How does Depakote interact with alcohol. What are the potential side effects of combining Depakote and alcohol. Why should patients avoid alcohol while taking Depakote. How can Depakote be used to treat alcohol dependence in certain cases.

Understanding Depakote: Uses and Mechanism of Action

Depakote, also known by its generic name divalproex sodium, is a medication primarily used to treat various neurological and psychiatric conditions. It belongs to a class of drugs called fatty acid derivative anticonvulsants. Depakote works by increasing the levels of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain, which has a calming effect on nerve activity.

What conditions does Depakote treat? Depakote is commonly prescribed for:

• Epilepsy
• Bipolar disorder
• Migraine prevention
• Mania

The medication comes in various formulations, including immediate-release tablets, extended-release tablets (Depakote ER), and sprinkle capsules. The choice of formulation depends on the specific condition being treated and the patient’s needs.

The Dangerous Combination: Depakote and Alcohol

Mixing Depakote with alcohol can lead to serious health risks and complications. The interaction between these two substances can significantly amplify the central nervous system depressant effects of both.

What happens when Depakote is combined with alcohol? The combination can result in:

• Increased dizziness
• Severe drowsiness
• Difficulty concentrating
• Impaired thinking and judgment
• Slowed reaction times

These effects can be particularly dangerous in situations requiring mental alertness, such as driving or operating machinery. The risks associated with this combination underscore the importance of avoiding alcohol consumption while taking Depakote.

Side Effects and Risks of Depakote Use

Even without the added complication of alcohol, Depakote can cause a range of side effects. Understanding these potential adverse reactions is crucial for patients and healthcare providers alike.

What are the common side effects of Depakote? Some frequently reported side effects include:

• Nausea and vomiting
• Stomach pain
• Drowsiness
• Dizziness
• Weight gain
• Hair loss
• Tremors

In rare cases, Depakote can cause more serious side effects such as liver damage, pancreatitis, or blood disorders. Patients should be monitored closely by their healthcare providers, especially during the initial stages of treatment.

Depakote’s Interactions with Other Substances

While the interaction with alcohol is particularly noteworthy, Depakote can interact with numerous other substances, including medications and certain foods. These interactions can affect the efficacy of Depakote or increase the risk of side effects.

Which substances can interact with Depakote? Some notable interactions include:

• Other anticonvulsants (e.g., phenytoin, carbamazepine)
• Blood thinners (e.g., warfarin)
• Certain antibiotics
• Aspirin and other NSAIDs
• Some antidepressants

It’s crucial for patients to inform their healthcare providers about all medications, supplements, and dietary habits to avoid potential harmful interactions.

Depakote in the Treatment of Alcohol Dependence

Interestingly, while mixing Depakote with alcohol is generally contraindicated, some research has explored the potential use of Depakote in treating alcohol dependence, particularly in individuals with co-occurring mood or anxiety disorders.

Can Depakote help treat alcohol dependence? Studies have shown mixed results:

• Some research suggests Depakote may help reduce irritability and impulsivity in alcohol-dependent individuals
• It may be particularly effective in those with co-morbid mood and anxiety disorders
• However, clear evidence for its efficacy in preventing alcohol relapse is lacking

A randomized, double-blind clinical trial has been proposed to examine the effectiveness of extended-release Depakote (Depakote-ER) in treating co-morbid mood and anxiety disturbances in alcohol-dependent subjects. This research aims to provide more definitive answers about Depakote’s potential role in alcohol dependence treatment.

Safety Precautions and Monitoring During Depakote Treatment

Given the potential for side effects and interactions, patients taking Depakote require careful monitoring and should adhere to specific safety precautions.

What safety measures should be taken when using Depakote? Key precautions include:

• Regular blood tests to monitor liver function and blood cell counts
• Avoiding activities requiring mental alertness until the medication’s effects are known
• Informing healthcare providers about all other medications and supplements
• Reporting any unusual symptoms or side effects promptly
• Adhering to the prescribed dosage and not altering it without medical advice

Patients should also be aware of the potential for withdrawal symptoms if Depakote is stopped abruptly. Any changes in medication regimen should be done under close medical supervision.

Depakote Use in Special Populations

The use of Depakote requires special consideration in certain populations due to increased risks or potential complications.

