{"id":18460,"date":"2023-05-03T20:38:35","date_gmt":"2023-05-03T13:38:35","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=18460"},"modified":"2023-05-14T21:55:16","modified_gmt":"2023-05-14T14:55:16","slug":"tuong-tac-thuoc-methotrexate-va-natri-valproate","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/tuong-tac-thuoc-methotrexate-va-natri-valproate\/","title":{"rendered":"T\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa ho\u1ea1t ch\u1ea5t Methotrexate v\u00e0 Natri valproate"},"content":{"rendered":"<p>Methotrexate v\u00e0 Natri Valproate l\u00e0 hai lo\u1ea1i thu\u1ed1c ph\u1ed5 bi\u1ebfn \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nhi\u1ec1u b\u1ec7nh l\u00fd kh\u00e1c nhau. Tuy nhi\u00ean, khi s\u1eed d\u1ee5ng c\u00f9ng nhau, hai lo\u1ea1i thu\u1ed1c n\u00e0y c\u00f3 th\u1ec3 t\u01b0\u01a1ng t\u00e1c v\u1edbi nhau v\u00e0 g\u00e2y ra t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng. Vi\u1ec7c hi\u1ec3u r\u00f5 v\u1ec1 t\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Methotrexate v\u00e0 Natri Valproate l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb b\u1ec7nh.<\/p>\n<p>M\u1ee9c \u0111\u1ed9 t\u01b0\u01a1ng t\u00e1c Methotrexate v\u00e0 Natri Valproate: trung b\u00ecnh (theo Drugs.com) [4]<\/p>\n<h2>1. Th\u00f4ng tin chung v\u1ec1 thu\u1ed1c Methotrexate<\/h2>\n<figure id=\"attachment_31321\" aria-describedby=\"caption-attachment-31321\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-31321 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/methotrexate-300x153.png\" alt=\"minh-hoa-thuoc-methotrexate\" width=\"300\" height=\"153\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/methotrexate-300x153.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/methotrexate-768x393.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/methotrexate.png 796w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-31321\" class=\"wp-caption-text\">Minh h\u1ecda thu\u1ed1c Methotrexate<\/figcaption><\/figure>\n<h3>a. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng<\/h3>\n<p>Methotrexate l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb m\u1ed9t s\u1ed1 b\u1ec7nh l\u00fd kh\u00e1c nhau, bao g\u1ed3m vi\u00eam kh\u1edbp v\u00e0 ung th\u01b0. Thu\u1ed1c n\u00e0y l\u00e0 m\u1ed9t lo\u1ea1i ch\u1ea5t \u1ee9c ch\u1ebf folic acid v\u00e0 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ng\u0103n ch\u1eb7n s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a c\u00e1c t\u1ebf b\u00e0o ung th\u01b0. Ngo\u00e0i ra, methotrexate c\u0169ng c\u00f3 t\u00e1c d\u1ee5ng gi\u1ea3m \u0111au v\u00e0 vi\u00eam, gi\u00fap c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a nh\u1eefng ng\u01b0\u1eddi m\u1eafc b\u1ec7nh.