Valproate (valproic acid) Coupons, Discounts & Cost
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Valproate general information
Valproate (valproic acid) has anticonvulsant effect. It has been shown that valproic acid has antiepileptic effects in various forms of epilepsy.
Valproic acid is metabolized in the liver. Unlike other antiepileptic drugs, Valproate does not affect other substances, such as estrogen and progesterone. Valproic acid is secreted mainly by the kidneys. A small fraction is excreted unchanged.
The dose of the drug should be lowered in patients with renal insufficiency.
Valproate is used in adults and children as monotherapy or in combination with other antiepileptic drugs. It is used for the treatment of generalized epileptic seizures, Lennox-Gastaut syndrome, partial epileptic seizures.
Also, this drug is effective in the following diseases: secondary generalized seizures (especially convulsions in young children), partial seizures (psychosensory type, psychomotor type), mixed forms of epilepsy, mania associated with bipolar affective disorders.
Valproate dosing regimen
It should be taken into account that this drug is prescribed for adults and children weighing more than 17 kg. Valproate is not prescribed for children under 6 years of age.
Treatment of epilepsy. The initial daily dose is 10-15 mg/kg of body weight. It should be gradually raised to the optimal dose. The average daily dose is 20-30 mg/kg of body weight.
The usual dose for children is 30 mg/kg/day.
The usual dose for adults is 20-30 mg/kg/day.
As for the elderly, the dose should be determined by the doctor. The daily dose is determined depending on the age and body weight of the patient.
Treatment of manic syndrome in bipolar disorders. The recommended initial dose is 20 mg/kg/day. The dose can be changed depending on the individual clinical response. The maximum dose should not exceed 3000 mg/day. The recommended maintenance dose for the treatment of bipolar disorders is 1000-2000 mg/day.
The daily dose should be taken preferably during meals (1 or 2 doses per day). Single administration is allowable in case of well-controlled epilepsy.
Do not crush and chew the tablets (swallow whole).
If the patient is already taking other antiepileptic drugs, then Valproate therapy should be started with lower doses. The dose should be increased gradually to reach the optimal dose in about 2 weeks.
The drug is used in children with a body weight of more than 17 kg. This drug is not recommended for use in children under 6 years of age.
Valproate contraindications
The main contraindications include: hypersensitivity to valproic acid, divalproex, valpromide or other components of the drug, acute and chronic hepatitis, severe forms of liver and pancreas insufficiency, hepatic porphyria, children up to 6 years of age.
Valproate side effects
Blood and lymphatic system: anemia, thrombocytopenia, pancytopenia, agranulocytosis, macrocytic anemia.
Metabolic disorders: increased appetite, weight gain, hyponatremia, hyperammonemia.
CNS: disorientation, confusion, hallucinations, aggression (these adverse reactions are mainly observed in children), tremor, extrapyramidal disorders, drowsiness, convulsions, memory impairment, headache, nystagmus, dizziness, encephalopathy, ataxia, paresthesia, reversible dementia. These adverse reactions are mainly observed during combination treatment (especially with phenobarbital or topiramate).
Vascular disorders: bleeding, vasculitis.
Digestive system: nausea, vomiting, gingival hyperplasia, stomatitis, upper abdominal pain, diarrhea. These symptoms usually disappear after a few days without treatment cancellation. Medical examination should be performed immediately in all patients who complain of acute abdominal pain when taking valproic acid.
Hepatobiliary disorders: liver damage. There have been reports of severe liver damage, including liver failure.
Skin and subcutaneous tissue: hypersensitivity, transient or dose-dependent alopecia, angioedema, rash, toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme.
Kidneys and urinary tract: kidney failure, kidney damage, enuresis, urinary incontinence, reversible Fanconi syndrome.
Respiratory system: pleural effusion.
Endocrine disorders: hirsutism, acne, male pattern baldness, hypothyroidism.
Musculoskeletal system: osteoporosis and fractures in patients receiving long-term therapy, systemic lupus erythematosus, rhabdomyolysis.
Reproductive system: dysmenorrhea, amenorrhea, male infertility, gynecomastia.
Valproate interaction
It is not recommended to use Valproate with neuroleptics, antidepressants, MAO inhibitors, benzodiazepine derivatives, ethanol, drugs that have hepatotoxic effects, antiplatelet drugs (including acetylsalicylic acid) and anticoagulants.
Valproate may increase the concentration of zidovudine.
Carbamazepine may reduce the concentration of valproic acid. Valproate potentiates the toxic effect of carbamazepine.
Special instructions for Valproate
This drug is used with caution in patients with pathological changes in the structure of blood cells, organic brain diseases, liver diseases, hypoproteinemia, renal dysfunction.
Patients who take other anticonvulsants should start Valproate therapy with lower doses.
It should be borne in mind that the risk of side effects is higher in case of combined anticonvulsant therapy.