Depakote (Valproate)
Class and Category of Drug
Before you buy Depakote (Valproate) online, read common information about the medication.
Chemical class: Carboxylic acid derivative
Therapeutic class: Anticonvulsant
Pregnancy category: D
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Drug Indications and Dosages
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To treat simple or complex absence seizures, complex partial seizures, myoclonic seizures, and generalized tonic-clonic seizures as monotherapy
Capsules, Delayed-Release Sprinkle Capsules, Delayed-Release Tablets, Syrup, Intravenous Infusion (Valproic Acid, Valproate Sodium , Divalproex Sodium )
Adults and adolescents. Initial: 10 to 15 mg/kg/day in divided doses b.i.d. or t.i.d., increased by 5 to 10 mg/kg daily every wk, as needed and as prescribed. Maximum: 60 mg/kg daily.
Children. Initial: 15 to 45 mg/kg daily in divided doses b.i.d. or t.i.d., increased by 5 to 10 mg/kg/day every wk, as needed and as prescribed.
As adjunct to treat simple or complex absence seizures, complex partial seizures, myoclonic seizures, and generalized tonic-clonic seizures
Capsules, Delayed-Release Sprinkle Capsules, Delayed-Release Tablets, Syrup, Intravenous Infusion (Valproic Acid, Valproate Sodium , Divalproex Sodium )
Adults and adolescents. 10 to 30 mg/kg/day in divided doses, increased by 5 to 10 mg/ kg/day every wk, as needed and as prescribed. Children. 30 to 100 mg/kg daily in divided doses, as prescribed.
Dosage Adjustment
For adults being converted from immediate-release divalproex tablets to delayed-release tablets, dosage increased to 8% to 20% more than total daily dose of immediate-release tablets and given once daily.
To treat acute manic phase of bipolar disorder
Delayed-Release Tablets (Divalproex Sodium ), Delayed-Release Capsules (Stavzor)
Adults. Initial: 750 mg daily in divided doses. Maximum: 60 mg/kg daily.
To prevent migraine headache
Tablets, Tablets (Divalproex Sodium ), Delayed-Release Capsules (Stavzor)
Adults. 250 mg every 12 hr, increased p.r.n. Maximum: 1 g daily.
Delayed-Release Tablets (Divalproex Sodium )
Adults. 500 mg daily, increased, as needed and prescribed, up to 1 g daily. Maximum: 1 g daily.
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Contraindications of Drug
Read contraindications if you want cheap Depakote (Valproate) online.
Hepatic dysfunction; hypersensitivity to valproic acid, valproate sodium, divalproex sodium, or their components; urea cycle disorders
Generic Drug Interactions
Drugs
aspirin, heparin, nonsteroidal anti-inflammatory drugs (NSAIDs), oral anticoagulants, thrombolytics: Increased inhibition of platelet aggregation and risk of bleeding
barbiturates, primidone: Increased blood levels of both drugs, additive CNS effects carbamazepine: Possibly decreased valproic acid effectiveness
carbapenem antibiotics (ertapenem, imipenem, meropenem): Reduced serum valproic acid level, causing loss of seizure control
cholestyramine: Decreased bioavailability of valproic acid
clonazepam: Increased risk of absence seizures
CNS depressants: Increased CNS depression
diazepam: Inhibited diazepam metabolism ethosuximide: Unpredictable blood ethosuximide level
felbamate: Impaired valproic acid metabolism and increased blood drug level haloperidol, loxapine, MAO inhibitors, maprotiline, phenothiazines, thioxanthenes, tricyclic antidepressants: Increased CNS depression, lowered seizure threshold lamotrigine: Decreased lamotrigine clearance
mefloquine: Decreased blood levels of valproic acid, divalproex, and valproate sodium; increased risk of seizures
phenytoin: Increased risk of phenytoin toxicity, loss of seizure control
Activities
alcohol use: Additive CNS depression
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Drugs Adverse Reactions
