Clinical Author's Note (Michael Stewart) 03/04/2018: valproate medicines must not be taken during pregnancy unless there is no suitable alternative. The 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.
Swallow Depakote® tablets with a drink of water. Do not chew or crush the tablets.
Take the tablets after a meal or a snack.
Each time you collect a new supply of tablets, make sure that they look the same as you have had before.
About valproate semisodium
|Type of medicine||An antiepileptic medicine|
|Used for||Treatment of mania associated with bipolar disorder (in adults)|
|Also called||Divalproex sodium (in US); Belvo®; Depakote®; Syonell®|
Bipolar disorder is a long-term condition where you have lows (periods of depression) and highs (periods of mania or hypomania).
Valproate semisodium is prescribed as a mood stabiliser in bipolar disorder. It is a mixture of two similar ingredients - valproic acid and sodium valproate. It will have been given to you to help keep your mood within normal limits by helping to control the episodes of mania.
Valproate semisodium can also be prescribed to help prevent migraines. If you have been given it for this reason, speak with your doctor if you have any questions about your treatment, as there is no information in the leaflet about this.
There is also a medicine with a similar name but which is used to treat a different condition. See the separate medicine leaflet called Sodium valproate for epilepsy for more information about this.
Before taking valproate semisodium
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 valproate semisodium 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 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 valproate semisodium
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about the tablets and it will provide you with a full list of the side-effects which you may experience from taking them.
- Take valproate semisodium exactly as your doctor tells you to. Your dose will be printed on the label of the pack to remind you about what the doctor said. It is usual to be prescribed two or three doses to take each day.
- Valproate semisodium should be taken with food, so take your doses with a snack or just after you have had a meal. Swallow the tablets whole with a drink of water. Do not chew or crush the tablets because they have a special protective coating.
- 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 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 doctor. This is so your doctor 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 your pharmacy, make sure that the tablets look to be the same as you have had before. If they are different, please discuss this with your pharmacist who will advise you.
- While you are taking valproate semisodium, 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.
- Your doctor is likely to recommend that you do not drink alcohol while you are on valproate semisodium.
- This medicine will not normally be prescribed for you if you are a woman who could become pregnant. This is because valproate semisodium can cause harm to an unborn child.
- 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 valproate semisodium and may be best avoided.
- Continue to take the tablets until your doctor tells you otherwise. Stopping treatment suddenly can cause problems, so if it becomes necessary for your treatment to stop, your doctor may want you to reduce your dose over a few days.
Can valproate semisodium 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 valproate semisodium. 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 valproate semisodium side-effects (these affect more than 1 in 10 people)||What can I do if I experience this?|
|Feeling sick (nausea)||This usually passes after the first few days. Remember to take the tablets after meals|
|Feeling shaky||If troublesome, speak with your doctor|
|Common valproate semisodium side-effects |
(these affect fewer than 1 in 10 people)
|What can I do if I experience this?|
|Stomach ache, diarrhoea||These usually pass after the first few days. Remember to take the tablets after meals|
|Headache||Drink plenty of water and ask a pharmacist to recommend a suitable painkiller. If the headaches continue, let your doctor 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 doctor know about any of these|
|Problems with your liver, changes to some blood test results||Your doctor will routinely check for these|
Important: valproate semisodium 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/or vomiting), dark urine or yellowing of your skin or the whites of your eyes (jaundice).
How to store valproate semisodium
- 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, Depakote® tablets; Sanofi, The electronic Medicines Compendium. Dated October 2020.
British National Formulary, 80th Edition (Sep 2020); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.