From the Research
Prednisolone is not contraindicated with Epilim (sodium valproate), and they can be used together when clinically necessary, though monitoring is recommended. When co-administering these medications, healthcare providers should be aware that prednisolone (a corticosteroid) may slightly reduce serum valproate levels in some patients, potentially requiring dose adjustments of Epilim to maintain therapeutic effectiveness, as seen in a study where sodium valproate was used in combination with prednisolone and pegylated interferon to treat HTLV-1-associated myelopathy/tropical spastic paraparesis 1. Additionally, long-term prednisolone use may increase the risk of osteoporosis, which could be a concern since Epilim itself is associated with decreased bone mineral density in some patients. Patients on this combination should have their seizure control monitored, particularly when starting or stopping prednisolone, as any significant changes in valproate levels could affect seizure management. Regular blood tests to monitor valproate levels may be advisable during concurrent therapy.
Some key points to consider when using prednisolone with Epilim include:
- Monitoring for potential interactions, such as reduced serum valproate levels
- Adjusting Epilim doses as needed to maintain therapeutic effectiveness
- Considering the risk of osteoporosis with long-term prednisolone use
- Monitoring seizure control, especially when starting or stopping prednisolone
- Regular blood tests to monitor valproate levels during concurrent therapy
It's also important to note that the use of corticosteroids like prednisolone has been shown to provide moderate short-term benefit for reducing pain and improving functioning, but with potential adverse effects such as toxicity to articular cartilage and numerous systemic side effects 2. However, in the context of using prednisolone with Epilim, the most recent and highest quality study available does not indicate a contraindication, but rather the need for careful monitoring and management 1.