Valproate semisodium

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Main article: Valproic acid
Valproate semisodium
Valproate-semisodium2DACS.svg
Systematic (IUPAC) name
sodium 2-propylpentanoic acid 2-propylpentanoate
Clinical data
Trade names Depakote
AHFS/Drugs.com monograph
MedlinePlus a682412
  • D, X (US; depends on its indication)
Oral
Pharmacokinetic data
Protein binding 10-18.5% (dose-dependent)
Metabolism Hepatic (30-50% via glucuronidation; 40% via β-oxidation & 15-20% via other oxidative pathways)
Half-life 9-16 hours (dose-dependent)
Excretion Renal (<3% unchanged)
Identifiers
PubChem CID 23663956
Chemical data
Formula C16H31NaO4

Valproate semisodium (INN, BAN) or divalproex sodium (USAN) consists of a compound of sodium valproate and valproic acid in a 1:1 molar relationship in an enteric coated form.[1] Its chief use in medicine is as a treatment for bipolar disorder, epilepsy and in the prevention of migraines.[2]

Medical uses[edit]

Main article: Valproic acid § Uses

It is used in the treatment of migraines, bipolar disorder and epilepsy.[2][3][4]

Adverse effects[edit]

Contraindications[edit]

Contraindications:[2]

  • Active liver disease
  • Personal or family history of drug-related liver dysfunction
  • Hypersensitivity to valproate semisodium, valproate, Valproic acid any of its excipients
  • Porphyria

Interactions[edit]

Drug interactions include:[2][3][4]

  • MAO inhibitors, antidepressants, benzodiazepines and antipsychotics — may potentiate its effects, including its side effects.
  • Phenobarbital — plasma concentrations of phenobarbital is increased. Decreases plasma concentrations of valproate.
  • Phenytoin — plasma concentrations of phenytoin are reduced. Decreases plasma concentrations of valproate.
  • Carbamazepine — toxic effects of carbamazepine are potentiated by this combination. Decreases plasma concentrations of valproate.
  • Lamotrigine — reduces lamotrigine's half-life by half.
  • Felbamate — may reduce felbamate's clearance by up to 16%. Felbamate may also reduce valproate plasma concentrations by 22-50%.
  • Zidovudine — increases plasma concentrations, potentially leading to zidovudine toxicity.
  • Temozolomide — slight, yet seemingly insignificant increase in temozolomide plasma concentrations.
  • Vitamin K-dependent anticoagulants (e.g. warfarin) — valproate may displace these drugs from the plasma proteins hence potentiating their effects.
  • Mefloquine and chloroquine induce valproate's metabolism, hence potentially reducing plasma concentrations of the drug.
  • Highly protein-bound agents (e.g. aspirin) may displace valproate from plasma proteins leading to potential valproate toxicity.
  • Cimetidine and erythromycin may increase valproate plasma concentrations.
  • Carbapenem antibiotics (e.g. imipenem) may reduce plasma levels of valproate by 60-100%.
  • Colestyramine may reduce valproate absorption from the small intestine
  • Rifampicin may decrease plasma concentrations of valproate.
  • Concomitant topiramate may induce encephalopathy in patients on valproate.

Branded formulations[edit]

  • Brazil – Depakote by Abbott Laboratories
  • Canada – Epival by Abbott Laboratories
  • Mexico – Epival and Epival ER (extended release) by Abbott Laboratories
  • United Kingdom – Depakote (for psychiatric conditions) and Epilim (for epilepsy) by Sanofi-Aventis and generics
  • United States – Depakote and Depakote ER (extended release) by Abbott Laboratories and generics
  • India – Valance and Valance OD by Abbott Healthcare Pvt Ltd,Divalid ER by Linux laboratories Pvt Ltd,Valex ER by Sigmund Promedica, Dicorate by Sun Pharma
  • Germany – Ergenyl Chrono by Sanofi-Aventis and generics
  • Chile – Valcote and Valcote ER by Abbott Laboratories
  • France and other European countries — Depakote
  • Peru – Divalprax by AC Farma Laboratories
  • China – Diprate OD

In the United States, generic versions of valproate semisodium became available on July 29, 2008.[5]

References[edit]

  1. ^ Valproate. Martindale: The Complete Drug Reference (Pharmaceutical Press). 17 October 2013. Retrieved 18 January 2014. 
  2. ^ a b c d "Depakote 250mg Tablets - Summary of Product Characteristics". electronic Medicines Compendium. Sanofi. 28 November 2013. Retrieved 18 January 2014. 
  3. ^ a b "DEPAKOTE (divalproex sodium) tablet, delayed release [AbbVie Inc.]". DailyMed. AbbVie Inc. September 2013. Retrieved 18 January 2014. 
  4. ^ a b "Depakote (divalproex sodium) dosing, indications, interactions, adverse effects, and more". Medscape Reference. WebMD. Retrieved 18 January 2014. 
  5. ^ "FDA Gives Thumbs Up to Generic Seizure Drug". Fdanews.com. 2008-08-07. Retrieved 2015-03-31. 

External links[edit]