Neither should anyone who has shown an allergy to Depakote in the past. Make sure the doctor knows about any liver problems, so a different medicine can be prescribed instead. Sometimes one kind of medicine changes the way another kind of medicine works in the body.
This is true not only for prescription medicines, but also for medicines you just pick up off the shelf at the store. For instance, aspirin ASA may increase the side effects from taking Depakote. If someone who is taking Depakote-especially a child-also starts to take the seizure medicine called Lamictal, the chances of a very dangerous rash will be increased. Adding the Lamictal slowly reduces this danger. Taking both Depakote and another seizure medicine, Klonopin, sometimes causes absence seizures to be much longer.
Any time a doctor suggests a new prescription, be sure to talk about what other medicines you are already using. If two kinds of medicine affect each other, the doctor may want to prescribe something else or change the amount to be taken. If a person taking one of these medicines starts taking Depakote, the first medicine will stay in the body longer. If the person keeps taking the same amount as before, soon there will be too much of it.
This may cause side effects like extreme tiredness and slurred speech. The person might seem to be drunk. A similar thing could happen with several other seizure medicines, but the effects for people taking these would probably not be too noticeable:.
All of these effects mean that if a person taking another seizure medicine starts taking Depakote too, the amount of the first medicine may need to be changed. Or if a person has been taking Depakote along with another seizure medicine, stopping either one of them means that the amount of the other one probably will have to be changed. Some other medicines do affect the way Depakote works in the body.
Make sure that the doctor is aware of all the medicines being used. Children under 2 or 3 years of age who take Depakote have a much higher risk of liver failure than adults or older children. The risk is very low for children over 10, perhaps 1 in 50, The risk is even higher for very young children who also take other seizure medicines, and it's highest of all for those with certain other serious disorders.
Usually the doctor will not prescribe Depakote for children at very high risk. Liver damage usually occurs within the first 6 months of treatment. The first signs of it are vomiting, loss of appetite, sluggishness, and perhaps loss of seizure control, yellow skin and eyes, or swelling. Higher-than-usual levels of the hormone testosterone have been found in many girls who take Depakote when they're older than about age No symptoms are apparent, but the doctor may want to watch for later problems, perhaps related to weight gain.
A few children who take Depakote seem to become more irritable but this is seldom a serious problem. To reduce side effects, the doctor probably will prescribe a low dose of Depakote to start and increase it slowly. Children usually start with a dose of 5 to 10 milligrams mg for each kilogram kg, about 2. This is usually given in two to four equal doses per day. Children taking a combination of Depakote and another seizure medicine usually need the higher doses because of interactions between the medicines.
The sprinkle capsule is an easy way to give Depakote to small children who cannot swallow tablets. The child's body absorbs the same amount of medicine, but it happens a bit more quickly than with the tablets.
Depakote is listed in Pregnancy Category D. This means that there is a risk to the baby, but the benefits may outweigh the risk for some women. In fact, a large majority of women who use Depakote during pregnancy have normal, healthy babies. Certain types of defects are increased especially if Depakote is taken during the first 3 months of pregnancy but they are still relatively uncommon. The risk of defects is higher for women who take more than one seizure medicine.
Women with a family history of birth defects also have a higher risk. The babies of women taking valproic acid have a greater than usual number of minor craniofacial abnormalities, organ malformations, limb deficiencies, or developmental delay. The risk of defects is higher for women who take more than one AED and for women with a family history of birth defects.
Moreover the NEAD study showed that children born to women who took Valproic acid, had lower IQ scores than children born to women with epilepsy who tool other seizure medications. Women with epilepsy who are pregnant or thinking about becoming pregnant should talk to their doctor about their seizure medicines. Taking more than one seizure medicine may increase the risk of birth defects, so doctors sometimes gradually reduce the number or amount of seizure medicines taken by women planning for pregnancy.
This is not done routinely, however, because it increases the risk of seizures. All women who are capable of becoming pregnant should take at least mcg 0. The most well-known of these is spina bifida, in which the spinal cord is not completely enclosed.
These defects are more common in the babies of women who take Depakote during the first 4 to 6 weeks of pregnancy. If the doctor thinks a woman is at especially high risk, a much larger dose of folic acid— mcg 4 mg per day—may be recommended. There's no proof that the folic acid will prevent the defects, however, so the doctor may recommend a check-up later in pregnancy. It is helpful for the doctor to check the levels of medicine in the blood regularly during pregnancy so that the dosage can be adjusted if necessary.
Breast-feeding by mothers taking Depakote should be safe for healthy, full-term newborns. The amount of medicine the baby gets through the milk is much less than the amount that doctors safely give to babies who take Depakote for seizures.
A recent large study has found that children who took this drug during pregnancy had children with lowered IQ and a risk of autism. If you are a woman on this drug and considering pregnancy, please talk to your doctor. Doctors have prescribed Depakote to people over 65 for many years with good results. These seniors do have a few special problems, however.
