$Unique_ID{BRK03373} $Pretitle{} $Title{valproic acid} $Subject{Depakene Abbott Depakote Myproic acid My-K Labs Divalproex sodium valproic Anticonvulsant seizure disorders gamma-aminobutyric brain} $Volume{} $Log{} Copyright (C) 1993 Publications International, Ltd. valproic acid ------------------------------------------------------------------------------ BRAND NAMES (Manufacturers) Depakene (Abbott) Depakote [*] (Abbott) Myproic acid (My-K Labs) valproic acid (various manufacturers) * Note: Divalproex sodium, sold under the brand name Depakote, is chemically and therapeutically similar to valproic acid. It has been formulated as an enteric-coated tablet in order to prolong its effects and to decrease stomach irritation. TYPE OF DRUG Anticonvulsant INGREDIENT valproic acid DOSAGE FORMS Capsules (250 mg) Enteric-coated tablets (125 mg, 250 mg, and 500 mg) Oral syrup (250 mg per 5-ml spoonful) Sprinkle capsule (125 mg) STORAGE Valproic acid should be stored at room temperature in tightly closed containers. This medication should never be frozen. USES Valproic acid is used to treat various seizure disorders. It prevents seizures or convulsions by increasing concentrations of a certain chemical (gamma-aminobutyric acid) in the brain. TREATMENT In order to avoid stomach irritation, you should take valproic acid with food or milk (unless your doctor directs you to do otherwise). The capsules or enteric-coated tablets should be swallowed whole. Chewing or opening the capsules before swallowing releases their contents, which may cause irritation of the mouth and throat. Each dose of valproic acid oral syrup should be measured carefully with a specially designed 5-ml measuring spoon. An ordinary kitchen teaspoon is not accurate enough to ensure that you receive the proper dose. Only the specially designed sprinkle capsules should be opened before swallowing. The entire content of the sprinkle capsule should be placed on a teaspoonful of applesauce or pudding and swallowed immediately. Do not chew the food-drug mixture. Valproic acid works best when the level of medication in the bloodstream is kept constant. It is best, therefore, to take the doses at evenly spaced intervals day and night. For example, if you are to take four doses a day, the doses should be spaced six hours apart. It is important to try not to miss any doses of this medication. If you do miss a dose and remember within six hours, take the missed dose immediately. If more than six hours has passed, do not take the missed dose at all; just return to your regular dosing schedule. Do not double the next dose of this medication. If you miss two or more consecutive doses of valproic acid, contact your doctor as soon as possible for further instructions. SIDE EFFECTS Minor. Constipation, diarrhea, dizziness, drowsiness, hair loss, headache, increased or decreased appetite, insomnia, nausea, stomach upset, vomiting, or weight gain or loss. These side effects should disappear as your body adjusts to the medication. To relieve constipation, increase the amount of fiber in your diet (fresh fruits and vegetables, salads, bran, and whole-grain breads), exercise, and drink more water (unless your doctor directs you to do otherwise). If you feel dizzy, sit or lie down for a while; get up slowly from a sitting or reclining position, and be careful on stairs. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about blurred vision, cramps, depression, facial edema (swelling), loss of coordination, menstrual disorders, mental disorders, skin rash, tremors, unusual bleeding or bruising, weakness, or yellowing of the eyes or skin. INTERACTIONS Valproic acid interacts with several other types of drugs: 1. Concurrent use of it with other central nervous system depressants (drugs that slow the activity of the brain and spinal cord), such as alcohol, antihistamines, barbiturates, muscle relaxants, narcotics, pain medications, phenothiazine tranquilizers, and sleeping medications, or with tricyclic antidepressants can lead to drowsiness. 2. Valproic acid can lead to bleeding complications when combined with oral anticoagulants (blood thinners, such as warfarin), aspirin, dipyridamole, or sulfinpyrazone. 3. Valproic acid can increase the blood levels and side effects of phenobarbital and primidone. 4. The combination of valproic acid and clonazepam or phenytoin can lead to an increase in seizure activity. 5. Aspirin may interfere with the metabolism of valproic acid, which may result in increased toxicity and increased side effects. Before beginning treatment with valproic acid, BE SURE TO TELL YOUR DOCTOR about any medications that you are currently taking, especially any of those medications listed above. WARNINGS * Tell your doctor about unusual or allergic reactions you have had to any medications, especially to valproic acid, sodium valproate, or divalproex sodium. * Be sure to tell your doctor if you now have or if you have ever had blood disorders, kidney disease, or liver disease. * If this drug makes you dizzy or drowsy, do not take part in any activity that requires alertness, such as driving a car or operating potentially dangerous machinery. * Before having surgery or any other medical or dental treatment, be sure to tell your doctor or dentist that you are taking this medication. * Do not stop taking this medication unless you first check with your doctor. Stopping the drug abruptly may lead to a worsening of your condition. Your doctor may want to reduce your dosage gradually or start you on another medication when valproic acid is discontinued. Make sure you have enough medication on hand to last through weekends, holidays, and vacations. * Diabetic patients should know that valproic acid can interfere with urine tests for ketones. You should, therefore, check with your doctor before adjusting your insulin dose to determine if changes are necessary. * Be sure to tell your doctor if you are pregnant. Valproic acid has been shown to cause birth defects in the offspring of animals that received large doses of the drug during pregnancy. It has also been associated with spinal cord birth defects in humans when used during the first three months of pregnancy. The risks and benefits of treatment should be discussed with your doctor. Also, tell your doctor if you are breast-feeding an infant. Small amounts of valproic acid pass into breast milk. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.