Which groups require special attention when using Depakote? Some key populations include:

• Pregnant women: Depakote can cause serious birth defects and developmental delays
• Women of childbearing age: Effective contraception is crucial due to the risks to fetal development
• Elderly patients: They may be more susceptible to side effects and require dose adjustments
• Patients with liver disease: Depakote can exacerbate liver problems
• Individuals with a history of depression or suicidal thoughts: Depakote may increase the risk of suicidal ideation

Healthcare providers must carefully weigh the benefits and risks when prescribing Depakote to these populations and implement appropriate monitoring strategies.

Depakote and Pregnancy: A Critical Concern

The use of Depakote during pregnancy deserves special attention due to its potential to cause severe birth defects and developmental issues. The risks associated with Depakote use during pregnancy are significant and well-documented.

What are the risks of taking Depakote during pregnancy? Some of the potential complications include:

• Neural tube defects (e.g., spina bifida)
• Craniofacial defects
• Cardiovascular malformations
• Developmental delays and cognitive impairments
• Increased risk of autism spectrum disorders

Due to these risks, Depakote is generally contraindicated during pregnancy, especially during the first trimester. Women of childbearing age who are prescribed Depakote should use effective contraception and discuss family planning with their healthcare provider.

Alternative Treatments and Considerations

Given the potential risks and interactions associated with Depakote, especially its contraindication with alcohol, it’s important to consider alternative treatment options in certain situations.

What alternatives to Depakote might be considered? Some options include:

• Other anticonvulsants (e.g., lamotrigine, topiramate) for epilepsy or bipolar disorder
• Lithium or atypical antipsychotics for bipolar disorder
• Beta-blockers or calcium channel blockers for migraine prevention
• Cognitive-behavioral therapy or other psychotherapeutic approaches for mood disorders

The choice of alternative treatment depends on the specific condition being treated, the patient’s individual characteristics, and the potential risks and benefits of each option. A thorough discussion with a healthcare provider is essential to determine the most appropriate treatment strategy.

Non-Pharmacological Approaches to Managing Conditions Treated by Depakote

In addition to pharmacological alternatives, various non-drug approaches can complement or, in some cases, replace Depakote treatment. These approaches can be particularly valuable for patients who cannot take Depakote due to alcohol use or other contraindications.

What non-pharmacological approaches can help manage conditions typically treated with Depakote? Some options include:

• Lifestyle modifications (e.g., stress reduction techniques, sleep hygiene)
• Dietary changes (e.g., ketogenic diet for epilepsy)
• Mindfulness and meditation practices
• Regular exercise routines
• Acupuncture or other complementary therapies

These approaches can be used in conjunction with medication or as standalone treatments, depending on the severity of the condition and the individual’s response. Integrating these non-pharmacological strategies can often lead to better overall outcomes and improved quality of life.

Patient Education and Counseling on Depakote Use

Effective patient education is crucial for ensuring safe and appropriate use of Depakote. Healthcare providers play a vital role in counseling patients about the medication’s benefits, risks, and proper usage.

What key points should be covered in patient education about Depakote? Essential information includes:

• The importance of adhering to the prescribed dosage schedule
• Potential side effects and when to seek medical attention
• The need to avoid alcohol and inform healthcare providers about all other medications
• The importance of regular follow-up appointments and blood tests
• Proper storage and handling of the medication
• What to do in case of a missed dose

Patients should also be encouraged to ask questions and voice any concerns they may have about their treatment. Open communication between patients and healthcare providers is essential for optimal treatment outcomes.

The Role of Support Systems in Depakote Treatment

The involvement of family members or other support persons can significantly enhance the effectiveness and safety of Depakote treatment. These individuals can provide valuable assistance and monitoring, especially in cases where the patient may have difficulty managing their medication independently.

How can support systems help in Depakote treatment? Family members or caregivers can:

• Help monitor for side effects or changes in behavior
• Assist with medication adherence and proper dosing
• Provide emotional support and encouragement
• Help maintain a healthy lifestyle that complements treatment
• Communicate important information to healthcare providers

Educating these support persons about Depakote, its effects, and potential risks is an important aspect of comprehensive patient care. Their involvement can contribute to better treatment outcomes and improved quality of life for the patient.

Long-Term Considerations and Follow-Up Care

Depakote treatment often extends over long periods, sometimes years or even decades. As such, long-term considerations and regular follow-up care are essential components of treatment.

