Clinical Author's Note (Michael Stewart) 03/04/2018: valproate medicines must not be taken during pregnancy unless there is no suitable alternative. MHRA and the European Medicines Agency have announced strengthened measures to further reduce the risk of exposure to valproate drugs during pregnancy. Any woman or girl of child-bearing potential who needs a valproate medicine must be enrolled on a pregnancy prevention programme. This will involve counselling on potential risks as well as ongoing pregnancy testing during treatment. Click on the link above for more information and speak with your doctor if you have any concerns.
Read the information leaflet from inside your pack.
Take sodium valproate regularly every day. Do not suddenly stop taking it as this can cause your symptoms to return.
If you develop tummy (abdominal) pain, sickness, yellowing of your skin or of the whites of your eyes (jaundice) or any unexplained bruising or bleeding, tell your doctor straightaway.
About sodium valproate
|Type of medicine||An antiepileptic medicine|
|Also called||Epilim®; Episenta®; Epival®; Convulex® (as valproic acid)|
|Available as||Tablets, oral liquid medicine, modified-release tablets, modified-release capsules, and sachets|
Sodium valproate is prescribed to treat epileptic disease and seizures. It can be taken both by adults and by children.
A seizure is a short episode of symptoms which is caused by a burst of abnormal electrical activity in the brain. Sodium valproate works by reducing these abnormal electrical activities.
There is also a medicine with a similar name but which is used to treat a different condition. See the medicine leaflet called Valproate semisodium for bipolar disorder for more information about this.
Before taking sodium valproate
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 sodium valproate it is important that your doctor knows:
- If you are pregnant, trying for a baby or breastfeeding.
- If you or a close member of your family have 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 have been told you have a mitochondrial disorder or a urea cycle disorder.
- 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 sodium valproate
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about sodium valproate and it will provide you with a full list of the side-effects which you may experience from taking it.
- Take sodium valproate exactly as your doctor tells you to. It is usual to start treatment on a low dose, and then for the dose to be increased gradually to a regular maintenance dose. Most people take one or two doses daily. Doses for children are tailored to their age and weight.
- Read the printed information with your supply for more details about how you should take your doses. For example, many brands of sodium valproate must be taken with or just after food. Some brands of tablets are crushable to make them easier to swallow. Others must be swallowed whole without crushing or chewing. The label on the pack and the printed information leaflet from inside will provide this sort of information for you. Alternatively, you can ask your pharmacist to advise you.
- If you have been prescribed sachets (granules), you can swallow the granules by pouring them into your mouth and swallowing them with a drink of water. If you prefer, you can sprinkle the granules on to some soft food (yoghurt or ice cream, for example) or into a cool drink. Do not chew the granules.
- Try to get into a habit of taking sodium valproate at the same time(s) each day. This will help you avoid missing 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
- When you first start a new treatment for epilepsy there may be a change in the number or type of seizures you experience. Your doctor will advise you about this.
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. You will need to have blood tests before you start the medicine and while you are taking it.
- There are several brands of sodium valproate available and your treatment could be affected by switching between brands made by different manufacturers. Each time you collect a new supply from your pharmacy, check to see if it looks the same as you have had before. If it is different, please discuss this with your pharmacist who will advise you.
- You need to take sodium valproate every day. Stopping treatment suddenly can cause problems. If it becomes necessary for the treatment to stop, your doctor will want you to reduce your dose over a few days.
- Sodium valproate can harm an unborn child so you must avoid getting pregnant while you are taking sodium valproate. Make sure you have discussed with your doctor 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 doctor so that you can be given advice from a specialist about alternative treatment before you become pregnant.
- People with epilepsy must stop driving. Your doctor will advise you about when it may be possible for you to start driving again. This will usually be after a year free of seizures.
- While you are being treated for epilepsy there is a small risk that you may develop mood changes, distressing thoughts and feelings about suicide. If this happens, you must tell your doctor about it straightaway.
- 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 sodium valproate.
Can sodium valproate 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 sodium valproate. 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 doctor or pharmacist if any of the following continue or become troublesome.
|Very common sodium valproate side-effects (these affect more than 1 in 10 people)||What can I do if I experience this?|
|Feeling sick (nausea), stomach pain||Stick to simple foods - avoid rich or spicy meals|
|Feeling shaky||If troublesome, speak with your doctor|
|Common sodium valproate side-effects (these affect fewer than 1 in 10 people)||What can I do if I experience this?|
|Hair loss||This is usually temporary and the hair regrows (although it may be curlier than before)|
|Headache||Drink plenty of water and ask your pharmacist to recommend a suitable painkiller. If the headaches continue, let your doctor know|
|Diarrhoea||Drink plenty of water to replace lost fluids|
|Feeling sleepy||Do not drive and do not use tools or machines. Do not drink alcohol|
|Increased weight||Try to eat a well-balanced diet and take regular exercise|
|Uncontrolled muscle movements, lack of concentration, allergic reactions, problems with hearing||Let your doctor know about any of these|
|Problems with your liver, changes to some blood test results||Your doctor will routinely check for these|
Important: sodium valproate 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 doctor know straightaway if you notice any of the following:
- An unexplained cough or sore throat, or any unusual bleeding or bruising.
- Extreme tiredness, tummy (abdominal) pain, sickness (nausea and vomiting), dark urine or yellowing of your skin or of the whites of your eyes (jaundice).
How to store sodium valproate
- 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 accident and emergency department 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.
If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Epilim® 200 mg and 500 mg gastro-resistant tablets; Sanofi, The electronic Medicines Compendium. Dated November 2019.
British National Formulary, 80th Edition (Sep 2020); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.