Is There a Possible Conflict Between Depakote and Accolate?

Sue: I have just started taking Depakote for seizures and bipolar disorder. Some of the cautions about other medications are similar to Accolate. Is there a possible conflict?

Dr. Kraemer: From your question, I would assume that you are using both Depakote and Accolate to treat two separate problems. Accolate (generic name zafirlukast) is an anti-leukotriene used to treat mild asthma. It has proven to be a very safe as a daily medicine to reduce symptoms and control some of the inflammation. In the last few years, we have learned more about its dosing and interactions.

When you take this drug with food, you seem to get a lower blood level. Therefore, it is recommended that you take this one hour before or two hours after meals. The only significant drug interaction is with the blood-thinning drug called warfarin.

If this combination is used, you will need to more closely monitor the prothrombin time or adjust the dose of warfarin. Also, there seems to be a higher blood level of zafirlukast when you also use aspirin, but this has not caused any problems. I am aware of no drug interactions with Depakote.