Valproic Acid: Divalproex Sodium, Sodium Valproate
(Depakene®, Depakote®, Epival®)
USED FOR:
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Absence seizures |
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Tonic-clonic (grand mal), myoclonic, atonic, tonic seizures |
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Partial seizures |
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Photosensitive seizures |
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Lennox-Gastaut syndrome |
PRECAUTIONS:
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Inform your doctor if you are a person with liver, kidney or blood disease or dysfunction. |
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Because of small risk of liver failure, patients and parents should report symptoms of weakness, lethargy, facial swelling, anorexia, jaundice, vomiting, and loss of seizure control. |
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Evidence of hemorrhaging or bruising or a blood clotting problem warrants immediate investigation. |
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Elderly persons should use caution. |
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- Refrain from activities requiring mental alertness or physical coordination (e.g. operating hazardous machines, driving) until you are sure that valproic acid does not affect your abilities. |
POSSIBLE SIDE EFFECTS:
Depending on the individual, side effects may occur at varying degrees or not at all, including:
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nausea |
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menstrual irregularities |
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vomiting |
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transient hair loss |
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indigestion |
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tremor (rare) |
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drowsiness |
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dizziness (rare) |
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fatigue |
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loss of coordination (rare) |
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emotional and behavioural disturbances |
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visual disturbances (rare) |
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weight gain |
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Allergic Reaction/Idiosyncratic - skin rash (if you notice a rash, seek immediate medical help) - bone marrow suppression, liver toxicity (see "Precautions" for symptoms), pancreatitis.
DRUG INTERACTIONS:
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Alcohol and other drugs that slow down the nervous system (CNS depressants) may interact with valproic acid to increase CNS depressant effects. |
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Phenobarbital and primidone may interact with valproic acid to produce severe CNS depression. |
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Clonazepam may interact with valproic acid to produce continuous absence seizures in people with a history of absence seizures. |
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Phenytoin interaction is complex; there have been reports of break-through seizures. |
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Carbamazepine concentrations may increase while valproic acid may decrease. |
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Lamotrigine metabolism is inhibited by valproic acid. |
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Asprin and warfarin affect blood clotting and should be used with caution while taking valproic acid. |
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Some anti-depressants may interact with valproic acid. |
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Oral contraceptives' efficacy not affected. |
Inform your doctor and pharmacist of any other medicines (prescription and nonprescription) or substances you are taking.
DAILY DOSAGE:
Adults - 1,000-2,000 mg.
Children - 15 - 40 mg/kg.
FORMS:
Syrup - 50 mg/ml
Tablets - 125, 250, and 500 mg
Capsules - 250, 500 mg capsules
Dosage should be individualized.
TIPS FOR USING VALPROIC ACID (Depakene®, Depakote®, Epival®):
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Swallow tablets or capsules without chewing. |
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Stomach upset may be helped by taking the drug with food. |
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Stomach upset usually disappears over time. |
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Sedation worse in combination drug therapy, and may disappear once doctor reduces other antiepileptic medication. |
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Valproic acid may interact with other antiepileptic drugs, so periodic blood level monitoring recommeded. |
MISSED DOSE:
Try to take each dose at the scheduled time. If you miss a dose, take it as soon as remembered. Do not take it if it is near the time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up. If you skip a whole day, inform your doctor.
STORAGE:
Store at room temperature (15 to 30oC), protect from light, heat, and moisture, and keep out of reach of children.
Do not use capsules that are discoloured
IN PREGNANCY:
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Anti-epileptic medications may slightly increase the risk of fetal abnormalities. |
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Women who are considering pregnancy should first consult their doctor |
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Risk of having a child with spina bifida is about 1-2% if exposed in the first trimester. |
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Generally, mothers should not breastfeed while on this drug. |
WARNING:
Abrupt withdrawal of any anti-epileptic medication may trigger status epilepticus, a potentially fatal condition of continued seizures without recovery. When there is a need for reduction, discontinuation or substitution of the medication, this should be done gradually and under the physician's care.
MORE INFORMATION YOU NEED TO KNOW ABOUT YOUR MEDICATION
CREDIT:
This drug fact sheet has been reviewed by the pharmacists of the Ontario Pharmacists' Association Drug Information and Research Centre (DIRC).
DISCLAIMER:
The material offered on the website of Epilepsy Toronto is to provide general information about epilepsy to the public. It is not intended to be taken as personal medical advice. Epilepsy Toronto, its employees, Board members, Medical Advisors, volunteers, agents and sponsors do not assume responsibility for inaccuracies or omissions or for consequences from the use of information obtained over this site or any links accessed through this site, and is not liable for any outcome or damages resulting from information in its content in either an indirect or direct form. We recognize that each individual's experience of epilepsy is different. Consult your physician and/or neurologist with any questions you have.
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