<\/p>\n<h3>b. Ch\u1ec9 \u0111\u1ecbnh<\/h3>\n<p>Methotrexate th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh vi\u00eam kh\u1edbp, \u0111\u1eb7c bi\u1ec7t l\u00e0 b\u1ec7nh vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p v\u00e0 b\u1ec7nh lupus ban \u0111\u1ecf. Thu\u1ed1c c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb m\u1ed9t s\u1ed1 b\u1ec7nh l\u00fd kh\u00e1c nh\u01b0 ung th\u01b0 h\u1ea1ch, ung th\u01b0 v\u00fa, ung th\u01b0 da v\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y. Methotrexate c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng duy nh\u1ea5t ho\u1eb7c k\u1ebft h\u1ee3p v\u1edbi c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c \u0111\u1ec3 t\u0103ng hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb.<\/p>\n<h3>c. \u0110\u01b0\u1eddng d\u00f9ng<\/h3>\n<p>Methotrexate c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng d\u01b0\u1edbi d\u1ea1ng thu\u1ed1c u\u1ed1ng ho\u1eb7c ti\u00eam d\u01b0\u1edbi da ho\u1eb7c t\u0129nh m\u1ea1ch. Li\u1ec1u l\u01b0\u1ee3ng v\u00e0 c\u00e1ch s\u1eed d\u1ee5ng c\u1ee7a thu\u1ed1c s\u1ebd ph\u1ee5 thu\u1ed9c v\u00e0o b\u1ec7nh l\u00fd c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 ch\u1ec9 \u0111\u01b0\u1ee3c \u0111\u1ecbnh r\u00f5 b\u1edfi b\u00e1c s\u0129 chuy\u00ean khoa. Nh\u1eefng ng\u01b0\u1eddi s\u1eed d\u1ee5ng methotrexate c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng ph\u1ee5 g\u00e2y h\u1ea1i \u0111\u1ebfn s\u1ee9c kh\u1ecfe.<\/p>\n<h3>d. T\u00e1c d\u1ee5ng ph\u1ee5<\/h3>\n<p>Methotrexate c\u00f3 th\u1ec3 g\u00e2y t\u00e1c d\u1ee5ng ph\u1ee5 nh\u01b0 bu\u1ed3n n\u00f4n, n\u00f4n m\u1eeda, ti\u00eau ch\u1ea3y v\u00e0 m\u1ec7t m\u1ecfi. Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, thu\u1ed1c c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng nh\u01b0 suy gan ho\u1eb7c suy th\u1eadn. V\u00ec v\u1eady, nh\u1eefng ng\u01b0\u1eddi s\u1eed d\u1ee5ng thu\u1ed1c c\u1ea7n tu\u00e2n th\u1ee7 \u0111\u00fang h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng c\u1ee7a b\u00e1c s\u0129 v\u00e0 li\u00ean h\u1ec7 ngay v\u1edbi b\u00e1c s\u0129 n\u1ebfu c\u00f3 b\u1ea5t k\u1ef3 t\u00e1c d\u1ee5ng ph\u1ee5 n\u00e0o.<\/p>\n<h2>2. Th\u00f4ng tin chung v\u1ec1 thu\u1ed1c Natri Valproate<\/h2>\n<h3>a. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng<\/h3>\n<p>Natri Valproate l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh nh\u01b0 \u0111\u1ed9ng kinh v\u00e0 r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c ch\u01b0a \u0111\u01b0\u1ee3c r\u00f5 r\u00e0ng, nh\u01b0ng n\u00f3 \u0111\u01b0\u1ee3c cho l\u00e0 ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch t\u0103ng c\u01b0\u1eddng ho\u1ea1t \u0111\u1ed9ng c\u1ee7a axit gamma-aminobutyric (GABA), m\u1ed9t ch\u1ea5t d\u1eabn truy\u1ec1n th\u1ea7n kinh c\u00f3 t\u00e1c d\u1ee5ng l\u00e0m gi\u1ea3m ho\u1ea1t \u0111\u1ed9ng th\u1ea7n kinh. Natri Valproate c\u0169ng c\u00f3 th\u1ec3 \u1ee9c ch\u1ebf ho\u1ea1t \u0111\u1ed9ng c\u1ee7a m\u1ed9t s\u1ed1 lo\u1ea1i enzyme trong c\u01a1 th\u1ec3, gi\u1ea3m s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a t\u1ebf b\u00e0o v\u00e0 gi\u1ea3m vi\u00eam.