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VALPROIC ACID (Systemic)
Some commonly used brand names are:
In the U.S.—
Valproic acid, valproate sodium, and divalproex belong to the group of medicines called anticonvulsants. They are used to control certain types of seizures in the treatment of epilepsy. Valproic acid, valproate sodium, and divalproex may be used alone or with other seizure medicine. Divalproex is also used to treat the manic phase of bipolar disorder (manic-depressive illness), and to help prevent migraine headaches.
Divalproex and valproate sodium form valproic acid in the body. Therefore, the following information applies to all of these medicines.
These medicines are available only with your doctor"s prescription, in the following dosage forms:
Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For valproic acid, valproate sodium, and divalproex, the following should be considered:
Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to valproic acid, valproate sodium, or divalproex. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy—Valproic acid, valproate sodium, and divalproex have been reported to cause birth defects when taken by the mother during the first 3 months of pregnancy. Also, animal studies have shown that valproic acid, valproate sodium, and divalproex cause birth defects when taken in doses several times greater than doses used in humans. However, these medicines may be necessary to control seizures in some pregnant patients. Be sure you have discussed this with your doctor.
Breast-feeding—Valproic acid, valproate sodium, and divalproex pass into the breast milk, but their effect on the nursing baby is not known. It may be necessary for you to take another medicine or to stop breast-feeding during treatment with valproic acid, valproate sodium, or divalproex. Be sure you have discussed the risks and benefits of this medicine with your doctor.
Children—Abdominal or stomach cramps, nausea or vomiting, tiredness or weakness, and yellow eyes or skin may be especially likely to occur in children, who are usually more sensitive to the effects of these medicines. Children up to 2 years of age, those taking more than one medicine for seizure control, and children with certain other medical problems may be more likely to develop serious side effects.
Older adults—Elderly people are especially sensitive to the effects of these medicines. This may increase the chance of side effects during treatment. The dose of this medicine may be lower for older adults.
Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking valproic acid, valproate sodium, or divalproex, it is especially important that your health care professional knows if you are taking any of the following:
Other medical problems—The presence of other medical problems may affect the use of these medicines. Make sure you tell your doctor if you have any other medical problems, especially:
Proper Use of This Medicine
For patients taking the capsule form of valproic acid:
For patients taking the delayed-release capsule form of divalproex:
For patients taking the delayed-release tablet form of divalproex:
For patients taking the syrup form of valproic acid:
For patients taking the oral dosage forms of valproic acid and divalproex:
This medicine must be taken exactly as directed by your doctor to prevent seizures and lessen the possibility of side effects.
Dosing—The dose of valproic acid, valproate sodium, or divalproex will be different for different patients. Follow your doctor"s orders or the directions on the label . The following information includes only the average doses of valproic acid, valproate sodium, or divalproex. If your dose is different, do not change it unless your doctor tells you to do so.
The number of capsules or tablets or teaspoonfuls of syrup that you take or the number of injections you receive depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using valproic acid, valproate sodium, or divalproex .
Missed dose—If you miss a dose of this medicine, and your dosing schedule is:
If you have any questions about this, check with your doctor.
Storage—To store this medicine:
Precautions While Using This Medicine
Your doctor should check your progress at regular visits , especially for the first few months that you take this medicine. This is necessary to allow dose adjustments and to reduce any unwanted effects.
Do not stop taking this medicine without first checking with your doctor . Your doctor may want you to gradually reduce the amount you are taking before stopping completely.
Before you have any medical tests, tell the doctor in charge that you are taking this medicine. The results of the metyrapone and thyroid function tests may be affected by this medicine.
Before having any kind of surgery, dental treatment, or emergency treatment, tell the medical doctor or dentist in charge that you are taking this medicine . Valproic acid, valproate sodium, or divalproex may change the time it takes your blood to clot, which may increase the chance of bleeding. Also, taking valproic acid, valproate sodium, or divalproex together with medicines that are used during surgery or dental or emergency treatments may increase the CNS depressant effects.
