Name: Valproic acid
Pregnancy Category D
Mechanism of action not understood: antiepileptic activity may be related to the metabolism of the inhibitory neurotransmitter, gamma-aminobutyric acid (GABA); divalproex sodium is a compound containing equal proportions of valproic acid and sodium valproate.
Sole and adjunctive therapy in simple (petit mal) and complex absence
Adjunctive therapy in patients with multiple seizure types, including absence seizures
Unlabeled uses: sole and adjunctive therapy in atypical absence, myoclonic and grand mal seizures; possibly effective therapy in atonic, complex partial, elementary partial, and infantile spasm seizures; prophylaxis for recurrent febrile seizures in children
Contraindicated in the presence of hypersensitivity to valproic acid, hepatic disease or significant hepatic dysfunction.
Use caution in the presence of children younger than 18 mo; children
younger than 2 y, especially those receiving multiple antiepileptic
drugs, those with congenital metabolic disorders, those with severe
seizures accompanied by severe mental retardation, those with organic
brain disorders (higher risk of developing fatal hepatotoxicity); pregnancy (incidence of neural tube defects in the fetus may be increased in mothers receiving valproic acid during the first trimester of pregnancy; do not discontinue antiepileptic therapy in pregnant women who are receiving such therapy to prevent major seizures; discontinuing medication is likely to precipitate status epilepticus, with attendant hypoxia and risk to both mother and unborn child); lactation.
- CNS: Sedation, tremor (may be dose-related), emotional upset, depression, psychosis, aggression, hyperactivity, behavioral deterioration, weakness
- GI: Nausea, vomiting, indigestion, diarrhea, abdominal cramps, constipation, anorexia with weight loss, increased appetite with weight gain
- Hematologic: Slight elevations in SGOT, SGPT, LDH; increases in serum
bilirubin, abnormal changes in other liver function tests, hepatic
failure, altered bleeding time; thrombocytopenia; bruising; hematoma
formation; frank hemorrhage; relative lymphocytosis;
leukopenia, eosinophilia, anemia, bone marrow suppression
- GU: Irregular menses, secondary amenorrhea
- Dermatologic: Transient increases in hair loss, skin rash, petechiae
Are you a Doctor, Pharmacist, PA or a Nurse?
Join the Doctors Lounge online medical community
Editorial activities: Publish, peer review, edit online articles.
Ask a Doctor Teams: Respond to patient questions and discuss challenging presentations with other members.