Valproate semisodium
Synonyms / Brand Names: Divalproex sodium, Valproate semisodium, Depakote, Depakote CP, Depakote ER, Depakote Sprinkle, Epival
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Dosing and Administration
Migraine
DEPAKOTE tablets are administered orally. The recommended starting dose is 250 mg twice
daily. Some patients may benefit from doses up to 1000 mg/day. In the clinical trials, there was
no evidence that higher doses led to greater efficacy.
Mania
For mania, the recommended initial dose is 750 mg daily in divided doses. The maximum recommended dosage is 60 mg/kg/day. For epilepsy, patients should initiate therapy at 10 to 15 mg/kg/day. No recommendation regarding the safety of valproate for use at doses above 60 mg/kg/day can be made. For migraines, the recommended starting dose is 250 mg twice daily. Some patients may benefit from doses up to 1000 mg/day.
Complex Partial Seizures
For adults and children 10 years of age or older.
Monotherapy (Initial Therapy): DEPAKOTE has not been systematically studied as initial
therapy. Patients should initiate therapy at 10 to 15 mg/kg/day. The dosage should be increased
by 5 to 10 mg/kg/week to achieve optimal clinical response. Ordinarily, optimal clinical
response is achieved at daily doses below 60 mg/kg/day. If satisfactory clinical response has not
been achieved, plasma levels should be measured to determine whether or not they are in the
usually accepted therapeutic range (50 to 100 μg/mL). No recommendation regarding the safety
of valproate for use at doses above 60 mg/kg/day can be made.
The probability of thrombocytopenia increases significantly at total trough valproate
plasma concentrations above 110 μg/mL in females and 135 μg/mL in males. The benefit of
improved seizure control with higher doses should be weighed against the possibility of a greater
incidence of adverse reactions.
For more information on dosing please refer to Instructions for administration
FDA Package Insert Resources
Indications, Contraindications, Side Effects, Drug Interactions, etc.
Calculate Creatine Clearance
On line calculator of your patients Cr Cl by a variety of formulas.
Convert pounds to Kilograms
On line calculator of your patients weight in pounds to Kg for dosing estimates.
Publication Resources
Recent articles, WikiDoc State of the Art Review, Textbook Information
Trial Resources
Ongoing Trials, Trial Results
Guidelines & Evidence Based Medicine Resources
US National Guidelines, Cochrane Collaboration, etc.
Media Resources
Slides, Video, Images, MP3, Podcasts, etc.
Patient Resources
Discussion Groups, Handouts, Blogs, News, etc.
International Resources
en Español
FDA Package Insert Resources
Indications
Contraindications
Side Effects
Drug Interactions
Precautions
Overdose
Instructions for Administration
How Supplied
Pharmacokinetics and Molecular Data
FDA label
FDA on Valproate semisodium
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Publication Resources
Most Recent Articles on Valproate semisodium
Review Articles on Valproate semisodium
Articles on Valproate semisodium in N Eng J Med, Lancet, BMJ
WikiDoc State of the Art Review
Textbook Information on Valproate semisodium
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Trial Resources
Ongoing Trials with Valproate semisodium at Clinical Trials.gov
Trial Results with Valproate semisodium
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Guidelines & Evidence Based Medicine Resources
US National Guidelines Clearinghouse on Valproate semisodium
Cochrane Collaboration on Valproate semisodium
Cost Effectiveness of Valproate semisodium
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Media Resources
Powerpoint Slides on Valproate semisodium
Images of Valproate semisodium
Podcasts & MP3s on Valproate semisodium
Videos on Valproate semisodium
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Patient Resources
Patient Resources on Valproate semisodium
Discussion Groups on Valproate semisodium
Patient Handouts on Valproate semisodium
Blogs on Valproate semisodium
Valproate semisodium in the News
Valproate semisodium in the Marketplace
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International Resources
Valproate semisodium en Español
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Adapted from the FDA Package Insert.