Valproic acid or valproate is available in Canada only by prescription.

Known as

Epival (divalproex sodium), Depakene (valproic acid), Depakote (USA)

Uses

Valproate is commonly used in children with generalized seizures who are prone to absence seizures and tonic-clonic seizures. It is also used for a variety of other seizures, in both children and adults, including tonic-clonic, myoclonic, complex partial, photosensitive, and the seizures associated with Juveninle Myoclonic Epilepsy (JME), Lennox-Gastaut syndrome and Dravet syndrome.

Girls and Women 

Valproate can cause birth defects, a reduced IQ, autism and other effects on brain development in children exposed to this drug in utero during pregnancy. Valproate should be avoided whereever possible as the initial treatment in girls and women with epilepsy.

If valproate is being proposed as a treatment option for a girl or woman with childbearing potential there should be a full discussion of the risks and benefits so that the individual (or her parents if the individual is a child) is fully informed of the risks associated with valproate use during pregnancy.

Girls and women taking valproate should receive information about effective methods of birth control to avoid an unplanned pregnancy.

Women planning a pregnancy should review their treatment options with an epilepsy specialist before becoming pregnant and consider booking a pre-pregnancy consultation with an obstetrician. If an unplanned pregnancy occurs, continue to take your antiseizure medication as advised and book an appointment with your healthcare provider.

How to Use

Take your medication as prescribed at the same time daily. Take it with food to prevent stomach upset. Use a measuring spoon, available at your pharmacy, to pour syrup. Consult your doctor about discontinuing any medication.

Side Effects

• Common at the initiation of use are: indigestion, nausea, vomiting, drowsiness, diarrhea, constipation, abdominal cramps, weight loss/gain and hair loss.
• Others side effect may include depression, aggression, weakness in muscles and joints, jaundice, irregular menses, blurred vision and skin rash. Liver failure has occurred rarely in children under two years of age.
• Exposure to valproate during pregnancy is associated with an increased risk of fetal malformations and neurodevelopmental delay.

Precautions

Do not chew the capsules or tablets. If you have kidney, blood or liver disease, or are breastfeeding an infant, inform your doctor. Use of medication under these conditions could be fatal. Because of sedating effects, use caution when driving or operating hazardous machinery. Inform your doctor of any anti-epileptic or other medication you take. Some combinations could be fatal.

Interactions

• Valproic acid may increase the effects of benzodiazepines (Valium, Librium, Tranxene, Xanax) and warfarin.
• Acetylsalicylic acid (ASA) and other salicylates (Alka Seltzer, Pepto Bismol, Anacin), and erythromycin may increase the effects of valproic acid.
• Carbamazepine, phenobarbital, phenytoin, and primidone may decrease the effects of valproic acid.
• Taken with alcohol and phenobarbital, valproic acid may cause severe depression of the central nervous system.
• Mixtures of valproic sodium and barbiturates may cause poisoning.
• Use of this medication with clonazepam may cause absence seizures.
• Use with any anticoagulants may result in excessive bleeding.

Missed Dose

Take the next dose as soon as you remember. Then resume your regular medication schedule.

Storage

Store at room temperature between 15˚C and 30˚C, away from children, heat, light and moisture.

Forms

tablets, (125 mg, 250 mg and 500mg), capsules (250 mg, 500 mg), syrup (5 m, red)

Click here to learn more about medication.

DisclaimerExpand Disclaimer Section