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 [1 ] bipolar disorder, epilepsy and in the prevention of migraines. [2 ]
Medical uses [ edit ]
It is used in the treatment of migraines, bipolar disorder and epilepsy.
[2 ] [3 ] [4 ]
Adverse effects [ edit ]
Adverse effects by frequency: [2 ] [3 ] [4 ]
Very common (>10% frequency):
Common (1-10% frequency):
Uncommon (0.01-0.1% frequency):
Rare (<0.01% frequency):
† Rare cases of lethargy occasionally progressing to stupor, sometimes with associated hallucinations or convulsions have been reported. Encephalopathy and coma have very rarely been observed. These cases are most often seen in association with other factors such as rapid dose escalations or withdrawal from other medications. They have usually been reversible on withdrawal of treatment or reduction of dosage. ‡ These cases most commonly occur in the paediatric population. ¶ Weight gain should be monitored closely as there is a potential link between weight gain and polycystic ovary syndrome.
Contraindications [ edit ]
Active liver disease
Personal or family history of drug-related liver dysfunction
Hypersensitivity to valproate semisodium,
valproate, Valproic acid any of its excipients
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, potentially, to potential valproate toxicity.
Cimetidine and erythromycin may reduce 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 ]
Additional brand names for this medication include Depacon, Depakene and Zalkote
In the United States, generic versions of [5 ] Depakote became available on July 29, 2008. [6 ]
References [ edit ]
This article needs additional citations for . verification (July 2009)
External links [ edit ]