What aspects of long-term Depakote use require ongoing attention? Key considerations include:

• Regular monitoring of blood levels to ensure therapeutic efficacy and avoid toxicity
• Periodic liver function tests and complete blood counts
• Monitoring for long-term side effects such as osteoporosis or polycystic ovary syndrome in women
• Reassessment of the need for continued treatment at regular intervals
• Adjustment of dosage based on age, weight changes, or other factors

Healthcare providers should establish a comprehensive follow-up plan that includes regular check-ups, blood tests, and discussions about treatment efficacy and any emerging concerns. This ongoing care helps ensure the continued safety and effectiveness of Depakote treatment over time.

Managing Depakote Treatment During Life Transitions

Various life transitions can impact Depakote treatment and may necessitate adjustments in medication management. These transitions can include changes in lifestyle, health status, or life stages.

What life transitions might affect Depakote treatment? Some important considerations include:

• Adolescence to adulthood: Dosage adjustments may be needed as body weight and metabolism change
• Pregnancy planning: Alternative treatments should be considered due to the risks associated with Depakote during pregnancy
• Menopause: Hormonal changes may affect medication efficacy or side effects
• Aging: Older adults may require dose adjustments due to changes in metabolism and increased sensitivity to side effects
• Development of new health conditions: Comorbidities may influence Depakote treatment or necessitate additional medications

Healthcare providers should proactively discuss these potential transitions with patients and develop strategies to manage Depakote treatment effectively throughout different life stages. This forward-thinking approach helps ensure continuity of care and maintains treatment efficacy while minimizing risks.

Research and Future Directions in Depakote Treatment

Ongoing research continues to explore new applications, formulations, and treatment strategies involving Depakote. These studies aim to improve the efficacy of treatment, reduce side effects, and expand the range of conditions for which Depakote may be beneficial.

What areas of Depakote research are currently being pursued? Some key research directions include:

• Development of new extended-release formulations to improve dosing convenience and reduce side effects
• Investigation of Depakote’s potential efficacy in treating additional psychiatric and neurological conditions
• Exploration of genetic factors that may influence individual response to Depakote
• Studies on the long-term effects of Depakote use, particularly in pediatric populations
• Research into combination therapies that may enhance Depakote’s effectiveness or mitigate its side effects

As research progresses, it’s likely that our understanding of Depakote’s mechanisms, applications, and optimal use will continue to evolve. Patients and healthcare providers should stay informed about these developments to ensure they are leveraging the most current knowledge in treatment decisions.

The Promise of Personalized Medicine in Depakote Treatment

The field of personalized medicine holds significant promise for optimizing Depakote treatment. By considering individual genetic, environmental, and lifestyle factors, healthcare providers may be able to tailor Depakote therapy more precisely to each patient’s needs.

How might personalized medicine improve Depakote treatment? Some potential applications include:

• Genetic testing to predict individual response to Depakote and likelihood of side effects
• Use of biomarkers to monitor treatment efficacy and adjust dosing more precisely
• Integration of data from wearable devices to track real-time response to medication
• Development of algorithms to predict optimal starting doses based on individual patient characteristics
• Customized combination therapies based on individual patient profiles

While many of these applications are still in the research phase, the potential for personalized medicine to revolutionize Depakote treatment is significant. As these approaches are refined and validated, they may lead to more effective, safer, and better-tolerated treatment regimens for patients requiring Depakote therapy.

Depakote and Alcohol/Food Interactions – Drugs.com

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There is 1 alcohol/food/lifestyle interaction with Depakote (divalproex sodium).

Alcohol can increase the nervous system side effects of divalproex sodium such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with divalproex sodium. Do not use more than the recommended dose of divalproex sodium, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Switch to professional interaction data

Depakote drug interactions

There are 380 drug interactions with Depakote (divalproex sodium).

Depakote disease interactions

There are 8 disease interactions with Depakote (divalproex sodium) which include:

• depression
• liver disease
• urea cycle disorders
• suicidal tendency
• HIV/CMV
• thrombocytopenia
• thyroid function tests
• urine ketone test

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More about Depakote (divalproex sodium)

• Depakote consumer information
• Check interactions
• Compare alternatives
• Pricing & coupons
• Reviews (321)
• Drug images
• Side effects
• Dosage information
• Patient tips
• During pregnancy
• Generic availability
• Support group
• Drug class: fatty acid derivative anticonvulsants
• Breastfeeding
• En español

Related treatment guides

• Mania
• Bipolar Disorder
• Epilepsy
• Migraine Prevention

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.

