Hyperammonemia Associated with Valproic Acid Concentrations

Table 3

VPA, 4-en VPA, and ammonia levels in a patient before and after carnitine supplementation.

	Patient; (without carnitine)	Patient; (with carnitine)
Plasma [VPA] (mg/L)	86.6	46.3
Saliva [VPA] VPA (mg/L)	1.9	0.68
Plasma [4-en VPA] (mg/L)	3.6	0.63
Ammonia concentration (𝜇g/dL)	295	75
[4-en VPA]/[VPA]	0.042	0.014

[4-en VPA]/[VPA]: metabolic ratio.