Central Nervous System: Agitation, ataxia, confusion, depression, dizziness, drowsiness, euphoria, hallucinations, headache, hyperesthesia, hypothermia, lack of coordination, lethargy, loss of seizure control, paresthesia, psychosis, sedation, suicidal ideation, tremor, vertigo, weakness
Eyes, Ears, Nose, And Throat: Diplopia, nystagmus, pharyngitis, spots before eyes
Endocrine: Galactorrhea, hyperglycemia
Gastrointestinal: Abdominal pain, anorexia, constipation, diarrhea, elevated liver function test results, hepatotoxicity, increased appetite, indigestion, nausea, pancreatitis, vomiting
Genitourinary: Menstrual irregularities
Hematologic: Eosinophilia, hematoma, leukope-nia, prolonged bleeding time, thrombocy-topenia
Musculoskeletal: Dysarthria
Skin: Alopecia, diaphoresis, erythema multiforme, jaundice, petechiae, photosensitivity, pruritus, rash, Stevens-Johnson syndrome
Other: Facial edema, hyperammonemia, injection site pain, weight gain or loss
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Nursing Considerations for Generic Drugs
Give oral valproic acid or divalproex with food to minimize gastrointestinal irritation, if needed.
Administer drug at least 2 hours before or 6 hours after cholestyramine.
Don't mix syrup with carbonated beverages; result ay be an unpleasant-tasting mixture and irritate mouth and throat.
Don't break or let patient chew delayed-release tablets.
As needed, sprinkle contents of delayed-release sprinkle capsules on small amount of semisolid food just before administration. Instruct patient not to chew contents of delayed-release sprinkle capsules.
For intravenous administration, dilute prescribed dose with at least 50 ml compatible diluent and infuse over 60 minutes.
Patient should be switched from intravenous to P.O. form of valproic acid as soon as possible.
Patient with hypoalbuminemia or another protein-binding deficiency is at increased risk for valproic acid toxicity.
Watch for evidence of decreased hepatic function, including anorexia, facial edema, jaundice, lethargy, loss of seizure control, malaise, vomiting, and weakness.
Monitor liver function test results, as ordered. Assess for signs and symptoms of hepatotoxicity during first 6 months of treatment, especially in children under age 2. Notify prescriber immediately if you suspect hepatotoxicity.
Monitor platelet count, as ordered, for signs of thrombocytopenia, and notify prescriber if they appear.
WARNING Hyperammonemia may occur even if liver function test results are normal. Monitor ammonia levels, as ordered. If patient develops unexplained lethargy, vomiting, or changes in mental status with an increase in ammonia level; if asymptomatic ammonia elevations are detected and persist; or if patient develops hypothermia even without hyperammonemia, expect to discontinue valproic acid.
Watch patient closely for suicidal tendencies, particularly when therapy starts and dosage changes, because depression may worsen temporarily during these times, possibly leading to suicidal ideation.
Monitor patient's drug level, as ordered, especially early in therapy and if patient takes other drugs because interactions can alter the blood level.
Drug may alter urine ketone test and thyroid function tests.
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Valproate
Preparations
International Brand Drug Names
The information about drugs (tablets, pills, capsules, creams, solution, nasal spray, inhaler) around the world.
British Pharmacopoeia, 2008 edition: Gastro-resistant Sodium Valproate Tablets; Sodium Valproate Oral Solution; Sodium Valproate Tablets;
The United States Pharmacopeia 31, 2008: Divalproex Sodium Delayed-Release Tablets; Valproate Sodium Injection; Valproic Acid Capsules; Valproic Acid Syrup.
Proprietary Preparations
Argentina: Depakene; Exibral; Logical; Tekaval; Valcote; Valnar;
Australia: Epilim; Valpro;
Austria: Convulex; Depakine; Depakine Chrono; Depakine Chronosphere; Epival;
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