Usually seniors can continue to take all the medicines they need, including Depakote, without trouble if the doctor changes the amount of some of them to make up for the way they affect each other. Seniors also tend to be more sensitive than younger adults to medicines and their side effects. For instance, many seniors have a problem with sleepiness, depression, weight gain, or shaking of the hands even before they start taking Depakote.
Drug information provided by: IBM Micromedex. Divalproex sodium is used to treat certain types of seizures epilepsy. This medicine is an anticonvulsant that works in the brain tissue to stop seizures. Divalproex sodium is also used to treat the manic phase of bipolar disorder manic-depressive illness and helps prevent migraine headaches. In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do.
This is a decision you and your doctor will make. For this medicine, the following should be considered:. Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals.
For non-prescription products, read the label or package ingredients carefully. Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of divalproex sodium in children. However, safety and efficacy have not been established for other indications in children, and to treat seizures in children younger than 10 years of age.
Because of divalproex sodium's toxicity, use in children younger than 2 years of age requires extreme caution. Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of divalproex sodium in the elderly. However, elderly patients are more likely to have unwanted effects eg, tremors or unusual drowsiness , which may require an adjustment in the dose for patients receiving divalproex sodium.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary.
When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur.
Taking felbamate with divalproex sodium may increase the level of divalproex sodium in your body and increase your risk of side effects. If you take felbamate with divalproex sodium, your doctor may adjust your dosage of divalproex sodium. Taking topiramate with divalproex sodium may increase your risk of high ammonia levels in your blood, or low body temperature hypothermia. Taking aspirin with divalproex sodium may increase the level of divalproex sodium in your body and increase your risk of side effects.
If you take aspirin with divalproex sodium, your doctor may adjust your dosage of divalproex sodium. Taking warfarin with divalproex sodium may increase the levels of warfarin in your body. Your doctor may monitor your INR more often if you need to take divalproex sodium together with warfarin. Taking these drugs with divalproex sodium may decrease the level of divalproex sodium in your body. This means that it may not work as well to treat your condition.
If you have to take a carbapenem antibiotic while taking divalproex sodium, your doctor will monitor your blood levels closely. Examples of these antibiotics include:. Taking zidovudine with divalproex sodium may increase the levels of zidovudine in your body. Your doctor may monitor you more closely for side effects. Taking some birth control medications with divalproex sodium can lower the amount of divalproex sodium in your body, making it less effective.
If you need to use hormonal contraception, such as the pill, your doctor will likely monitor the amount of divalproex sodium in your body. Taking certain mood disorder and seizure drugs with divalproex sodium may increase the levels of these drugs in your body. Your doctor may adjust your dosage of these medications or monitor you more closely for side effects. Examples of these drugs include:. Taking other mood disorder and seizure drugs with divalproex sodium may decrease the level of divalproex sodium in your body.
Your doctor may adjust your dosage of divalproex sodium. Taking rifampin with divalproex sodium may decrease the level of divalproex sodium in your body. If you take these drugs together, your doctor may adjust your dosage of divalproex sodium. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
If you develop these symptoms, call or your local emergency services or go to the nearest emergency room. Taking it again could be fatal cause death. Divalproex sodium can cause drowsiness and dizziness. For people with liver disease: If you have a history of liver disease, you may have a higher risk of liver failure within the first six months of treatment with this drug. Your doctor will monitor you for signs of liver damage.
For people with mitochondrial disease: If you have Alpers-Huttenlocher syndrome or have a family history of this metabolic disorder, you may have a higher risk of liver failure when taking divalproex sodium. It may raise your risk of hyperammonemia high ammonia levels in your blood. This condition can be fatal. For pregnant women: This drug may cause serious harm to your pregnancy.
If you take this drug during pregnancy, your baby is at risk for serious birth defects. These include birth defects that affect the brain, spinal cord, heart, head, arms, legs, and the opening where urine comes out. This drug may also cause decreased IQ and thinking, learning, and emotional disorders in your baby.
According to published case reports, fatal liver failure has also been observed in the children of women who used this drug while pregnant. If you become pregnant while taking this drug, talk to your doctor about registering with the North American Antiepileptic Drug Pregnancy Registry. Check the manufacturer's leaflet in your pack of medicine. Each time you collect a new supply of medication, make sure that they look the same as you have had before.
Divalproex sodium is a mixture of two similar ingredients - valproic acid and sodium valproate. It is an anticonvulsant medicine used to treat bipolar disorder , epilepsy and seizures , and to prevent migraine headaches.
A seizure is a short episode of symptoms which is caused by a burst of abnormal electrical activity in the brain. Divalproex sodium works by reducing these abnormal electrical activities. Bipolar disorder is a long-term condition where you have lows periods of depression and highs periods of mania or hypomania. Divalproex sodium is prescribed as a mood stabilizer in bipolar disorder. It helps keep your mood within normal limits by helping to control the episodes of mania.
For people with migraine headaches, divalproex sodium can be used to help prevent you having a migraine attack. It does not help to relieve a migraine if one happens.
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking divalproex sodium it is important that your physician knows:. Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them.
The table below contains some of the most common ones associated with divalproex sodium.
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