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Generic name: Valproate (val pro ate)

Brand name: Depakote (dep a coat)

Other names: valproic acid, sodium valproate, divalproex sodium, Depakote Sprinkles, Depakene

 WHY is this drug prescribed?

WHEN should it be used?

HOW should it be used?

 What SPECIAL INSTRUCTIONS should I follow while using this drug?

 What SIDE EFFECTS can this medication cause? What can I do about them?

 What OTHER PRECAUTIONS should I follow while using this drug?
 
 

WHY is this drug prescribed? Valproate acts on the brain to decrease the risk of seizures. It works best at reducing the spread of seizures across the brain. It is used alone or with other drugs to control many types of seizures. It is also used to treat migraine headaches and chronic facial pain.

WHEN should it be used? Valproate usually is taken three to four times a day. Follow the instructions on your prescription label carefully, and ask your pharmacist or doctor to explain any part that you do not understand. Valproate (Depakote) can be taken before, during, or after meals although it is best taken with meals or on a very regular schedule. Valproic acid (Depakene) should always be taken with food.

HOW should it be used? Valproate comes in tablets and coated particles in capsules ("sprinkles"). Valproic acid (Depakene) comes in capsules and liquid. Depakene is not used as often as Depakote. Your prescription label tells you how much to take at each dose.

• Swallow the Depakene capsules whole. Do not break them or chew them. These capsules are designed to release the valproic acid slowly to avoid stomach upset or throat irritation.
• Depakote Sprinkles capsules can be swallowed whole or broken to release the sprinkles. The sprinkles can be mixed with soft food (such as applesauce or pudding). Swallow the mixture without chewing.
• Ask your pharmacist any questions you have about refilling your prescription. Various types of valproate have different effects. When you pick up a refill at your pharmacy, always look at the medication before leaving to be sure that is the same as the drug that you have been taking. Do not take the medication if it looks different; talk to your pharmacist. Different types of valproate may have the same amounts in each capsule but they may be absorbed by your body differently. Switching brands may results in slightly different blood levels of valproate.
• If you use the liquid form (Depakene), you may obtain a specially marked measuring spoon from your pharmacist to be sure of an accurate dose. A regular teaspoon holds about 5 cc (cubic centimeters) or 5 ml (milliliters) of fluid. A tablespoon holds three times as much or 15 ml.

What SPECIAL INSTRUCTIONS should I follow while using this drug?

• Valproate can cause dizziness, incoordination, blurred or double vision, or drowsiness. Do not drive a car, operate machinery, handle weapons, or do anything that requires alertness until you know how this drug affects you. Ask your physician when you can go back to driving.
• Keep all appointments with your doctor so that your doctor can monitor your response to this medication. Your dose may need to be adjusted frequently, especially when you first take valproate.
• Take valproate exactly as your doctor has directed. Do not take more or less of it or take it more or less often than as instructed. If you experience difficulties with side effects, call your doctor before you change the dose.
• Do not stop taking this drug without consulting your doctor. Stopping the drug abruptly can cause seizures. Your doctor probably will want to decrease your dose gradually.
• Contact your doctor if you continue to have seizures or convulsions while taking this medication. If you get frequent seizures, it is often helpful to keep a log or a diary to track your seizures.
• Be sure that you have enough medication on hand at all times. Plan ahead when getting refills to avoid running out.
• If you give this drug to a child, observe and keep a record of the child's moods, behavior, attention span, hand-eye coordination, and ability to solve problems and perform tasks requiring thought. This information can help the doctor determine whether to continue the drug or to change the dose.
• If you become pregnant while taking valproate, you should contact your doctor promptly to discuss whether or not to stop taking the medication. See Side Effects below.

What SIDE EFFECTS can this medication cause? What can I do about them?

• Weight gain, increased appetite - Discuss diets and dietary counseling with your physicians.
• Temporary hair loss - This may resolve without changes in 3 to 4 months. Call your doctor if this becomes a severe problem or persists beyond 4 months.
• Nausea, vomiting, stomach upset
• Tremor, unwanted hand, arm, or leg movement - Inform your doctor at the next opportunity.
• Skin rashes, bruising, frequent or severe infections, yellowing of the skin, stomach pain - Call your doctor immediately.
• Anemia, low white blood cell count, blood clotting problems, liver damage, damage to the pancreas - Your doctor will check your blood periodically to look for these conditions.
• Before using valproate, a woman who can become pregnant should consider the fact that valproate has been associated with birth defects, in particular, with spina bifida and other defects related to failure of the spinal canal to close normally. The incidence of these birth defects was 1 to 2% in women with epilepsy taking valproate in the first 12 weeks of pregnancy. Women with epilepsy may have a slightly higher risk of having children with birth defects compared to the general population even if they are not taking seizure medications. The incidence of such birth defects in the general population is 0.1 to 0.2%. Usually the risks of harm due to seizures outweigh the chances of birth defects so it is best to continue the medication if you have epilepsy - discuss these risks in detail with your doctor. In some patients, the risk of birth defects can be decreased by taking vitamins - ask your doctor about whether or not you should be taking vitamin supplements.

What OTHER PRECAUTIONS should I follow while using this drug?

• Before you take valproate, tell your doctor if you are pregnant (or even if you think you could become pregnant), breast-feeding, if you have kidney or liver disease.
• Valproate can affect the action of other drugs, and many drugs can affect the action of valproate. Before you take this drug, tell your doctor what prescription and non-prescription drugs you are taking, especially other seizure medications, anticoagulants ("blood thinners"), medication for depression, chloramphenicol, doxycycline, and birth-control pills.
• Valproate does not appear to change the effectiveness of birth-control pills. However, your blood may need to be monitored when starting or stopping birth-control pills. Ask your doctor for details.
• Use caution when drinking alcohol; these substances can add to the drowsiness from valproate. Alcohol can also cause severe liver damage.
• Keep this medication in the container it came in, tightly closed, and out of the reach of children. Store at room temperature.

This information is intended as an educational aid. It does not cover all possible actions, precautions, side effects, or interactions of this medication. It is not intended as medical advice for individual problems. Please contact your physician if you have further questions.