VALPROIC ACID

• Liver problems during the first 6 months of starting treatment. Take laboratory test before, and during treatment to monitor this side effect.
• Pancreatitis.
• Symptoms of liver and pancreatitis: unusual tiredness, weakness, swelling of the face, stomach/abdominal pain, loss of appetite, dark urine, yellowing eyes/skin, or persistent nausea/vomiting.
• Birth defects, lower child’s IQ when taking this medication during pregnancy.

• diarrhea
• dizziness
• drowsiness
• hair loss
• blurred/double vision
• change in menstrual periods
• ringing in the ears
• shakiness (tremor)
• unsteadiness
• weight changes
• signs of infection (e.g., fever, persistent sore throat, swollen lymph nodes), chest pain, easy bruising/unexplained bleeding, fast/slow/irregular heartbeat, swelling of hands/feet, uncontrolled eye movement (nystagmus), feeling cold/shivering, rapid breathing, loss of consciousness.
• depression, suicidal thoughts/attempts, or other mental/mood problems. Tell your doctor right away if you or your family/caregiver notice any unusual/sudden changes in your mood, thoughts, or behavior including signs of depression, suicidal thoughts/attempts, thoughts about harming yourself.
• severe brain disorder (encephalopathy): unexplained weakness, vomiting, or sudden mental/mood changes (such as confusion).
• serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Precautions

Inform your doctor of your medical history especially of: liver disease, pancreatitis, certain metabolic disorders (such as urea cycle disorders, Alpers-Huttenlocher syndrome), alcohol abuse, bleeding problems, brain disease (dementia), kidney disease, low body water (dehydration), poor nutrition.

Avoid performing activities that require alertness or clear vision such as driving, using machinery because this drug may cause drowsiness, dizziness, unsteadiness, or tremor. Drowsiness, dizziness, unsteadiness can increase the risk of falling.

Not recommended to use by pregnant and breastfeeding women.

Interactions

• Certain antidepressants (e.g., amitriptyline, nortriptyline, phenelzine), certain benzodiazepines (e.g., clonazepam, diazepam), certain antibiotics (carbapenems such as doripenem, imipenem), guanfacine, mefloquine, other medications for seizure (e.g., carbamazepine, ethosuximide, felbamate, lamotrigine, phenobarbital, phenytoin, rufinamide, topiramate), rifampin, vorinostat, warfarin, zidovudine.
• Low-dose aspirin, as prescribed by your doctor for specific medical reasons such as heart attack or stroke prevention (usually these dosages are 81-325 milligrams per day), should be continued.
• Drowsiness including alcohol, antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), and narcotic pain relievers (such as codeine, hydrocodone).

Overdose

Symptoms of overdose may include: excessive drowsiness, coma, irregular/slow heartbeat.

Missed Dose: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage: Store away from direct light and moisture. Discard properly, do not flush down the toilet.

Brands

Available Brands

• Depacon [ Abbott ]
• Depakene [ Abbott ]
• Valparin-200 [ Torrent ]

Also marketed as

• Aleptiz [ Apotex ]