<\/p>\n<h3>b. Ch\u1ec9 \u0111\u1ecbnh<\/h3>\n<p>Natri Valproate th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u1ed9ng kinh, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u0111\u1ed9ng kinh c\u1ee5c b\u1ed9 ho\u1eb7c to\u00e0n th\u1ec3. Ngo\u00e0i ra, thu\u1ed1c c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n nh\u01b0 r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n mani v\u00e0 r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n th\u1ea5t th\u01b0\u1eddng. Natri Valproate c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd kh\u00e1c nh\u01b0 \u0111au \u0111\u1ea7u v\u00e0 \u0111au d\u1ea1 d\u00e0y.<\/p>\n<h3>c. T\u00e1c d\u1ee5ng ph\u1ee5<\/h3>\n<p>Natri Valproate c\u00f3 th\u1ec3 g\u00e2y ra m\u1ed9t s\u1ed1 t\u00e1c d\u1ee5ng ph\u1ee5 nh\u01b0 bu\u1ed3n n\u00f4n, n\u00f4n m\u1eeda, ti\u00eau ch\u1ea3y v\u00e0 m\u1ea5t c\u00e2n b\u1eb1ng. Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, thu\u1ed1c c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng nh\u01b0 \u0111\u1ed9t qu\u1ef5 v\u00e0 suy gan. Natri Valproate c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng kh\u00e1c nh\u01b0 r\u1ed1i lo\u1ea1n ti\u1ec1n s\u1ea3n khoa v\u00e0 ch\u1ee9c n\u0103ng gan. Nh\u1eefng ng\u01b0\u1eddi s\u1eed d\u1ee5ng thu\u1ed1c c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd v\u00e0 li\u00ean h\u1ec7 ngay v\u1edbi b\u00e1c s\u0129 n\u1ebfu c\u00f3 b\u1ea5t k\u1ef3 t\u00e1c d\u1ee5ng ph\u1ee5 n\u00e0o. B\u00e1c s\u0129 c\u0169ng c\u00f3 th\u1ec3 \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u l\u01b0\u1ee3ng ho\u1eb7c chuy\u1ec3n sang lo\u1ea1i thu\u1ed1c kh\u00e1c n\u1ebfu c\u1ea7n thi\u1ebft \u0111\u1ec3 gi\u1ea3m t\u00e1c d\u1ee5ng ph\u1ee5.<\/p>\n<h2>3. B\u00e1o c\u00e1o t\u01b0\u01a1ng t\u00e1c thu\u1ed1c methotrexate v\u00e0 natri valproate<\/h2>\n<p>M\u1ed9t s\u1ed1 b\u00e1o c\u00e1o \u0111\u00e3 ghi nh\u1eadn tr\u01b0\u1eddng h\u1ee3p t\u01b0\u01a1ng t\u00e1c thu\u1ed1c-thu\u1ed1c n\u00e0y. M\u1ed9t tr\u01b0\u1eddng h\u1ee3p li\u00ean quan \u0111\u1ebfn vi\u1ec7c s\u1eed d\u1ee5ng methotrexate li\u1ec1u th\u1ea5p h\u00e0ng tu\u1ea7n \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh v\u1ea9y n\u1ebfn [2], v\u00e0 tr\u01b0\u1eddng h\u1ee3p th\u1ee9 hai li\u00ean quan \u0111\u1ebfn vi\u1ec7c truy\u1ec1n methotrexat li\u1ec1u cao \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh b\u1ea1ch c\u1ea7u \u1edf tr\u1ebb em [3]. Trong c\u1ea3 hai tr\u01b0\u1eddng h\u1ee3p, n\u1ed3ng \u0111\u1ed9 natri valproat trong huy\u1ebft thanh gi\u1ea3m \u0111\u00e1ng k\u1ec3 \u0111\u00e3 \u0111\u01b0\u1ee3c ghi nh\u1eadn ngay sau khi d\u00f9ng methotrexat, d\u1eabn \u0111\u1ebfn c\u00e1c c\u01a1n \u0111\u1ed9ng kinh.<\/p>\n<figure id=\"attachment_18479\" aria-describedby=\"caption-attachment-18479\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-18479 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/natri-valproate-300x206.jpg\" alt=\"minh-hoa-thuoc-natri-valproate\" width=\"300\" height=\"206\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/natri-valproate-300x206.