Before taking Depakote, tell your doctor about all of your medical conditions. Especially tell your doctor if you:
- drink alcohol
- have or have had depression, mood problems, or suicidal thoughts or behavior
- have UCD
- have liver or kidney problems
- are pregnant or breastfeeding
Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.
Depakote is available in 125 mg, 250 mg, and 500 mg strength tablets.
Depakote is available in 125 mg strength sprinkle capsules.
Active ingredient: divalproex
Inactive ingredients: vary by manufacturer
Common side-effects are
- Nausea
- Somnolence
- Dizziness
- Vomiting
- Abdominal pain
- Diarrhea
- Increased appetite
- Weight gain
- Weight loss
- Alopecia
- Fever
- Anorexia
- Constipation
- Thinking abnormal
- Amnesia
- Flu syndrome
- Infection
- Bronchitis
- Peripheral edema
- Insomnia
- Nervousness
- Depression
Less common are
- Fatigue
- Peripheral edema
- Acne
- Dizziness
- Drowsiness
- Hair loss
- Headaches
- Nausea
- Sedation
- Tremors
Depakote is used to treat:
- Monotherapy and adjunctive therapy of complex partial seizures and simple and complex absence seizures
- Adjunctive therapy in patients with multiple seizure types that include absence seizures
Serious side effects have been reported with Depakote including:
- Liver toxicity: Your doctor will want to monitor your liver function tests. Tell your healthcare provider right away if you have some or all of the following symptoms…
- yellowish tint to eyes and skih
- stomach pain and swelling
- itchiness
- dark urine color and/or pale stool color
- bloody or tar-colored stool
- fatigue
- nausea and/or loss of appetite
- Pancreatitis: Tell your healthcare provider right away if you have some or all of the following symptoms…
- a swollen and tender abdomen
- nausea
- vomiting
- fever
- a fast pulse
- Suicidal behavior or ideation: Tell your healthcare provider right away if you have some or all of the following symptoms…
- new or worsening feelings of depression
- suicidal thoughts or behavior
- any unusual changes in mood or behavior
- Thrombocytopenia (low platelet counts): Your doctor may want monitor platelet counts and bleeding tests. Tell your healthcare provider right away if you have some or all of the following symptoms…
- bleeding that does not stop
- bruising
- Hyperammonemia and hyperammonemic encephalopathy (a condition of brain dysfunction): Tell your healthcare provider right away if you have some or all of the following symptoms…
- inexplicable tiredness and fatigue
- vomiting
- changes in mental status
- Hypothermia: A drop in body temperature to 95 degrees Fahrenheit or less (hypothermia) has been reported with Depakote therapy.Tell your healthcare provider right away if you have some or all of the following symptoms…
- fatigue
- confusion
- coma
- changes heart rate, blood pressure, or breathing
- Multi-organ hypersensitivity (allergic) reaction: Tell your healthcare provider right away if you have some or all of the following symptoms…
- fever
- rash
- decreased urination
- joint pain
- weakness or loss of energy
- Because this reaction may have effects on many organs of the body, not all symptoms are included.
- Somnolence (drowsiness): This effect is seen especially in the elderly population. Depakote dosage should be increased slowly and with regular monitoring for fluid and nutritional intake.
Depakote can cause dizziness or blurred vision. Do not drive or operate heavy machinery until you know how Depakote affects you.
Do not take Depakote if you:
- have liver disease or significant liver dysfunction
- have a known hypersensitivity (allergy) to the drug
- are diagnosed with urea cycle disorder (UCD)
Depakote is prescribed in the following forms:
- Capsule
- Extended-release tablet
- Delayed-release tablet
- Sprinkle capsule
- Syrup
Depakote Sprinkle Capsules may be swallowed whole or the contents may be sprinkled on soft food. The drug/food mixture should be swallowed immediately (avoid chewing)
Safety of doses above 60 mg/kg/day is not established.
Complex Partial Seizures: Start at 10 to 15 mg/kg/day, increasing at 1 week intervals by 5 to 10 mg/kg/day to achieve optimal clinical response; if response is not satisfactory, check valproate plasma level; see full prescribing information for conversion to monotherapy
Absence Seizures: Start at 15 mg/kg/day, increasing at 1 week intervals by 5 to 10 mg/kg/day until seizure control or limiting side effects
Store Depakote at room temperature.
Keep this and all medicines out of the reach of children.
Tell your doctor if you are pregnant or plan to become pregnant.
The FDA categorizes medications based on safety for use during pregnancy. Five categories – A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.
Depakote falls into category D. There is evidence of risk to the unborn baby based on studies in humans or adverse reaction data, but this medication may be given to a pregnant woman if her healthcare provider believes that its benefits to the pregnant woman outweigh any possible risks to her unborn baby.
Depakote may harm your unborn baby.
Excessive amounts of Depakote can result in tremor, stupor, respiratory depression, coma, metabolic acidosis, and death. Overdosage in children is usually of an accidental nature, whereas with adults it is more likely to be an intentional act.
In case of overdose seek medical attention.
Take Depakote exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.
- Mania: Initial dose is 750 mg daily, increasing as quickly as possible to achieve response or desired levels in the blood. The maximum recommended dosage is 60 mg/kg/day.
