed — limited human data
FDA category + note
Top interactionssee all 4 →
- Valproic AcidSevereDatabaseKimi deep-research + Cla
Available in India
36 branded formulations. Look up specific brands in the Drugs workspace.
Mechanism
Binds penicillin-binding proteins (esp. PBP2/PBP3) inhibiting bacterial cell-wall peptidoglycan cross-linking → bactericidal lysis; broad Gram-positive/Gram-negative/anaerobe coverage with stability to many beta-lactamases.
Indications
Complicated intra-abdominal infectionsComplicated urinary tract infections including pyelonephritis
Dosing
- Adult
- 500 mg IV every 8 h (1-h infusion; prolonged 4-h infusion used for resistant organisms).
- Pediatric
- Not established.
- Renal adjustment
- CrCl 30–50: 250 mg q8h. CrCl 11–29: 250 mg q12h. Dialysis: limited data — specialist dosing.
- Hepatic adjustment
- No adjustment (not hepatically cleared).
- Geriatric
- Adjust per renal function.
- Max dose
- 1.5 g/day (500 mg q8h)
Pharmacokinetics
Onset
IV immediate
Peak effect
End of 1-h infusion
Duration
q8h dosing
Half-life
~1 h
Bioavailability
100% IV
Protein binding
~8%
Metabolism
Minimal (dehydropeptidase-I to inactive metabolite)
Excretion
Renal (~70% unchanged)
Contraindications
- Anaphylaxis to doripenem or other carbapenems/beta-lactams
- Inhalational use (not for ventilator-associated pneumonia — increased mortality/lower cure in trial)
Side effects
Common
HeadacheNausea/diarrhoeaRashPhlebitisAnaemia
Serious
- Anaphylaxis/severe hypersensitivity (carbapenem cross-reactivity)
- Clostridioides difficile colitis
- Seizures (high dose/renal impairment)
- Pneumonitis with inhalational use (off-label)
Pregnancy & lactation
Pregnancy
Use only if clearly needed — limited human data
Lactation
Limited data; caution
Drug interactions
Live Oral Typhoid Vaccine
Moderate
Database
Antibacterial inactivation of vaccine
Separate timing
Source: Kimi deep-research + Cla
Probenecid
Moderate
Database
Reduced renal clearance of doripenem → raised levels
Avoid co-administration
Source: Kimi deep-research + Cla
Warfarin
Moderate
Database
Possible altered INR (gut flora)
Monitor INR
Source: Kimi deep-research + Cla
8 additional low-confidence interactions hidden — those rows lack a documented mechanism or management plan in our sources.
Related guidelines
Ask House about Doripenem
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Harrison 22e, Katzung·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19