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/natri-valproate.jpg 705w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-18479\" class=\"wp-caption-text\">Natri Valproate v\u00e0 t\u01b0\u01a1ng t\u00e1c thu\u1ed1c v\u1edbi Methotrexate<\/figcaption><\/figure>\n<h2>4. C\u01a1 ch\u1ebf t\u01b0\u01a1ng t\u00e1c \u0111\u1ec1 xu\u1ea5t gi\u1eefa Methotrexate v\u00e0 Natri Valproate<\/h2>\n<p>C\u01a1 ch\u1ebf t\u01b0\u01a1ng t\u00e1c gi\u1eefa natri valproat v\u00e0 methotrexat c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c gi\u1ea3i th\u00edch b\u1edfi s\u1ef1 c\u1ea1nh tranh li\u00ean k\u1ebft v\u1edbi protein. Methotrexat l\u00e0 m\u1ed9t axit y\u1ebfu v\u00e0 t\u1ef7 l\u1ec7 li\u00ean k\u1ebft v\u1edbi albumin l\u00e0 75%, trong khi natri valproat li\u00ean k\u1ebft v\u1edbi albumin \u1edf m\u1ee9c \u0111\u1ed9 cao \u0111\u1ebfn 90%. Do \u0111\u00f3, methotrexat c\u1ea1nh tranh v\u1edbi natri valproat \u0111\u1ec3 li\u00ean k\u1ebft v\u1edbi albumin. Sau khi natri valproat b\u1ecb d\u1ecbch chuy\u1ec3n kh\u1ecfi albumin, n\u1ed3ng \u0111\u1ed9 t\u1ef1 do t\u0103ng l\u00ean l\u00e0m t\u0103ng chuy\u1ec3n h\u00f3a \u1edf gan, d\u1eabn \u0111\u1ebfn gi\u1ea3m n\u1ed3ng \u0111\u1ed9 natri valproate trong huy\u1ebft thanh.<\/p>\n<h2>5. C\u00e1ch x\u1eed tr\u00ed khi ph\u1ea3i s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi hai lo\u1ea1i thu\u1ed1c<\/h2>\n<p>B\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng valproate v\u00e0 methotrexate \u0111\u1ed3ng th\u1eddi c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u0111\u00e1p \u1ee9ng l\u00e2m s\u00e0ng c\u1ee7a valproate. B\u00e1c s\u0129 c\u1ea7n c\u00e2n nh\u1eafc \u0111o n\u1ed3ng \u0111\u1ed9 valproate trong huy\u1ebft thanh sau khi b\u1eaft \u0111\u1ea7u ho\u1eb7c ng\u1eebng methotrexate v\u00e0 theo d\u00f5i t\u00ecnh tr\u1ea1ng l\u00e2m s\u00e0ng theo h\u01b0\u1edbng d\u1eabn c\u1ee7a nh\u00e3n s\u1ea3n ph\u1ea9m.<\/p>\n<p>Ngo\u00e0i ra, s\u1eed d\u1ee5ng valproate v\u00e0 methotrexate c\u00f9ng nhau c\u00f3 th\u1ec3 t\u0103ng nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng gan. Theo d\u00f5i ch\u1ee9c n\u0103ng gan \u0111\u1ecbnh k\u1ef3 v\u00e0 sinh thi\u1ebft gan l\u00e0 c\u1ea7n thi\u1ebft khi s\u1eed d\u1ee5ng methotrexate l\u00e2u d\u00e0i. B\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c quan t\u00e2m \u0111\u1ebfn c\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 <a href=\"http:\/\/noithathoaphat.in\/\">tri\u1ec7u ch\u1ee9ng ti\u1ec1m \u1ea9n c\u1ee7a nhi\u1ec5m \u0111\u1ed9c gan<\/a>, ch\u1eb3ng h\u1ea1n nh\u01b0 s\u1ed1t, ph\u00e1t ban, ng\u1ee9a, ch\u00e1n \u0103n, bu\u1ed3n n\u00f4n, n\u00f4n, m\u1ec7t m\u1ecfi, \u0111au h\u1ea1 s\u01b0\u1eddn ph\u1ea3i, n\u01b0\u1edbc ti\u1ec3u s\u1eabm m\u00e0u, ph\u00e2n nh\u1ea1t m\u00e0u v\u00e0 v\u00e0ng da. N\u1ebfu c\u00f3 b\u1ea5t k\u1ef3 d\u1ea5u hi\u1ec7u \u0111\u00e1ng ng\u1edd n\u00e0o, b\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c ch\u0103m s\u00f3c y t\u1ebf k\u1ecbp th\u1eddi.