Major	Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate	Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor	Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown	No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Placebo Controlled Trial of Depakote ER in Alcohol Dependent Patients With Mood and/or Anxiety Symptoms – Full Text View

Alcohol dependence afflicts 14 million individuals in the U.S. The alcohol related costs to society are enormous and alcohol dependence is a significant public health problem. Although pharmacotherapy for the treatment of alcohol dependence and relapse prevention has expanded, the identification of evidence based treatment strategies is of critical importance. Anticonvulsants, including the divalproex sodium (DVP) formulation of valproate, have established effectiveness for mood disorders, and therapeutic response of mood and anxiety symptoms to DVP has been demonstrated in a number of psychiatric conditions. While DVP has been demonstrated as a treatment option for the acute alcohol withdrawal syndrome, a clear treatment effect has not been found in studies examining DVP for ongoing relapse prevention in alcohol dependence. These latter studies had limited power and excluded subjects with co-morbid mood and anxiety disorders, individuals who may, by extension of the former studies, show the greatest response to treatment with DVP. Despite the exclusion of subjects with mood and anxiety disorders, alcohol dependent individuals treated with DVP compared to placebo showed greater improvement in irritability and a trend toward greater decreases on measures of impulsivity and aggression. A strategy integrating the above findings would target treatment with DVP more specifically to alcohol dependent individuals with mood and anxiety disturbances.

This randomized, double-blind clinical trial will examine the effectiveness of extended release DVP (Depakote-ER) in the treatment of co-morbid mood and anxiety disturbance in alcohol dependent subjects. The primary hypothesis is that subjects treated with Depakote-ER will have significantly lower scores on the Symptom Checklist (SCL-90-R) than will placebo treated subjects over the course of the study. Secondary hypotheses include: 1) Compared to placebo treated subjects, subjects treated with Depakote-ER will demonstrate significantly lower scores on additional measures of depression, anxiety, and irritability, 2) will have fewer alcohol use days and fewer drinks per drinking day, and 3) will evidence better retention in alcohol dependence treatment.

Eligible subjects will complete baseline assessments and a 7-day run on Depakote-ER prior to randomization. After the 7-day baseline period and run in with Depakote-ER, subjects will be randomized and then transition to either 12 weeks of Depakote-ER or placebo, to begin upon completion of the 7-day run-in baseline period. Valproic acid level obtained at the end of the baseline period will be used to adjust the dose of Depakote-ER (or matched placebo) as needed to target a valproic level of 70-120 ug/ml. Dose increase, if needed, will occur with the study medication dispensed at the next follow up visit (scheduled for the end of the 1st week of active study medication or placebo). Subjects with valproic acid levels > 120 ug/ml at the end of the baseline period will be contacted as soon as possible and instructed to decrease their dose of Depakote-ER (or matched placebo) accordingly. Subjects randomized to the placebo condition will receive a placebo matched in number and appearance to the dosage of Depakote-ER prescribed during the 7-day baseline period. If needed, the number of placebo pills will be adjusted to match the change in the Depakote-ER dosage determined necessary based on the valproic acid level obtained at the end of the 7-day baseline period.

Duration of Subject Participation: Subjects will receive either divalproex sodium extended release (Depakote-ER) or matched placebo for 12 weeks. Subjects will continue to receive other “treatment as usual” within the Addiction Treatment Center in accordance with their ongoing clinical program treatment plan. The standard expectation within the context of treatment as usual is for at least 6 months of treatment involvement. A limited number of psychotropic medications will be allowed during the study. A benzodiazepine (usually chlordiazepoxide or lorazepam, in accordance with standard practice and generally given in an as needed symptom triggered manner) can be prescribed during the acute detoxification period (first 7 days). Hydroxyzine can be prescribed PRN for anxiety, and zolpidem PRN (not to exceed 5 nights per week) for insomnia, throughout the course of the study.

Alcohol and medicines – Alkoinfo.ee

If a person does not recognize the problem himself, it is difficult to send him for treatment. There are certain criteria for referral to compulsory treatment.

