Dipodium (divalproex sodium): Uses, Dosage & Side Effects

What it's for (Indications)

Divalproex sodium is indicated for the treatment of various forms of epilepsy and seizures, including complex partial seizures.
It is also used for mania.
To achieve maximum benefit, it should be taken regularly at the same time each day, with the quantity determined by medical condition and response to treatment.

Dosage Information

Type	Guideline
Standard	Divalproex sodium extended-release tablets are intended for once-a-day oral administration. They should be taken by mouth with food, as directed by the doctor. Swallow the tablet whole; do not crush or chew it, as this can irritate the mouth or throat. Do not increase the quantity or take this product more often than directed. For mania, the initial dose is 25 mg/kg/day, increasing as rapidly as possible to achieve therapeutic response or desired plasma level, with a maximum recommended dosage of 60 mg/kg/day. For complex partial seizures, start at 10 mg/kg/day to 15 mg/kg/day, increasing at 1-week intervals by 5 mg/kg/day to 10 mg/kg/day to achieve optimal clinical response, with a maximum recommended dosage of 60 mg/kg/day. If response is not satisfactory, check valproate plasma levels. Store at room temperature and keep out of reach of children.

Type

Guideline

Standard

Divalproex sodium extended-release tablets are intended for once-a-day oral administration. They should be taken by mouth with food, as directed by the doctor. Swallow the tablet whole; do not crush or chew it, as this can irritate the mouth or throat. Do not increase the quantity or take this product more often than directed. For mania, the initial dose is 25 mg/kg/day, increasing as rapidly as possible to achieve therapeutic response or desired plasma level, with a maximum recommended dosage of 60 mg/kg/day. For complex partial seizures, start at 10 mg/kg/day to 15 mg/kg/day, increasing at 1-week intervals by 5 mg/kg/day to 10 mg/kg/day to achieve optimal clinical response, with a maximum recommended dosage of 60 mg/kg/day. If response is not satisfactory, check valproate plasma levels. Store at room temperature and keep out of reach of children.

Safety & Warnings

Common Side Effects

Patients may experience gastrointestinal upset, weight gain, hair loss, headache, liver injury, rash, aggression, bone marrow failure, easy bruising/bleeding, sore throat, nausea/vomiting, yellowing eyes/skin, stomach/abdominal pain, constipation, dark urine, unusual tiredness/weakness, signs of infection, and unusual/sudden weight gain.
Serious adverse reactions include hepatic failure, birth defects, decreased IQ following in utero exposure, pancreatitis, hyperammonemic encephalopathy, suicidal behavior and ideation, bleeding and other hematopoietic disorders, hypothermia, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)/Multiorgan hypersensitivity reactions, and somnolence in the elderly.
If any of these symptoms are persistent or severe, consult a doctor immediately.

Serious Warnings

Black Box Warning: WARNING: LIFE THREATENING ADVERSE REACTIONS Hepatotoxicity General Population: Hepatic failure resulting in fatalities has occurred in patients receiving valproate and its derivatives. These incidents usually have occurred during the first six months of treatment. Serious or fatal hepatotoxicity may be preceded by non-specific symptoms such as malaise, weakness, lethargy, facial edema, anorexia, and vomiting. In patients with epilepsy, a loss of seizure control may also occur.
Pregnant ladies must consult their doctor before taking this medicine for a better analysis, as divalproex sodium can cause birth defects and decreased IQ following in utero exposure.
Patients who are allergic to divalproex sodium or any of its components should consult a doctor before use.
Caution is advised if taking any vitamins, nutritional supplements, or herbal products.
If swelling is experienced, consult a doctor immediately.
High concentrations of divalproex sodium might result in severe pain.
Patients should be monitored for hepatic failure, especially during the first six months of treatment, which may be preceded by non-specific symptoms such as malaise, weakness, lethargy, facial edema, anorexia, and vomiting.
Pancreatitis, hyperammonemic encephalopathy, suicidal behavior and ideation, bleeding and other hematopoietic disorders, hypothermia, and DRESS/multiorgan hypersensitivity reactions are serious risks.
Somnolence may occur in the elderly.
Driving should be avoided when taking this medicine as it may affect ability to drive.
Alcohol consumption should be avoided.
If a patient has had a false positive urine test for diabetes or is a woman of child-bearing age, they should consult their doctor before using this medication.

How it Works (Mechanism of Action)

Divalproex sodium dissociates to the valproate ion in the gastrointestinal tract. The exact mechanisms by which valproate exerts its therapeutic effects have not been established, but it is suggested that its activity in epilepsy is related to increased brain concentrations of gamma-aminobutyric acid (GABA).