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Drugs reference index «valproic acid»

valproic acid

Generic Name: valproic acid (val PRO ik A sid)Brand names: Depakene, Stavzor, Depacon

What is valproic acid?

Valproic acid affects chemicals in the body that may be involved in causing seizures.

Valproic acid is used to treat various types of seizure disorders. Valproic acid is sometimes used together with other seizure medications.

Valproic acid may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about valproic acid?

In rare cases, valproic acid has caused life-threatening liver failure, especially in children younger than 2 years old. Children of this age may be at even greater risk for liver problems if they use more than one seizure medication, if they have a metabolic disorder, or if they have a brain disease causing mental impairment (such as Creutzfeldt-Jacob disease, Huntington disease, multiple sclerosis, or a brain injury or infection).

Valproic acid has also caused rare cases of life-threatening pancreatitis (inflammation of the pancreas). Pancreatitis can come on suddenly and symptoms may start even after you have been taking valproic acid for several years.

Seek emergency medical attention if the person taking this medicine has nausea, vomiting, stomach pain, or loss of appetite, low fever, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes). These symptoms may be early signs of liver damage. Some of these symptoms may also be early signs of pancreatitis. Valproic acid can cause birth defects. Do not use this medication without your doctor's consent if you are pregnant. It could cause harm to the unborn baby. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment.

You may have thoughts about suicide while taking this medication. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

What should I discuss with my healthcare provider before taking valproic acid?

In rare cases, valproic acid has caused life-threatening liver failure, especially in children younger than 2 years old. Children of this age may be at even greater risk for liver problems if they use more than one seizure medication, if they have a metabolic disorder, or if they have a brain disease causing mental impairment (such as Creutzfeldt-Jacob disease, Huntington disease, multiple sclerosis, or a brain injury or infection).

Valproic acid has also caused rare cases of life-threatening pancreatitis (inflammation of the pancreas). Pancreatitis can come on suddenly and symptoms may start even after you have been taking valproic acid for several years. Do not take valproic acid if you have liver disease or a urea cycle disorder.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use this medication:

  • a bleeding or blood clotting disorder;

  • a history of head injury, brain disorder, or coma;

  • a family history of a urea cycle disorder;

  • a family history of infant deaths with unknown cause; or

  • HIV or CMV (cytomegalovirus) infection.

You may have thoughts about suicide while taking this medication. Tell your doctor if you have new or worsening depression or suicidal thoughts during the first several months of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

FDA pregnancy category D. This medication can cause harm to an unborn baby. Do not use valproic acid without your doctor's consent if you are pregnant. Tell your doctor if you become pregnant during treatment. Valproic acid can cause birth defects. Use an effective form of birth control while you are using this medication. Valproic acid passes into breast milk and could harm a nursing infant. Do not take valproic acid without telling your doctor if you are breast-feeding a baby.

How should I take valproic acid?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take each dose with a full glass of water. Drink plenty of water while you are taking this medication. Your dose may need to be changed if you do not get enough fluids each day.

Measure the liquid form of valproic acid with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

To be sure this medication is not causing harmful effects, your liver function will need to be tested. Do not miss any scheduled visits to your doctor.

Do not stop taking valproic acid without first talking to your doctor, even if you feel better. You may have increased seizures if you stop taking valproic acid suddenly. You will need to use less and less before you stop the medication completely. Swallow the capsule whole. Do not crush, chew, or break a capsule because the medicine may irritate your mouth or throat when you swallow it. Carry an ID card or wear a medical alert bracelet stating that you are taking valproic acid, in case of emergency. Any doctor, dentist, or emergency medical care provider who treats you should know that you are taking a seizure medication. Store valproic acid at room temperature away from moisture and heat.

See also: Valproic acid dosage in more detail

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include sleepiness or drowsiness, shallow breathing, weak pulse, or loss of consciousness.

What should I avoid while taking valproic acid?

Avoid drinking alcohol, which can increase some of the side effects of valproic acid. Valproic acid can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Valproic acid can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun.

Valproic acid side effects

Seek emergency medical attention if the person taking this medicine has nausea, vomiting, stomach pain, or loss of appetite, low fever, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes). These symptoms may be early signs of liver damage. Some of these symptoms may also be early signs of pancreatitis.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
  • unexplained weakness with vomiting and confusion or fainting;

  • easy bruising or bleeding;

  • fever, chills, skin rash, swollen glands, flu symptoms;

  • urinating less than usual;

  • blood in your urine;

  • weakness, lack of coordination;

  • a red, blistering, peeling skin rash;

  • extreme drowsiness; or

  • double vision or back-and-forth movements of the eyes.