Law on Psychiatric Care, § 11. Involuntary and unavoidable psychiatric care, states that
(1) Without the consent of the person or his legal representative, a person is sent to the psychiatric department of a hospital for treatment under the procedure of emergency psychiatric care, or treatment is continued regardless of his will (hereinafter referred to as compulsory treatment). ), only if the following circumstances occur together:
1) the person has a severe mental disorder that limits their ability to understand or control their behaviour;
2) by not being treated in a hospital, a person endangers the life, health or safety of himself or other persons due to a mental disorder;
3) other psychiatric care is not enough.

In case of delirium, an ambulance can be called. A person is admitted to the hospital if he is dangerous, and even then he can be kept there for 48 hours without a court order. Just because a person drinks, one cannot treat him against his will. Unfortunately, this is the bitter truth. Often, simply spending some time sober in a hospital is not enough to treat an alcohol use disorder (dependence). It is a lifelong condition that requires long-term treatment, sometimes even years, before a person can remain sober. Even if your family member sobers up, it takes willpower to stay sober. Here we come to a person’s own intrinsic motivation, which is the basis for maintaining sobriety in the future. You can do your best, but if the family member does not take responsibility and sees the need to change their drinking, the help provided will only be temporary and will not produce the desired result.
To increase motivation and understand the severity of the problem, you can talk to a family member who drinks about how you and others feel about his drinking and how it affects you. This should be done in a calm tone, avoiding accusations, nit-picking, threats and moralizing. You must speak when a family member is sober. Try to choose a time and place where you can talk calmly and have enough time. If he notices the attack, he may tell you that this is not a problem for him, or he may act aggressively and make excuses. Unfortunately, you cannot force a member of your family to go to treatment. However, you can try to motivate him. You can also read about how to talk to him about it and express your concerns here.

If a family member does not want help, you can take care of yourself and save yourself. You can read about how to deal with what is happening to you here.

There are also self-help groups for loved ones whose family members abuse alcohol. For more information and help, contact the Al-Anon Family Group, which is a fellowship of relatives and friends of people who abuse alcohol, whose members share their experience, strength, and hope for solving common problems.

Anyone who suffers or has suffered because a loved one abuses alcohol can join the group. Additional Information.

You can also read more about alcohol on the Alkoinfo website to better understand the nature of the alcohol disorder. On this website, you will also find treatment options and contacts to contact if a family member wishes to receive assistance.
Good luck!

Valproic Acid and Derivatives | Memorial Sloan Kettering Cancer Center

Adult Medication

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This document, provided by Lexicomp ^® , contains all the information you need to know about this medicine, including indications, directions for use, side effects, and when your healthcare provider should be contacted.

Trade names: USA

Depacon [DSC]; Depakene [DSC]; Depakote; Depakote ER; Depakote Sprinkles

Trade names: Canada

APO-Divalproex; APO-Valproic Acid; Depakene; epival; MYLAN-Divalproex; PMS-Valproic; PMS-Valproic Acid; SANDOZ Valproic [DSC]; TEVA-Divalproex [DSC]

Warning

All Forms:

• The use of this drug was accompanied by violations of the liver. In some cases, these violations have led to death. In most cases, liver problems occurred within the first 6 months after starting this drug. Sometimes problems do not improve after stopping treatment with this drug. Call your doctor right away if you develop signs of liver problems such as dark urine, fatigue, lack of appetite, nausea or abdominal pain, light-colored stools, vomiting, yellowing of the skin or eyes. In patients suffering from seizures, there may be a loss of control over seizures.
• Perform blood tests as directed by your doctor. Consult with your doctor.
• The risk of life-threatening liver problems is increased in children under 2 years of age. The risk is highest in patients taking more than 1 anti-seizure drug or who have a metabolic disorder, severe epilepsy with mental retardation, or congenital brain disease. Consult your doctor.
• Patients with a genetic liver disorder are at an increased risk of developing liver failure due to a mitochondrial disorder such as Alpers-Huttenlocher syndrome. You may need genetic testing to detect this disease. If you have or may have mitochondrial disorders, do not take this drug without talking to your doctor.
• This drug can cause serious birth defects if taken during pregnancy. It can also lower your child’s IQ and may increase the risk of autism or ADHD. If you are pregnant or may become pregnant, check with your doctor to make sure this drug is right for you. Use birth control to prevent pregnancy while you are taking this drug. If you become pregnant while taking this drug, contact your doctor immediately.
• Do not take this migraine prevention drug if you are pregnant or not using birth control to prevent pregnancy.
• This drug can cause very serious and sometimes deadly problems with the pancreas (pancreatitis). Such a danger exists both at the very beginning of taking the drug, and many years after its use. Symptoms of pancreatitis include abdominal pain, nausea, vomiting, or decreased appetite. If any of these symptoms occur, contact your doctor immediately.

