Chemical Names: Valproic Acid, Divalproex sodium|
Brand Names: Dapakene, Depakote
Manufacturer: Abbott Laboratories
Description: Divalproex sodium is a compound made up of sodium valproate and valproic acid. Its mechanism of action is poorly understood. Its anti-seizure efficacy may be related to increased brain concentrations of GABA (gamma-aminobutyric acid).
Indications and Uses: Divalproex sodium is indicated for use as sole and adjunctive therapy in the treatment of simple and absence seizures and adjunctively in patients with multiple seizure types that include absence seizures. It is also indicated for the treatment of manic episodes associated with bipolar disorder (manic-depression).
Contraindications, Warnings, and Precautions: It should not be given to patients with liver disease or significant liver dysfunction. Divalproex sodium may cause birth defects if used in pregnant women. Women who become pregnant while on it should be advised of the risk to the fetus. Since it is excreted in breast milk, caution should be exercised in administering divalproex sodium to nursing mothers. It should not be stopped abruptly in seizure patients. Divalproex sodium may cause thrombocytopenia (lowering of blood platelets), affect blood clotting times and suppress bone marrow production. Hence CBCs (complete blood counts) with platelets should be monitored regularly. There are numerous drugs which affect/interact with divalproex sodium. In particular, caution should be exercised when co-administering it with aspirin, Felbamate, Rifampin, Carbamazepine, Clonazepam, Diazepam, Ethosuximide, Lamotrigine, Phenobarbital, Primidone, Phenytoin, Tolbutamide, Warfarin, and Zidovudine.
Adverse Reactions: Possible common side effects are sedation (initially), nausea, indigestion, tremors, and photosensitivity. One may also experience diarrhea, hair loss (usually temporary), weight gain, and a change in menstrual period. Any signs of unusual bleeding or bruising, mental confusion, lack of coordination, yellowing of eyes or skin or swelling of the face should immediately be reported to your doctor. These signs may indicate hepatic (liver) toxicity and/or dangerous suppression of blood counts.
Dosing Range: Initial dosing will vary according to age and indication. The dose should be increased to within the desired plasma range (i.e. blood level between 50 to 125 micrograms per ml of blood). The maximum recommended dose is 60 mg per kilogram per day.
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