How does Depakote interact with alcohol and other substances. What are the contraindications for Depakote and Depakote ER. Why should certain health conditions be considered before taking Depakote.

What is Depakote and What Are Its Uses?

Depakote and Depakote ER (divalproex sodium) are prescription medications primarily used to treat various neurological and psychiatric conditions. These drugs have gained significant importance in the medical field due to their versatility and effectiveness.

The main uses of Depakote and Depakote ER include:

• Treatment of certain types of seizures in adults and some children
• Management of bipolar disorder in adults
• Prevention of migraine headaches in adults

These medications have proven to be invaluable in improving the quality of life for many patients suffering from these conditions. However, like all powerful medications, they come with potential risks and interactions that need to be carefully considered.

Depakote and Alcohol: A Potentially Dangerous Combination

While Depakote and Depakote ER are not known to have direct interactions with alcohol, combining these medications with alcoholic beverages can lead to potentially dangerous outcomes. The primary concern stems from the fact that both Depakote and alcohol can cause drowsiness and dizziness as side effects.

When alcohol is consumed while taking Depakote or Depakote ER, these side effects may be intensified, leading to:

• Increased risk of accidents
• Impaired judgment
• Heightened drowsiness
• Exacerbated dizziness

Due to these potential risks, healthcare providers often recommend avoiding alcohol consumption during Depakote treatment. However, the exact recommendations may vary based on individual circumstances.

Consulting Your Healthcare Provider

Can patients safely consume any amount of alcohol while on Depakote? The answer to this question is not straightforward and depends on various factors. It’s crucial for patients to have an open and honest discussion with their healthcare provider about their alcohol consumption habits.

Your doctor can provide personalized advice on:

1. Whether it’s safe for you to consume alcohol at all while on Depakote
2. If some alcohol consumption is permissible, what amount might be considered safe
3. Potential risks specific to your health condition and medication regimen
4. Alternative strategies to manage social situations where alcohol might be present

Contraindications: When Depakote Should Not Be Prescribed

Certain health conditions and factors can significantly increase the risk of harm from Depakote or Depakote ER. In these cases, healthcare providers typically avoid prescribing these medications. These situations are known as contraindications.

Liver Problems and Depakote

Why is Depakote contraindicated in patients with liver problems? Depakote and Depakote ER can cause severe liver damage, which can be life-threatening in some cases. For individuals with existing liver issues or a history of liver problems, the risk of further damage is significantly higher. Additionally, liver damage can interfere with how these drugs work to manage seizures, potentially reducing their effectiveness.

Mitochondrial Disorders and Depakote Risk

Mitochondrial disorders are rare genetic conditions affecting the mitochondria, which are crucial for cellular energy production. Patients with certain mitochondrial disorders have an elevated risk of liver damage when taking Depakote or Depakote ER. As a result, these medications are typically not prescribed to individuals with known mitochondrial disorders.

Urea Cycle Disorders: A Dangerous Combination

Urea cycle disorders are genetic conditions that impair the body’s ability to process and eliminate urea, a chemical made from ammonia. Depakote and Depakote ER can cause ammonia to accumulate in the body, which is particularly dangerous for individuals with urea cycle disorders. The combination can lead to dangerously high ammonia levels, potentially causing brain damage.

Pregnancy and Depakote: A Serious Concern

Is Depakote safe during pregnancy? The answer is a resounding no. Depakote and Depakote ER can cause significant harm to a developing fetus if taken during pregnancy. The risks are so severe that these medications are absolutely contraindicated during pregnancy.

Potential risks to the fetus include:

• Neural tube defects
• Developmental delays
• Cognitive impairments
• Other congenital malformations

Women of childbearing age who are prescribed Depakote should use effective contraception and discuss their family planning goals with their healthcare provider. If pregnancy occurs while taking Depakote, it’s crucial to contact a healthcare provider immediately to discuss the risks and potential alternatives.

Drug Interactions: Medications to Avoid with Depakote

Depakote and Depakote ER can interact with various medications, potentially altering their effectiveness or increasing the risk of side effects. It’s crucial for patients to inform their healthcare providers about all medications they are taking, including over-the-counter drugs and supplements.

Topiramate and Depakote: A Dangerous Duo

Why is the combination of topiramate (Topamax) and Depakote dangerous? When taken together, these medications can lead to two potentially life-threatening conditions:

1. Hyperammonemia (high blood ammonia levels): This can cause brain dysfunction and cognitive impairment.
2. Hypothermia: Dangerously low body temperature, which can lead to various health complications.

Due to these severe risks, healthcare providers typically avoid prescribing Depakote and topiramate together.