All oral preparations:

• This drug comes with a separate patient information leaflet called Patient Drug Information. Read it carefully each time you take this drug. If you have any questions about this drug, ask your doctor, pharmacist, or other health care professional.

What is this drug used for?

• Used to treat seizures.
• It is used to prevent migraine.
• Used to treat bipolar disorder.
• This drug may also be used for other indications. Consult your doctor.

What should I tell my doctor BEFORE taking this drug?

• If you have an allergy to this drug, any of its ingredients, other drugs, foods or substances. Tell your doctor about your allergies and how they have manifested.
• If you have any of the following health problems: liver disease or a urea cycle disorder.

This list of drugs and conditions that may interfere with this drug is not all-inclusive.

Tell your doctor and pharmacist about all medicines you take (prescription and over-the-counter, natural products and vitamins) and any health problems you have. You need to make sure that this drug is safe for your conditions and in combination with other drugs you are already taking. Do not start or stop taking any drug or change the dosage without your doctor’s advice.

What do I need to know or do while taking this drug?

For all uses of this drug:

• Tell all your health care workers that you are taking this drug. These are doctors, nurses, pharmacists and dentists.
• Avoid driving or doing other tasks or jobs that require alertness or keen eyesight until you know how this drug affects you.
• Perform blood tests as directed by your doctor. Consult with your doctor.
• Check with your doctor before using alcohol, marijuana or other forms of cannabis, or prescription or over-the-counter drugs that can slow you down.
• This drug may affect the results of some lab tests. Tell all your health care workers and laboratory staff that you are taking this drug.
• If you are unable to eat or drink as usual, please consult your physician. This includes illness, fasting, certain procedures, or surgery.
• Some brands of this drug contain peanut butter. If you are allergic to peanuts, ask your pharmacist to test this brand of product for peanut oil content.
• There is an increased chance of bleeding. Be careful and avoid injury. Use a soft toothbrush and an electric razor.
• This drug has been associated with increased levels of ammonia in the blood. This can lead to certain brain disorders. Some fatalities. Consult your doctor.
• In some individuals, certain brain disorders were not accompanied by an increase in the level of ammonia in the blood. In some cases, these brain disorders resolved after discontinuation of treatment with this drug. However, in some cases they did not go completely. Consult your doctor.
• There was a serious reaction that could be deadly. In most cases, this reaction was accompanied by symptoms such as fever, rash, inflammation of the lymph nodes, and dysfunction of various organs such as the liver, kidneys, blood, heart, muscles, joints and lungs. If you have any questions, please consult your doctor.
• If you are 65 years of age or older, use this drug with caution. You may experience more side effects.
• This drug may affect a man’s ability to have a child. Consult your doctor.
• Tell your doctor if you are breastfeeding. It is necessary to consult whether the drug poses any risk to the child.

Anti-seizure:

• Talk to your doctor if your seizures change or get worse after you start taking this drug.

What side effects should I report to my doctor immediately?

WARNING. In rare cases, this drug can cause serious and sometimes deadly side effects in some patients. Contact your doctor or seek medical attention right away if you have any of the following signs or symptoms that may be associated with serious side effects:

