Valproic Acid (Systemic)

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:

• Acetaminophen (e.g., Tylenol) (with long-term, high-dose use) or
• Amiodarone (e.g., Cordarone) or
• Amitriptyline and nortriptyline
• Anabolic steroids (nandrolone [e.g., Anabolin], oxandrolone [e.g., Anavar], oxymetholone [e.g., Anadrol], stanozolol [e.g., Winstrol]) or
• Androgens (male hormones) or
• Anticoagulants
• Aspirin
• Barbiturates or
• Carbamazepine (e.g., Tegretol) or
• Carmustine (e.g., BiCNU) or
• Dantrolene (e.g., Dantrium) or
• Daunorubicin (e.g., Cerubidine) or
• Disulfiram (e.g., Antabuse) or
• Estrogens (female hormones) or
• Ethosuximide
• Etretinate (e.g., Tegison) or
• Gold salts (medicine for arthritis) or
• Mercaptopurine (e.g., Purinethol) or
• Methotrexate (e.g., Mexate) or
• Methyldopa (e.g., Aldomet) or
• Naltrexone (e.g., Trexan) (with long-term, high-dose use) or
• Phenothiazines (acetophenazine [e.g., Tindal], chlorpromazine [e.g., Thorazine], fluphenazine [e.g., Prolixin], mesoridazine [e.g., Serentil], perphenazine [e.g., Trilafon], prochlorperazine [e.g., Compazine], promazine [e.g., Sparine], promethazine [e.g., Phenergan], thioridazine [e.g., Mellaril], trifluoperazine [e.g., Stelazine], triflupromazine [e.g., Vesprin], trimeprazine [e.g., Temaril]) or
• Plicamycin (e.g., Mithracin) - There is an increased risk of serious side effects to the liver

• Central nervous system (CNS) depressants (medicines that cause drowsiness) or
• Tricyclic antidepressants (medicine for depression) - There may be an increase in CNS depressant effects

• Carbenicillin by injection (e.g., Geopen) or
• Dipyridamole (e.g., Persantine) or
• Inflammation or pain medicine, except narcotics, or
• Pentoxifylline (e.g., Trental) or
• Sulfinpyrazone (e.g., Anturane) or
• Ticarcillin (e.g., Ticar) - Valproic acid, valproate sodium, or divalproex may increase the chance of bleeding because of decreased blood clotting ability; the potential of aspirin, medicine for inflammation or pain, or sulfinpyrazone to cause stomach ulcer and bleeding may also increase the chance of bleeding in patients taking valproic acid, valproate sodium, or divalproex

• Heparin - There is an increased risk of side effects that may cause bleeding

• Mefloquine - The amount of valproic acid, valproate sodium, or divalproex that you need to take may change

• Other anticonvulsants (medicine for seizures) - There is an increased risk of seizures or other unwanted effects

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:

• Blood disease or
• Brain disease or
• Kidney disease - There is an increased risk of serious side effects

• Liver disease - Valproic acid, valproate sodium, or divalproex may make the condition worse

• Pancreatitis - may be life threatening, stop using valproate if you have this condition

• Urea cycle disorders - my lead to serious side effects or death