Valproic Acid and Derivatives

This information from Lexicomp^® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Depakote; Depakote ER; Depakote Sprinkles

Brand Names: Canada

APO-Divalproex; APO-Valproic Acid; Depakene; Epival; JAMP-Valproic Acid; MYLAN-Divalproex; PMS-Valproic; PMS-Valproic Acid; TEVA-Divalproex [DSC]

What is this drug used for?

• It is used to treat seizures.
• It is used to prevent migraine headaches.
• It is used to treat bipolar disorder.
• It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take this drug?

• If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
• If you have any of these health problems: Liver disease or a urea cycle disorder.

This is not a list of all drugs or health problems that interact with this drug.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

For all uses of this drug:

• Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
• Avoid driving and doing other tasks or actions that call for you to be alert or have clear eyesight until you see how this drug affects you.
• Have blood work checked as you have been told by the doctor. Talk with the doctor.
• Talk with your doctor before you use alcohol, marijuana or other forms of cannabis, or prescription or OTC drugs that may slow your actions.
• This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take this drug.
• If you are not able to eat or drink like normal, talk with your doctor. This includes if you are sick, fasting, or you are having certain procedures or surgery.
• Some brands of this drug have peanut oil in them. If you are allergic to peanuts, check with your pharmacist to see if your brand has peanut oil in it.
• You may bleed more easily. Be careful and avoid injury. Use a soft toothbrush and an electric razor.
• High blood levels of ammonia have happened with this drug. This can lead to certain brain problems. In some people, this has been deadly. Talk with the doctor.
• Some people have had certain brain problems without high blood levels of ammonia. Sometimes, these brain problems have gone back to normal after this drug was stopped. However, sometimes they have not fully gone back to normal. Talk with the doctor.
• A severe and sometimes deadly reaction has happened. Most of the time, this reaction has signs like fever, rash, or swollen glands with problems in body organs like the liver, kidney, blood, heart, muscles and joints, or lungs. If you have questions, talk with the doctor.
• If you are 65 or older, use this drug with care. You could have more side effects.
• This drug may affect being able to father a child. Talk with the doctor.
• Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

For seizures:

• If seizures are different or worse after starting this drug, talk with the doctor.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Signs of infection like fever, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.
• Signs of high ammonia levels like a heartbeat that does not feel normal, breathing that is not normal, feeling confused, pale skin, slow heartbeat, seizures, sweating, throwing up, or twitching.
• Chest pain.
• Swelling in the arms or legs.
• Change in eyesight.
• Memory problems or loss.
• Change in balance.
• Trouble walking.
• Any unexplained bruising or bleeding.
• Purple spots or redness of the skin.
• Not able to pass urine or change in how much urine is passed.
• Muscle pain or weakness.
• Joint pain or swelling.
• Shakiness.
• Not able to control eye movements.
• Ringing in ears.
• Feeling cold.
• Like other drugs that may be used for seizures, this drug may rarely raise the risk of suicidal thoughts or actions. The risk may be higher in people who have had suicidal thoughts or actions in the past. Call the doctor right away about any new or worse signs like depression; feeling nervous, restless, or grouchy; panic attacks; or other changes in mood or behavior. Call the doctor right away if any suicidal thoughts or actions occur.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Headache.
• Constipation, diarrhea, stomach pain, upset stomach, throwing up, or decreased appetite.
• Increased appetite.
• Feeling dizzy, sleepy, tired, or weak.
• Trouble sleeping.
• Weight gain or loss.
• Hair loss.
• Feeling nervous and excitable.
• Flu-like signs.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

All oral products:

• Take with or without food. Take with food if it causes an upset stomach.
• Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.
• Do not stop taking this drug all of a sudden without calling your doctor. You may have a greater risk of seizures. If you need to stop this drug, you will want to slowly stop it as ordered by your doctor.
• If you take cholestyramine, you may need to take it at some other time than this drug. Talk with your pharmacist.

Tablets and capsules:

• Swallow whole. Do not chew, break, or crush.
• Take with a full glass of water.
• If you have trouble swallowing, talk with your doctor.

Long-acting tablets:

• If you see parts of this drug in your stool, call your doctor.

Sprinkle capsule:

• You may swallow whole or mix the contents of the capsule with certain foods like applesauce. Take the mixture right away. Do not store for later use.
• Do not chew the mixture.
• If you see parts of this drug in your stool, call your doctor.

Liquid:

• Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, ask the pharmacist for a device to measure this drug.

Injection:

• It is given as an infusion into a vein over a period of time.

What do I do if I miss a dose?

All oral products:

• Take a missed dose as soon as you think about it.
• If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
• Do not take 2 doses at the same time or extra doses.

Injection:

• Call your doctor to find out what to do.

How do I store and/or throw out this drug?

All oral products:

• Store at room temperature in a dry place. Do not store in a bathroom.

Injection:

• If you need to store this drug at home, talk with your doctor, nurse, or pharmacist about how to store it.

All products:

• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

• If your symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your drugs with others and do not take anyone else’s drugs.
• Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
• Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2023-03-22

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