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Valproic acid

Supportive Care

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What is valproic acid?

Valproic acid (also called Depakote® or Depakene®) is used to prevent seizures. It is also used to treat some psychiatric illnesses and to prevent migraine headaches. Valproic acid is available in several forms taken by mouth:

  • For immediate-release, a 50-mg/ml red syrup, a 125-mg blue-and-white sprinkle capsule, and a 250-mg orange soft gelatin capsule
  • For extended-release, a 125-mg red tablet, a 250-mg peach tablet, and a 500-mg pink tablet

It is also available as a clear liquid given by vein.

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Possible side effects

  • Nausea and vomiting
  • Feeling dizzy, drowsy, and unsteady

Symptoms of an allergic reaction include: rash, hives, itching, chills, fever, headache, muscle ache, shortness of breath, coughing, tightness in the throat, swelling of the face or neck.

Not all patients who take valproic acid will experience these side effects. Common side effects are bolded, but there may be others. Please report all suspected side effects to your doctor or pharmacist.

Find more information on side effects.

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Possible late effects

  • Nausea, vomiting, constipation, or diarrhea
  • Stomach pain and indigestion
  • Blurred or double vision
  • Decreased coordination
  • Feeling dizzy, drowsy, and unsteady
  • Tired feeling
  • Muscle aches
  • Agitated and irritable
  • Slurred speech
  • Tremor
  • Headache
  • Dry mouth
  • Skin rash
  • Hair loss
  • Temporary changes in liver function
  • Easy bruising, unusual bleeding
  • Low blood counts
  • Trouble sleeping
  • Allergic reaction with symptoms of fever, rash, swelling of face and lips, and muscle aches

These are the most common side effects, but there may be others. Please report all side effects to the doctor or nurse.

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Tips for patients and families

Be sure to discuss all questions and instructions with your doctor or pharmacist. 

  • Do not stop taking this medicine until your doctor tells you to do so. If you stop taking it without being told, your chances of having a seizure may increase.
  • Store valproic acid at room temperature.
  • The doctor will slowly increase your dose of valproic acid when you first begin taking it.
  • This medicine may cause you to feel dizzy and drowsy. Do not operate heavy equipment or drive a motor vehicle until you see how this medicine will affect you.
  • If you develop a rash after starting valproic acid, you may be allergic to this medicine. Call your doctor, pharmacist, or nurse right away.
  • It is very important that you take valproic acid exactly as directed. This will keep the blood levels constant during the day and night. If you miss a dose, follow these guidelines:
    • If the next dose is not due for at least 4 hours, take the missed dose right away.
    • If the next dose is due in less than 4 hours, do not take the missed dose. Take the next dose at the scheduled time. Never take a double dose unless your doctor or pharmacist tells you to do so.
  • Valproic acid may affect the way other medicines work. These medicines include warfarin and other seizure medicines.
  • Several medicines can increase the side effects of valproic acid or increase the blood level of valproic acid. These include:
    • Other seizure medicines
    • Pain medicines
    • Antihistamines (including over-the counter sleeping pills and allergy medicines, such as Benadryl®)
    • Aspirin
    • Sedatives
    • Rifampin
  • Alcohol (found in many over-the-counter cough/cold medicines) can increase the drowsy feeling caused by valproic acid.
  • Always tell your doctor if you are taking any of these medicines, or if you start taking any new medicine while taking valproic acid.
  • The staff will draw blood samples regularly to check for changes in liver function.

Drug at Home:

  • The sprinkle capsule may be swallowed whole or sprinkled on soft food, such as applesauce or pudding. Do not chew the food containing the sprinkles. Eat all the soft food to receive the entire dose.
  • The delayed release tablets and the soft gelatin capsule should be swallowed whole. Do not cut or crush the capsules or tablets.
  • Do not mix the syrup with soda pop drinks.
  • Take valproic acid with food if stomach upset occurs.