Depakote

By Medically reviewed by hellodoktor

Generic Name: Depakote Brand Name(s): Generics only. No brands available.

Uses

What is Depakote® (divalproex sodium) used for?

Depakote® affects chemicals in the body that may be involved in causing seizures.

Depakote® is used to treat various types of seizure disorders. It is sometimes used together with other seizure medications.

Depakote® is also used to treat manic episodes related to bipolar disorder (manic depression), and to prevent migraine headaches.

Depakote® may also be used for purposes not listed in this medication guide.

How should I take Depakote® (divalproex sodium)?

Take Depakote® exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Drink plenty of water while you are taking this medication. Your dose may need to be changed if you do not get enough fluids each day.

You may open the Depakote® sprinkle capsule and sprinkle the medicine into a spoonful of pudding or applesauce to make swallowing easier. Swallow this mixture right away.

Do not crush, chew, break, or open a delayed-release or extended-release tablet or capsule. Swallow it whole.

While using Depakote®, you may need frequent blood tests.

If you need surgery, tell the surgeon ahead of time that you are using Depakote®.

Do not stop using Depakote® suddenly, even if you feel fine. Stopping suddenly may cause a serious, life-threatening type of seizure. Follow your doctor’s instructions about tapering your dose.

How do I store Depakote® (divalproex sodium)?

Depakote® is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Depakote® in the bathroom or the freezer. There may be different brands of Depakote® that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Depakote® down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Depakote® (divalproex sodium)?

Before using this drug, tell your doctor if:

  • You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
  • You are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • You have allergy with any of active or inactive ingredients of Depakote® or other medications.
  • You have any other illnesses, disorders, or medical conditions.

You should not use Depakote® if you have:

  • Liver disease
  • A urea cycle disorder
  • A genetic mitochondrial disorder such as Alpers’ disease or Alpers-Huttenlocher syndrome, especially in a child younger than 2years old

Depakote® can cause liver failure that may be fatal, especially in children under age 2 and in people with liver problems caused by a genetic mitochondrial disorder.

Some young people have thoughts about suicide when first taking Depakote®. Your doctor will need to check your progress at regular visits while you are using this medicine. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Do not use Depakote® to prevent migraine headaches if you are pregnant.

If you take Depakote® for seizures or manic episodes, this medicine can harm an unborn baby or cause birth defects, and may affect cognitive ability (reasoning, intelligence, problem-solving) later in the child’s life. However, having a seizure during pregnancy could harm both the mother and the baby. Do not start or stop taking the medicine during pregnancy without your doctor’s advice.

Use effective birth control while using Depakote®, and tell your doctor right away if you become pregnant.

Tell your doctor if you start or stop using hormonal contraception that contains estrogen (birth control pills, injections, implants, skin patches, and vaginal rings). Estrogen can interact with divalproex sodium and make it less effective in preventing seizures.

Seizure control is very important during pregnancy. The benefit of preventing seizures may outweigh any risks posed by taking Depakote®. There may be other seizure medications that can be more safely used during pregnancy. Follow your doctor’s instructions about taking this medicine while you are pregnant.

Divalproex sodium can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breastfeeding a baby.

Is it safe during pregnancy or breastfeeding?

There isn’t enough information about the safety of using Depakote® during pregnancy and breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Depakote®.

Side effects

What side effects can occur from Depakote® (divalproex sodium)?

Common side effects may include:

  • Mild nausea or vomiting
  • Mild stomach pain
  • Diarrhea
  • Headache
  • Mild dizziness
  • Weakness
  • Tremors
  • Problems with balance or walking
  • Blurred vision, double vision
  • Changes in appetite
  • Weight gain

Call your doctor at once if you have any of these other side effects:

  • Confusion, tiredness, cold feeling, vomiting, change in your mental state
  • Easy bruising, unusual bleeding (nose, mouth, or gums), purple or red pinpoint spots under your skin
  • Severe drowsiness
  • Worsening seizures
  • Signs of inflammation in your body – swollen glands, flu symptoms, severe tingling or numbness, muscle weakness, chest pain, new or worsening cough with fever, trouble breathing
  • Severe skin reaction – fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling

Get emergency medical help if you have any of these signs of an allergic reaction: to Depakote hives; fever, swollen glands, mouth sores, difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if the person taking this medicine has early signs of liver or pancreas problems, such as loss of appetite, upper stomach pain (that may spread to your back), ongoing nausea or vomiting, dark urine, swelling in the face, or jaundice (yellowing of the skin or eyes).

