$Unique_ID{BRK02178}
$Pretitle{}
$Title{VALPROIC ACID}
$Subject{Depakene (Abbott)
Depakote (Abbott)
Myproic acid (My-K Labs)
valproic acid (various manufacturers)}
$Volume{}
$Log{}

Copyright (C) 1991 Publications International, Ltd.


VALPROIC ACID
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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)
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.
     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 extreme 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.
     BE SURE TO TELL YOUR DOCTOR about any medications you are currently
taking, especially any 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.
     * Before starting to take this medication, 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.

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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.
