Delayed or extended release tablets should be swallowed whole with a drink of water. Do not chew or crush the tablets.
Some capsules can be opened and the contents sprinkled on to soft food such as applesauce. Check the manufacturer's leaflet in your pack of medicine.
Take your doses after a meal or a snack.
Each time you collect a new supply of medication, make sure that they look the same as you have had before.
About divalproex sodium
|Type of medicine||An anticonvulsant medicine|
|Used for||Treatment of mania associated with bipolar disorder, epilepsy, prevention of migraine|
|Also called||Depakote®; Depakote® ER; Depakote® Sprinkle; valproate semisodium|
|Available as||Capsules, tablets|
Divalproex sodium is a mixture of two similar ingredients - valproic acid and sodium valproate. It is an anticonvulsant medicine used to treat bipolar disorder, epilepsy and seizures, and to prevent migraine headaches.
A seizure is a short episode of symptoms which is caused by a burst of abnormal electrical activity in the brain. Divalproex sodium works by reducing these abnormal electrical activities.
Bipolar disorder is a long-term condition where you have lows (periods of depression) and highs (periods of mania or hypomania). Divalproex sodium is prescribed as a mood stabilizer in bipolar disorder. It helps keep your mood within normal limits by helping to control the episodes of mania.
For people with migraine headaches, divalproex sodium can be used to help prevent you having a migraine attack. It does not help to relieve a migraine if one happens.
Before taking divalproex sodium
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking divalproex sodium it is important that your physician knows:
- If you are pregnant, trying for a baby or breast-feeding.
- If you or a close member of your family have any liver problems.
- If you have any problems with the way your kidneys work.
- If you have an inflammatory condition called systemic lupus erythematosus (also called lupus, or SLE).
- If you have a rare inherited blood disorder called porphyria.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take divalproex sodium
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about your medicine and it will provide you with a full list of the side-effects which you may experience from taking it.
- Take divalproex sodium exactly as your physician tells you to. Your dose will be printed on the label of the pack to remind you about what the physician has said.
- Your dose of divalproex sodium will depend on the reason you are taking it, your age and your body weight. Your physician will usually prescribe a lower dose to start with and then ask you to increase the dose over a few days. This helps you find the dose that controls your symptoms whilst keeping side-effects to a minimum.
- Extended release tablets are usually taken once a day. Capsules and delayed release tablets are usually taken two or three times a day.
- Divalproex sodium should be taken with food, so take your doses with a snack or just after you have had a meal.
- If you have been given delayed or extended release tablets, swallow them whole with a drink of water. Do not chew or crush the tablets because they have a special protective coating.
- Some brands of capsules (eg, Depakote® Sprinkles) can be opened and the contents mixed with a soft food such as applesauce. Carefully open the capsule and pour the entire contents onto a spoonful of applesauce. This should then be swallowed without chewing the granules or pellets.
- Try to get into a habit of taking the tablets at the same times each day. This will help you avoid missing any doses.
- If you do forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case leave out the missed dose. Do not take two doses together to make up for a forgotten dose.
Getting the most from your treatment
- Try to keep your regular appointments with your physician. This is so they can check on your progress. You will need to have some blood tests from time to time, particularly during the first few months of treatment.
- Each time you collect a new supply of medicine from the pharmacy, make sure that the medicine looks to be the same as you have had before. If it is different, please discuss this with your pharmacist who will advise you.
- While you are taking divalproex sodium, there is a small risk that you may develop mood changes, distressing thoughts and feelings about suicide. If this happens, you must tell your physician about it straightaway.
- Your physician is likely to recommend that you do not drink alcohol while you are on divalproex sodium.
- This medicine will not normally be prescribed for you if you are a woman who could become pregnant. This is because divalproex sodium can cause harm to an unborn child. If you are already taking divalproex sodium you must avoid getting pregnant. Make sure you have discussed with your physician which types of contraception are suitable for you and your partner. If you are a woman and want to have a family, discuss this with your physician so that you can be given advice about alternative treatment before you become pregnant.
- If you have been prescribed divalproex sodium to help prevent migraines, it is unlikely to stop all migraine attacks completely. However, the number and severity of attacks are often much reduced by a preventative medicine. It is useful for you to keep a migraine diary to monitor how well a medicine is working.
- If you buy any medicines, always check with a pharmacist that they are suitable to take with your other medicines. Medicines which contain aspirin (such as some cold or flu remedies and painkillers) can interfere with divalproex sodium and may be best avoided.
- Continue to take divalproex sodium until your physician tells you otherwise. Stopping treatment suddenly can cause problems, so if it becomes necessary for your treatment to stop, your physician may want you to reduce your dose over a few days.
Can divalproex sodium cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with divalproex sodium. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your physician or pharmacist if any of the following continue or become troublesome.
|Very common divalproex sodium side-effects (these affect more than 1 in 10 people)||What can I do if I experience this?|
|Feeling nauseous||This usually passes after the first few days. Remember to take your doses after meals|
|Feeling shaky||If troublesome, speak with your physician|
|Common divalproex sodium side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Stomach ache, diarrhea||These usually pass after the first few days. Remember to take your doses after meals|
|Headache||Drink plenty of water and ask your pharmacist to recommend a suitable painkiller. If the headaches continue, let your physician know.|
|Increased appetite and weight gain||Try to eat a well-balanced diet and take regular exercise|
|Feeling sleepy or tired|
Do not drive and do not use tools or machines while affected
|Thinning of your hair||This is usually temporary and the hair regrows (although it may be curlier than before)|
|Uncontrolled muscle movements, lack of concentration, allergic reactions, problems with hearing, mood changes, painful periods|
Let your physician know about any of these
|Problems with your liver, changes to some blood test results||Your physician will routinely check for these|
Important: divalproex sodium has been associated with a number of serious unwanted effects affecting the blood, pancreas and liver. Although these occur less commonly than some of the side-effects listed above, you must let your physician know straightaway if you notice any of the following:
- An unexplained cough or sore throat, or any unusual bleeding or bruising.
- Extreme tiredness, severe stomach pain, vomiting, dark urine or yellowing of your skin or the whites of your eyes (jaundice).
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store divalproex sodium
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the emergency room of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Ask your pharmacist about ways to dispose of medicines safely in your local area.
If you have any questions about this medicine ask your physician or pharmacist.
Further reading and references
FDA Label, Depakote® ER, divalproex sodium tablet, extended release; AbbVie Inc. DailyMed, National Institutes of Health, U.S National Library of Medicine. Dated March 7, 2017
FDA Label, Depakote® Sprinkles, divalproex sodium capsule; AbbVie Inc. DailyMed, National Institutes of Health, U.S National Library of Medicine. Dated March 13, 2017