NutriStack
Alcohol and Valproic Acid, a caution.
Alcohol can add to valproic acid's dizziness, sleepiness, and impaired coordination, and it may increase concern for liver injury. A case-control study of valproic acid-induced liver injury found alcohol consumption was associated with greater risk of serious DILI. The combination is especially risky with liver disease, elevated liver enzymes, pancreatitis history, high valproate levels, or heavy drinking.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Alcohol and Valproic Acid
- Pair type
- Caution
- Evidence (highest tier)
- Moderate
- Source citations
- 2 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Moderate evidence
Caution
What is happening. Alcohol can add to valproic acid's dizziness, sleepiness, and impaired coordination, and it may increase concern for liver injury. A case-control study of valproic acid-induced liver injury found alcohol consumption was associated with greater risk of serious DILI. The combination is especially risky with liver disease, elevated liver enzymes, pancreatitis history, high valproate levels, or heavy drinking.
Mechanism. Valproic acid is hepatically metabolized through glucuronidation and mitochondrial beta-oxidation, and toxic metabolites can contribute to hepatic injury. Alcohol adds CNS depression and can worsen hepatic oxidative stress and mitochondrial vulnerability, increasing both impairment and liver-safety concerns.
Recommendation. Avoid heavy or binge alcohol while taking valproic acid, and avoid alcohol completely if you have liver disease or abnormal liver tests. Do not skip or double valproic acid doses around drinking without prescriber guidance. Ask about liver-function monitoring and seek urgent care for severe abdominal pain, jaundice, confusion, vomiting, or extreme sleepiness.
Sources (2)
- Meseguer ES, Elizalde MU, Borobia AM, Ramirez E. Valproic Acid-Induced Liver Injury: A Case-Control Study from a Prospective Pharmacovigilance Program in a Tertiary Hospital. J Clin Med. 2021;10(6):1153. PMID 33801850
- Guo HL, Jing X, Sun JY, Hu YH, Xu ZJ, Ni MM, et al. Valproic Acid and the Liver Injury in Patients with Epilepsy: An Update. Curr Pharm Des. 2019;25(3):343-351. PMID 30931853
Stack Score
How this pair moves the number.
Effect on the composite score
If both Alcohol and Valproic Acid are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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