Valproic Acid, Oral/Injection

What are other names for this medicine?

Type of medicine: antiseizure

Generic and brand names: divalproex sodium, oral; valproate sodium, oral; valproic acid, injection; valproic acid, oral; Depacon; Depakene Capsules; Depakene Syrup; Depakote; Depakote ER; Depakote Sprinkle; Myproic Acid

What is this medicine used for?

This medicine may be taken by mouth or given by injection to treat:

• seizures
• manic episodes (periods of excitement) in people with bipolar disorder.

It may be taken by mouth to help prevent migraine headaches. It may also be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• bleeding or blood-clotting disorders
• cytomegalovirus (CMV) infection
• HIV or AIDS
• liver or pancreas problems
• urea cycle disorder (too much ammonia in the blood)

You should not take this medicine if you have urea cycle disorder or liver disease.

Also tell your provider if you have recently had a head injury or brain surgery.

Females of childbearing age: This medicine is not usually given to pregnant women because it can harm the baby. If you are pregnant, tell your healthcare provider. Do not become pregnant during treatment with this medicine. If you become pregnant, contact your healthcare provider right away. Do not breast-feed while you are receiving this medicine.

How do I use it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes, along with any other medicine prescribed. Take it regularly to control your seizures.

Do not stop taking this medicine without your healthcare provider's approval. You may have to reduce your dosage gradually to avoid an increase in seizures.

This medicine may be given by IV infusion (through a needle into your vein) for a few days. Usually you are switched as soon as possible to capsules, tablets, a syrup, or sprinkles to be taken by mouth. Take the medicine with food to lessen the chance that the medicine will upset your stomach.

Swallow the tablets or capsules whole with a full glass (8 ounces) of water.

If your healthcare provider has prescribed sprinkle capsules, they may be swallowed whole, or they may be opened and the contents sprinkled on soft food (for example, applesauce or pudding) and swallowed without chewing.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: drowsiness, shallow breathing, fainting.

What should I watch out for?

You will need to have blood tests regularly to see how this medicine affects you. Your healthcare provider may need to adjust your dosage. Keep all appointments for these tests.

This medicine may cause liver damage. If while taking this medicine you develop weakness, tiredness, loss of appetite, vomiting, facial swelling, or yellowing of your skin or eyes, contact your healthcare provider right away.

This medicine can cause pancreatitis. If while taking this medicine you develop abdominal pain, nausea, or vomiting, contact your healthcare provider right away.

This medicine can cause birth defects. Make sure you understand what the risks and benefits of treatment are.

Antiseizure medicines may increase suicidal thoughts or actions in some people. Call your healthcare provider right away if you have new or increased thoughts of suicide.

This medicine may make you drowsy. Do not drive or operate machinery unless you are fully alert.

This medicine increases the effects of alcohol and other drugs that slow down your nervous system. Do not drink alcohol or take other medicines unless your healthcare provider approves.

This medicine may interfere with results of certain lab tests. Check with your healthcare provider if you have diabetes or thyroid problems.

If you need emergency care, lab work, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Serious (report these to your healthcare provider right away): Clumsiness, increased seizures, severe abdominal pain, nausea, vomiting, loss of appetite, facial swelling, weakness, yellowing of skin or eyes, unusual bruising or bleeding, severe tiredness, hallucinations (seeing or hearing things that are not there), double vision, dark urine, light colored bowel movements.

Other: Diarrhea, drowsiness, mild stomach upset, dizziness, trembling, fast heart rate, joint pain, hair loss, menstrual changes.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• alcohol
• alfuzosin (Uroxatral)
• antianxiety medicines such as diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin), lorazepam (Ativan), buspirone (BuSpar), and hydroxyzine (Atarax)
• antibiotics such as erythromycin (Erythrocin, E.E.S., EryPed), ertapenem (Invanz), imipenem (Primaxin), meropenem (Merrem), and rifampin (Rifadin, Rimactane)
• antidepressants such as amitriptyline and nortriptyline (Aventyl, Pamelor)
• antipsychotic medicines such as clozapine (Clozaril), chlorpromazine (Thorazine)
• antiseizure medicines such as carbamazepine (Carbatrol, Tegretol), ethosuximide (Zarontin), felbamate (Felbatol), lamotrigine (Lamictal), phenobarbital, phenytoin (Dilantin), topiramate (Topamax), and primidone (Mysoline)
• aspirin and other salicylates
• cholestyramine (Questran)
• cimetidine (Tagamet)
• herbal products such as St. John's wort, evening primrose oil, chaparral, comfrey, and coltsfoot
• isoniazid
• meropenem (Merrem)
• propoxyphene (Darvocet, Darvon)
• risperidone (Risperdal)
• sedatives such as flurazepam (Dalmane) and temazepam (Restoril)
• warfarin (Coumadin)

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicines in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.