Report any new or worsening symptoms to your doctor, such as mood or behavior changes, depression, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Depakote® (divalproex sodium)?

Depakote® may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Depakote® (divalproex sodium)?

Depakote® may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Depakote® (divalproex sodium)?

Depakote® may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Health conditions that may interact with this drug are:

  • Liver problems caused by a genetic mitochondrial disorder
  • A history of depression, mental illness, or suicidal thoughts or actions
  • A family history of a urea cycle disorder or infant deaths with unknown cause
  • HIV or CMV (cytomegalovirus) infection

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using Depakote® (divalproex sodium).

What is the dose of Depakote® (divalproex sodium) for an adult?

Mania

Depakote tablets are administered orally. The recommended initial dose is 750 mg daily in divided doses. The dose should be increased as rapidly as possible to achieve the lowest therapeutic dose which produces the desired clinical effect or the desired range of plasma concentrations.

In placebo-controlled clinical trials of acute mania, patients were dosed to a clinical response with a trough plasma concentration between 50 and 125 mcg/mL.

Maximum concentrations were generally achieved within 14 days. The maximum recommended dosage is 60 mg/kg/day.

Complex Partial Seizures

For adults and children 10 years of age or older.

Monotherapy (Initial Therapy)

  • Depakote® has not been systematically studied as initial therapy. Patients should initiate therapy at 10 to 15 mg/kg/day.
  • The dosage should be increased by 5 to 10 mg/kg/week to achieve optimal clinical response.
  • Ordinarily, optimal clinical response is achieved at daily doses below 60 mg/kg/day.
  • If satisfactory clinical response has not been achieved, plasma levels should be measured to determine whether or not they are in the usually accepted therapeutic range (50 to 100 mcg/mL).
  • No recommendation regarding the safety of valproate for use at doses above 60 mg/kg/day can be made.

Conversion to Monotherapy

  • Patients should initiate therapy at 10 to 15 mg/kg/day.
  • The dosage should be increased by 5 to 10 mg/kg/week to achieve optimal clinical response.
  • Ordinarily, optimal clinical response is achieved at daily doses below 60 mg/kg/day.
  • If satisfactory clinical response has not been achieved, plasma levels should be measured to determine whether or not they are in the usually accepted therapeutic range (50-100 mcg/mL).
  • No recommendation regarding the safety of valproate for use at doses above 60 mg/kg/day can be made.
  • Concomitant antiepilepsy drug (AED) dosage can ordinarily be reduced by approximately 25% every 2 weeks.
  • This reduction may be started at initiation of Depakote® therapy, or delayed by 1 to 2 weeks if there is a concern that seizures are likely to occur with a reduction.
  • The speed and duration of withdrawal of the concomitant AED can be highly variable, and patients should be monitored closely during this period for increased seizure frequency.

Adjunctive Therapy

  • Depakote may be added to the patient’s regimen at a dosage of 10 to 15 mg/kg/day.
  • The dosage may be increased by 5 to 10 mg/kg/week to achieve optimal clinical response.
  • Ordinarily, optimal clinical response is achieved at daily doses below 60 mg/kg/day.
  • If satisfactory clinical response has not been achieved, plasma levels should be measured to determine whether or not they are in the usually accepted therapeutic range (50 to 100 mcg/mL).
  • No recommendation regarding the safety of valproate for use at doses above 60 mg/kg/day can be made. If the total daily dose exceeds 250 mg, it should be given in divided doses.

Simple and Complex Absence Seizures

The recommended initial dose is 15 mg/kg/day, increasing at one week intervals by 5 to 10 mg/kg/day until seizures are controlled or side effects preclude further increases.

The maximum recommended dosage is 60 mg/kg/day.

If the total daily dose exceeds 250 mg, it should be given in divided doses.

Migraine

Depakote® is indicated for prophylaxis of migraine headaches in adults.

Depakote tablets are administered orally. The recommended starting dose is 250 mg twice daily. Some patients may benefit from doses up to 1,000 mg/day. In the clinical trials, there was no evidence that higher doses led to greater efficacy.

What is the dose of Depakote® (divalproex sodium) for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Depakote® (divalproex sodium) available?

Depakote® is available in the following dosage forms and strengths:

  • Tablet, delayed release divalproex sodium 125mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room

What should I do if I miss a dose?

If you miss a dose of Depakote®, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

msBahasa Malaysia

Review Date: July 14, 2017 | Last Modified: September 13, 2019

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