[4]<\/p>\n<p><b>Tuy\u00ean b\u1ed1 mi\u1ec5n tr\u1eeb tr\u00e1ch nhi\u1ec7m: <\/b><span style=\"font-weight: 400;\">C\u00e1c quy\u1ebft \u0111\u1ecbnh li\u00ean quan \u0111\u1ebfn \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c ph\u1ea3i d\u1ef1a tr\u00ean \u0111\u00e1nh gi\u00e1 \u0111\u1ed9c l\u1eadp c\u1ee7a b\u00e1c s\u0129 l\u00e2m s\u00e0ng, thay \u0111\u1ed5i th\u00f4ng tin v\u1ec1 m\u1ed9t lo\u1ea1i thu\u1ed1c (v\u00ed d\u1ee5: Th\u00f4ng tin \u0111\u01b0\u1ee3c trong t\u00e0i li\u1ec7u v\u00e0 th\u00f4ng tin s\u1ea3n ph\u1ea9m m\u1edbi nh\u1ea5t c\u1ee7a nh\u00e0 s\u1ea3n xu\u1ea5t) v\u00e0 thay \u0111\u1ed5i th\u1ef1c h\u00e0nh y t\u1ebf.<\/span><\/p>\n<p>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/p>\n<ol>\n<li>Pharmacy Retailing (NZ) Ltd t\/a Healthcare Logistics. 2022. <em>Epilim New Zealand Data Sheet\u00a0<\/em>15 September 2022<em>.\u00a0<\/em>URL:\u00a0<a href=\"https:\/\/www.medsafe.govt.nz\/profs\/Datasheet\/e\/Epilimtabsyrliqiv.pdf\">medsafe.govt.nz\/profs\/datasheet\/e\/Epilimtabsyrliqiv.pdf<\/a><\/li>\n<li>Cherian A, Shetty SC, Divya KP, et al. 2021. Weekly methotrexate may reduce valproate levels causing relapse of genetic generalized epilepsy.\u00a0<em>Epilepsy &amp; Behavior Reports<\/em>\u00a016(7 May): 100457. DOI: doi.org\/10.1016\/j.ebr.2021.100457<\/li>\n<li>Schr\u00f8der H and Ostergaard JR. 1994. Interference of high-dose methotrexate in the metabolism of valproate?\u00a0<em>Pediatriatric Hematology and Oncology<\/em>\u00a011(4): 445-9. DOI: 10.3109\/08880019409140546<\/li>\n<li>Drugs.com. URL: https:\/\/www.drugs.com\/interactions-check.php?drug_list=1590-11350,2286-17497&amp;types%5B%5D=major&amp;types%5B%5D=minor&amp;types%5B%5D=moderate&amp;types%5B%5D=food&amp;types%5B%5D=therapeutic_duplication&amp;professional=1<\/li>\n<li>Medsafe. URL: https:\/\/www.medsafe.govt.nz\/profs\/PUArticles\/March2023\/Administration-of-methotrexate-in-patients-taking-sodium-valproate.html<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Methotrexate v\u00e0 Natri Valproate l\u00e0 hai lo\u1ea1i thu\u1ed1c ph\u1ed5 bi\u1ebfn \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nhi\u1ec1u b\u1ec7nh l\u00fd kh\u00e1c nhau. Tuy nhi\u00ean, khi s\u1eed d\u1ee5ng c\u00f9ng nhau, hai lo\u1ea1i thu\u1ed1c n\u00e0y c\u00f3 th\u1ec3 t\u01b0\u01a1ng t\u00e1c v\u1edbi nhau v\u00e0 g\u00e2y ra t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng. Vi\u1ec7c hi\u1ec3u r\u00f5 v\u1ec1 t\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Methotrexate [&hellip;]<\/p>\n","protected":false},"author":56,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[12],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>T\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa ho\u1ea1t ch\u1ea5t Methotrexate v\u00e0 Natri valproate - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u00e1o c\u00e1o m\u1edbi 2023 v\u1ec1 t\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Methotrexate v\u00e0 Natri Valproate tr\u00ean l\u00e2m s\u00e0ng. 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