Valproic acid, valproate sodium, and divalproex will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine .
For diabetic patients:
Your doctor may want you to carry a medical identification card or bracelet stating that you are taking this medicine.
This medicine may cause some people to become drowsy or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are drowsy or not alert .
Side Effects of This Medicine
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
body aches or pain ; congestion; cough; dryness or soreness of throat; fever ; hoarseness runny nose; tender, swollen glands in neck ; trouble in swallowing; voice changes
Abdominal or stomach cramps (severe); behavioral, mood, or mental changes; blurred vision;; confusion; ; continuous, uncontrolled back-and-forth and/or rolling eye movements; earache, redness or swelling in ear; dizziness,; double vision; faintness, or light-headedness when getting up from a lying or sitting position suddenly; sweating; unusual tiredness or weakness; fast, irregular, pounding, or racing heartbeat or pulse; heavy, nonmenstrual vaginal bleeding; increase in seizures; loss of appetite; nausea or vomiting (continuing); rapid weight gain; spots before eyes; swelling of face, arms, hands, lower legs, or feet; tingling of hands or feet; tiredness and weakness; unusual bleeding or bruising; unusual weight gain or loss; vomiting of blood or material that looks like coffee grounds; yellow eyes or skin
Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
Abdominal or stomach cramps (mild); acid or sour stomach; belching; heartburn; indigestion; stomach discomfort, upset or pain; change in menstrual periods; crying paranoia; quick to react or overreact emotionally; rapidly changing moods; depersonalization; dysphoria; diarrhea; euphoria; hair loss; indigestion; lack or loss of strength; loss of appetite; loss of bowel control; mental depression; nausea and vomiting; paranoia; quick to react or overreact emotionally; rapidly changing moods; sleepiness or unusual drowsiness; trembling of hands and arms; unusual weight loss or gain
Less common or rare
Absence of or decrease in body movement; absent, missed, or irregular menstrual periods; stopping of menstrual bleeding; anxiety; nervousness; restlessness; bloated full feeling; bloody or cloudy urine; bloody nose; bruising; burning, crawling, itching, numbness, prickling, "pins and needles" , or tingling feelings; burning, dry or itching eyes; change in taste; chills; clumsiness or unsteadiness; coin-shaped lesions on skin; cold sweats; confusion; constipation; cramps; decreased awareness or responsiveness; degenerative disease of the joint; difficult, burning, or painful urination; difficulty in moving; discharge; excessive tearing of eye; discouragement; dizziness; drowsiness; dry mouth; excess air or gas in stomach or intestines; excessive muscle tone; muscle tension or tightness; muscle stiffness; feeling of constant movement of self or surroundings; feeling sad or empty; feeling of warmth or heat; ; flushing or redness of skin, especially on face and neck; frequent urge to urinate; headache; heavy bleeding; irregular heartbeats; irritability; joint pain; swollen joints; lack of appetite; lip smacking ; uncontrolled chewing movements; loss of hair; loss of interest or pleasure; loss of memory; problems with memory; mimicry of speech or movements; muscle aching or cramping; muscle pains or stiffness; mutism; negativism; normal menstrual bleeding occurring earlier, possibly lasting longer than expected; pain; passing gas; peculiar postures or movements, mannerisms or grimacing; puffing of cheeks; rapid or worm-like movements of tongue; redness, swelling, or soreness of tongue; severe sleepiness; shortness of breath; difficult or labored breathing; small red or purple spots on skin; stuffy nose; runny nose; sneezing; redness, pain, swelling of eye, eyelid, or inner lining of eyelid; seeing, hearing, or feeling things that are not there; sensation of spinning; shaking; shortness of breath; hyperventilation; skin rash; sweating; tightness in chest; tiredness; trouble concentrating; trouble in speaking; slurred speech; trouble sleeping; uncontrolled chewing movements; uncontrolled movements of arms and legs; unusual excitement, restlessness, or irritability; wheezing
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
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