• Signs of an allergic reaction such as rash, hives, itching, red and swollen skin with blisters or peeling, possibly accompanied by fever, wheezing or wheezing, tightness in the chest or throat, trouble breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue or throat.
• Signs of infection, such as fever, chills, very bad pain in the throat, ear, or sinuses, cough, more sputum or change in color, pain when urinating, mouth sores, or a sore that doesn’t heal.
• Signs of high ammonia levels such as irregular heartbeat, trouble breathing, confusion, pale skin, bradycardia, seizures, sweating, vomiting, or muscle twitches.
• Chest pain.
• Swelling of the hands or feet.
• Vision change.
• Impairment or loss of memory.
• Balance change.
• Difficulties with walking.
• Any unexplained bruising or bleeding.
• The appearance of purple spots on the skin or redness of the skin.
• Difficulty urinating or a change in the amount of urine produced.
• Muscle pain or weakness.
• Pain or inflammation in the joints.
• Shiver.
• Loss of control over eye movements.
• Tinnitus.
• Chills.
• Like other seizure medicines, this medicine can rarely increase the risk of suicidal ideation or behavior. This risk may be higher in people who have tried or had suicidal thoughts in the past. Call your doctor right away if you develop or worsen symptoms such as depression, nervousness, anxiety, irritability, panic attacks, or other mood or behavioral disturbances. If you have suicidal thoughts or attempted suicide, contact your doctor immediately.

What are some other side effects of this drug?

Any medicine can have side effects. However, for many people, side effects are either minor or non-existent. Contact your doctor or seek medical attention if these or any other side effects bother you or do not go away:

• Headache.
• Constipation, diarrhea, abdominal pain, nausea, vomiting, or decreased appetite.
• Increased appetite.
• Feeling dizzy, drowsy, tired or weak.
• Sleep disorders.
• Weight gain or loss.
• Hair loss.
• Nervous tension and agitation.
• Flu-like symptoms.

This list of possible side effects is not exhaustive. If you have any questions about side effects, please contact your doctor. Talk to your doctor about side effects.

You can report side effects to the National Health Board.

You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.

What is the best way to take this drug?

Use this drug as directed by your doctor. Read all the information provided to you. Strictly follow all instructions.

All oral preparations:

• Take with or without food. Take with food if medicine causes nausea.
• Keep taking this drug as instructed by your doctor or other health care professional, even if you feel well.
• Do not stop taking this drug abruptly without consulting your doctor. This can increase the risk of seizures. If necessary, taking this drug should be stopped gradually, in accordance with the doctor’s instructions.
• If you are taking cholestyramine, you may need to take it at a different time from when you take this drug. Consult with a pharmacist.

Tablets and capsules:

• Swallow whole. Do not chew, break or crush.
• Take this drug with a full glass of water.
• If you have difficulty swallowing, check with your doctor.

Long acting tablets:

• If you see particles of this drug in your stool, contact your doctor.

Split capsule:

• You can swallow the capsule whole or mix the contents of the capsule with certain foods such as applesauce. Take the mixture immediately. Do not store for future use.
• The mixture should not be chewed.
• If you see particles of this drug in your stool, contact your doctor.

Liquid:

• Liquid doses should be measured with caution. Use the dispenser that comes with the medication. If the dispenser is not provided in the package, ask the pharmacist for a dosing agent for this drug.

Injection:

• This drug is administered by infusion intravenously continuously for a certain time.

What if I miss a dose of a drug?

All oral preparations:

• Take the missed dose as soon as you can.
• If it’s time for your next dose, don’t take the missed dose and then go back to your regular dosing schedule.
• Do not take 2 doses or an additional dose at the same time.

Injection:

• See your doctor for further instructions.

How do I store and/or discard this drug?

All oral preparations:

• Store at room temperature in a dry place. Do not store in the bathroom.

Injection:

• If you need to store this drug at home, check with your doctor, nurse, or pharmacist for storage conditions.

All forms:

• Keep all medicines in a safe place. Keep all medicines out of the reach of children and pets.
• Dispose of unused or expired drugs. Do not empty into a toilet or sewer unless instructed to do so. If you have any questions about disposing of medicines, ask your pharmacist. Drug disposal programs may be in place in your area.

General information about medicines

• If your health does not improve or even worsens, see your doctor.
• Do not give your medicine to anyone and do not take other people’s medicines.
• Some medicines may come with other patient information leaflets. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other health care professional.
• Some medicines may come with other patient information leaflets. Check with your pharmacist. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other health care professional.
• If you think you have overdosed, call a poison control center or get medical help right away. Be prepared to tell or show what drug you took, how much, and when it happened.

Consumer Use of Information and Limitation of Liability

This summary information includes a summary of the diagnosis, treatment and/or drug product. It is not intended to be a comprehensive source of data and should be used as a tool to help the user understand and/or evaluate potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a particular patient.