Less serious side effects may include:

  • mild drowsiness;

  • diarrhea, constipation, upset stomach;

  • changes in your menstrual periods;

  • enlarged breasts;

  • tremor (shaking);

  • hair loss;

  • weight changes;

  • vision changes; or

  • unusual or unpleasant taste in your mouth.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Valproic acid Dosing Information

Usual Adult Dose for Seizure Prophylaxis:

Valproate sodium injection:Initial dose: 10 to 15 mg/kg/day intravenously divided over 4 doses administered every 6 hours.Maintenance dose: 30 to 60 mg/kg/day intravenously divided over 4 doses administered every 6 hours.Intravenous doses may be broken into 2 to 3 divided doses/day. However, if this frequency is chosen, trough levels should be carefully monitored.Use of valproate sodium injection for periods of more than 14 days has not been studied. Patients should be switched to oral valproate products as soon as it is clinically feasible.Capsules or syrup:Initial dose: 10 to 15 mg/kg/day orally in 1 to 3 divided dosesMaintenance dose: 30 to 60 mg/kg/day orally in 2 to 3 divided dosesTotal daily doses in excess of 250 mg should be given in divided doses.

Usual Adult Dose for Mania:

Initial dose: 750 mg valproic acid delayed release capsules orally daily in divided doses. Delayed release capsules must be swallowed whole.The dose should be increased as rapidly as possible to achieve the lowest therapeutic dose which produces the desired clinical effect or the desired range of plasma concentrations. In placebo-controlled clinical trials of acute mania, patients were dosed to a clinical response with a trough plasma concentration between 50 and 125 mcg per mL. Maximum concentrations were generally achieved within 14 days.The maximum recommended dosage is 60 mg/kg/day.There is no body of evidence available from controlled trials to guide a clinician in the longer-term management of a patient who improves during valproic acid delayed release capsules treatment of an acute manic episode. While it is generally agreed that pharmacological treatment beyond an acute response in mania is desirable, both for maintenance of the initial response and for prevention of new manic episodes, there are no systematically obtained data to support the benefits of valproic acid delayed release capsules in such longer-term treatment.

Usual Adult Dose for Migraine Prophylaxis:

Initial dose: 250 mg valproic acid delayed release capsules orally twice daily. Valproic acid delayed release capsules must be swallowed whole.Some patients may benefit from doses up to 1000 mg/day. In clinical trials, there was no evidence that higher doses led to greater efficacy.

Usual Pediatric Dose for Seizure Prophylaxis:

Greater than or equal to 10 years:Valproate sodium injection:Initial dose: 10 to 15 mg/kg/day intravenously divided over 4 doses administered every 6 hours.Maintenance dose: 30 to 60 mg/kg/day intravenously divided over 4 doses administered every 6 hours.Intravenous doses may be broken into 2 to 3 divided doses a day. However, if this frequency is chosen, trough levels should be carefully monitored.Use of valproate sodium injection for periods of more than 14 days has not been studied. Patients should be switched to oral valproate products as soon as it is clinically feasible.Capsules or syrup:Initial dose: 10 to 15 mg/kg/day orally in 1 to 3 divided dosesMaintenance dose: 30 to 60 mg/kg/day orally in 2 to 3 divided dosesTotal daily doses in excess of 250 mg should be given in divided doses.

What other drugs will affect valproic acid?

Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for depression or anxiety can add to sleepiness caused by valproic acid. Tell your doctor if you regularly use any of these medicines, or any other seizure medication.

Tell your doctor about all other medications you use, especially:

  • topiramate (Topamax);

  • tolbutamide (Orinase);

  • a blood thinner such as warfarin (Coumadin);

  • aspirin or acetaminophen (Tylenol);

  • zidovudine (Retrovir);

  • clozapine (Clozaril, Fazaclo);

  • diazepam (Valium);

  • meropenem (Marum) or imipenem and cilastatin (Primaxin);

  • rifampin (Rifadin, Rimactane, Rifater); or

  • ethosuximide (Zarontin).

This list is not complete and there may be other drugs that can interact with valproic acid. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about valproic acid.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 9.01. Revision Date: 12/14/2009 9:57:21 AM.
  • valproic acid Advanced Consumer (Micromedex) - Includes Dosage Information
  • Valproic acid Detailed Consumer Information (PDR)
  • Valproic Acid MedFacts Consumer Leaflet (Wolters Kluwer)
  • Depacon Prescribing Information (FDA)
  • Depacon Advanced Consumer (Micromedex) - Includes Dosage Information
  • Depacon MedFacts Consumer Leaflet (Wolters Kluwer)
  • Depakene Prescribing Information (FDA)
  • Stavzor Delayed-Release Capsules MedFacts Consumer Leaflet (Wolters Kluwer)
  • Stavzor Consumer Overview

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