- Complex Partial Seizures: Start at 10 to 15 mg/kg/day, increasing at 1 week intervals by 5 to 10 mg/kg/day to achieve clinical response. The maximum recommended dosage is 60 mg/kg/day.
- Absence Seizures: Start at 15 mg/kg/day, increasing at 1 week intervals by 5 to 10 mg/kg/day until seizure control or side effects are not tolerable. The maximum recommended dosage is 60 mg/kg/day.
- Migraine: The recommended starting dose is 250 mg twice daily, thereafter increasing to a maximum of 1000 mg/day as needed.
Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:
- Hepatic enzyme-inducing medications such as phenytoin (Dilantin), carbamazepine (Tegretol, Equetro), phenobarbital, rifampin (Rifadin)
- Hepatic enzyme-inhibitors medication such as felbamate (Felbatol)
- Aspirin (Ecotrin)
- carbapenem antibiotics such as meropenem (Merrem), imipenem (Primaxin), and ertapenem (Invanz)
- diazepam (Valium)
- ethosuximide (Zarontin)
- lamotrigine (Lamictal)
- phenytoin (Dilantin)
- tricyclic antidepressants such as selegiline (Emsam, Eldepryl) amitryptyline (Elavil), and nortryptyline (Pamelor, Aventyl)
- warfarin (Coumadin, Jantoven)
- topiramate (Topamax)
- zidovudine (Retovir, Trizivir)
This is not a complete list of Depakote drug interactions. Ask your doctor or pharmacist for more information.
Depakote (Valproic acid; Valproate semisodium) is an oral medication that is primarily used for the treatment and prevention of epileptic seizures. It has also been used to treat bipolar disorder, and as a preventive medication for migraine headaches. It is part of a class of medications called anticonvulsants.
Valproic acid has also been used to treat aggressive outbursts in children who have attention deficit hyperactivity disorder, and chorea (a group of movement disorders).
Valproic acid is believed to work by enhancing the action of a neurotransmitter in the brain called GABA, as well as blocking the action of electrical channels in the brain.
Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Depakote, there are no specific foods that you must exclude from your diet when receiving Depakote.
Hepatotoxicity
Hepatic failure resulting in fatalities has occurred in patients receiving valproate and its derivatives. Children under the age of two years are at a considerably increased risk of developing fatal hepatotoxicity, especially those on multiple anticonvulsants, those with congenital metabolic disorders, those with severe seizure disorders accompanied by mental retardation, and those with organic brain disease. When Depakote is used in this patient group, it should be used with extreme caution and as a sole agent. The benefits of therapy should be weighed against the risks. The incidence of fatal hepatotoxicity decreases considerably in progressively older patient groups.
These incidents usually have occurred during the first six months of treatment. Serious or fatal hepatotoxicity may be preceded by non-specific symptoms such as malaise, weakness, lethargy, facial edema, anorexia, and vomiting. In patients with epilepsy, a loss of seizure control may also occur. Patients should be monitored closely for appearance of these symptoms. Liver function tests should be performed prior to therapy and at frequent intervals thereafter, especially during the first six months.
Fetal Risk
Valproate can cause major congenital malformations, particularly neural tube defects (e.g., spina bifida). Valproate should not be administered to a woman of childbearing potential unless the drug is essential to the management of her medical condition. This is especially important when valproate use is considered for a condition not usually associated with permanent injury or death (e.g., migraine). Women should use effective contraception while using valproate.
Pancreatitis
Cases of life-threatening pancreatitis have been reported in both children and adults receiving valproate. Some of the cases have been described as hemorrhagic with a rapid progression from initial symptoms to death. Cases have been reported shortly after initial use as well as after several years of use. Patients and guardians should be warned that abdominal pain, nausea, vomiting, and/or anorexia can be symptoms of pancreatitis that require prompt medical evaluation. If pancreatitis is diagnosed, valproate should ordinarily be discontinued. Alternative treatment for the underlying medical condition should be initiated as clinically indicated.
Take Depakote exactly as prescribed.
Depakote comes in tablet or sprinkle capsule forms and is taken by mouth 1 to 2 times day.
Depakote tablets should be swallowed whole and should not be crushed or chewed.
Depakote sprinkle capsules may be swallowed whole or may be taken by carefully opening the capsule and sprinkling the entire contents on a small amount of soft food such as applesauce or pudding. The mixture should be swallowed immediately (avoid chewing). Do not store for future use.
If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of Depakote at the same time.
Tell your doctor if you are breastfeeding or plan to breastfeed.
Depakote is excreted in human milk. Caution should be exercised when Depakote is given to a nursing mother.
Depakote is a prescription medication used to treat seizures, manic episodes for those with bipolar disorder, and to prevent migraine headaches.
This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.
Depakote may cause you to experience dizziness. Do not drive a car or operate machinery while taking Depakote. Alcohol can increase the drowsiness caused by Depakote.
Tell your doctor if you are taking any other medications or supplements. Be sure to tell you your doctor if you are pregnant, plan to become pregnant or are breast feeding.
It is also important to tell your doctor if you have plan to have any surgeries in the future.
Hepatotoxicity, including fatalities, usually during first 6 months of treatment. Children under the age of two years are at considerably higher risk of fatal hepatotoxicity. Monitor patients closely, and perform liver function tests prior to therapy and at frequent intervals thereafter Teratogenicity, including neural tube defects. Pancreatitis, including fatal hemorrhagic cases