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Metabolic pathways of valproic acid. In adults, the majority of valproate dose is eliminated via glucuronidation and mitochondrial β-oxidation pathways, and about 15-20% of the dose is metabolized by CYP enzymes. In contrast, valproate metabolism is shifted towards CYP-dependent route in children. Abbreviations: UGT: UDP-glucuronyl transferase, GSH: glutathion.
