Main article: Valproic acid
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. Its chief use in medicine is as a treatment for bipolar disorder, epilepsy and in the prevention of migraines.
It is used in the treatment of migraines, bipolar disorder and epilepsy.
- Active liver disease
- Personal or family history of drug-related liver dysfunction
- Hypersensitivity to valproate semisodium, valproate, Valproic acid any of its excipients
Drug interactions include:
- 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.
- 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.
- PAMs (abridged; see here for a full list): α-EMTBL
- Alcohols (e.g., ethanol)
- Avermectins (e.g., ivermectin)
- Barbiturates (e.g., phenobarbital)
- Benzodiazepines (e.g., diazepam)
- Bromide compounds (e.g., potassium bromide)
- Carbamates (e.g., meprobamate)
- Dihydroergolines (e.g., ergoloid (dihydroergotoxine))
- Fenamates (e.g., mefenamic acid)
- Flavonoids (e.g., apigenin, hispidulin)
- Imidazoles (e.g., etomidate)
- Kava constituents (e.g., kavain)
- Neuroactive steroids (e.g., allopregnanolone, cholesterol)
- Nicotinamide (niacinamide)
- Nonbenzodiazepines (e.g., β-carbolines (e.g., abecarnil), cyclopyrrolones (e.g., zopiclone), imidazopyridines (e.g., zolpidem), pyrazolopyrimidines (e.g., zaleplon))
- Phenols (e.g., propofol)
- Piperidinediones (e.g., glutethimide)
- Pyrazolopyridines (e.g., etazolate)
- Quinazolinones (e.g., methaqualone)
- Retigabine (ezogabine)
- Skullcap constituents (e.g., baicalin)
- Sulfonylalkanes (e.g., sulfonmethane (sulfonal))
- Valerian constituents (e.g., valerenic acid)
- Volatiles/gases (e.g., chloral hydrate, chloroform, diethyl ether, paraldehyde, sevoflurane)
- NAMs: 1,3M1B
- α5IA (LS-193,268)
- β-Lactams (e.g., penicillins, cephalosporins, carbapenems)
- FG-7142 (ZK-31906)
- Fiproles (e.g., fipronil)
- Flavonoids (e.g., amentoflavone, oroxylin A)
- Fluoroquinolones (e.g., ciprofloxacin)
- Iomazenil (123I)
- Isopregnanolone (sepranolone)
- Pentetrazol (metrazol)
- Picrotoxin (i.e., picrotin and picrotoxinin)
- Pregnenolone sulfate
- Ro 15-4513
- Ro 19-4603