Aspirin and Depakote Interactions

Aspirin, when taken with Depakote or Depakote ER, can increase the risk of side effects from these medications. The interaction may lead to:

• Increased bleeding risk
• Gastrointestinal irritation
• Altered drug levels in the blood

Patients taking Depakote should consult their healthcare provider before using aspirin or aspirin-containing products.

Carbapenem Antibiotics and Depakote Efficacy

Carbapenem antibiotics, such as ertapenem (Invanz) and meropenem (Merrem), can significantly reduce the effectiveness of Depakote and Depakote ER. This interaction occurs because carbapenem antibiotics can decrease the blood levels of valproic acid, the active ingredient in Depakote.

As a result, patients taking Depakote who require antibiotic treatment should discuss alternative options with their healthcare provider to ensure their seizure control or other symptoms remain adequately managed.

Other Important Interactions and Considerations

While we’ve covered some of the most significant interactions and contraindications for Depakote and Depakote ER, there are other important factors to consider:

Allergic Reactions

Individuals who have previously experienced an allergic reaction to Depakote, Depakote ER, or any of their ingredients should not take these medications. Allergic reactions can be severe and potentially life-threatening. In such cases, healthcare providers will explore alternative treatment options.

Supplements, Herbs, and Vitamins

Do natural supplements interact with Depakote? While not as well-studied as drug interactions, some supplements, herbs, and vitamins may potentially interact with Depakote and Depakote ER. It’s crucial for patients to disclose all supplements they are taking to their healthcare provider.

Some supplements that may interact with Depakote include:

• St. John’s Wort
• Vitamin E
• Folic acid
• Melatonin

These interactions can affect drug levels, efficacy, or increase the risk of side effects. Always consult with a healthcare provider before starting or stopping any supplements while taking Depakote.

Monitoring and Safety Precautions

Given the potential for interactions and side effects, patients taking Depakote or Depakote ER typically require regular monitoring. This may include:

1. Blood tests to check liver function and drug levels
2. Regular check-ups to assess effectiveness and side effects
3. Monitoring for signs of unusual bleeding or bruising
4. Assessments of mental health and cognitive function

Healthcare providers may adjust dosages or recommend additional precautions based on these monitoring results.

Patient Education and Empowerment

How can patients ensure their safety while taking Depakote? Education and open communication with healthcare providers are key. Patients should:

• Understand the potential side effects and warning signs to watch for
• Keep a list of all medications and supplements they are taking
• Report any unusual symptoms or concerns promptly
• Follow dosing instructions carefully
• Attend all scheduled follow-up appointments

By staying informed and proactive, patients can help ensure the safe and effective use of Depakote or Depakote ER.

Alternatives to Depakote: Exploring Other Options

For individuals who cannot take Depakote due to contraindications or severe interactions, alternative medications may be available. The choice of alternative depends on the specific condition being treated and individual patient factors.

Alternative Medications for Seizures

What other options are available for seizure control? Some alternatives to Depakote for seizure management include:

• Carbamazepine (Tegretol)
• Levetiracetam (Keppra)
• Lamotrigine (Lamictal)
• Phenytoin (Dilantin)

Alternatives for Bipolar Disorder

For bipolar disorder treatment, alternatives to Depakote may include:

• Lithium
• Atypical antipsychotics (e.g., quetiapine, olanzapine)
• Lamotrigine
• Carbamazepine

Migraine Prevention Alternatives

Alternative medications for migraine prevention include:

• Topiramate (when not contraindicated)
• Beta-blockers (e.g., propranolol)
• Amitriptyline
• CGRP antagonists (e.g., erenumab, fremanezumab)

The choice of alternative medication should always be made in consultation with a healthcare provider, taking into account the individual’s specific medical history, current health status, and other medications.

The Future of Depakote and Neurological Treatment

As medical research continues to advance, our understanding of Depakote, its interactions, and potential alternatives continues to evolve. Ongoing studies are exploring:

• New formulations with potentially fewer side effects
• Genetic factors that may influence drug response and risk of side effects
• Novel treatment approaches for seizures, bipolar disorder, and migraines
• Improved methods for monitoring drug levels and predicting interactions

These advancements may lead to more personalized and effective treatment strategies in the future, potentially reducing the risks associated with Depakote use while maintaining or improving its therapeutic benefits.

The Role of Pharmacogenomics

How might genetic testing impact Depakote treatment in the future? Pharmacogenomics, the study of how genes affect a person’s response to drugs, is an exciting area of research that may revolutionize how we prescribe medications like Depakote.

Potential benefits of pharmacogenomic testing for Depakote include:

1. Identifying individuals at higher risk for side effects
2. Predicting which patients are more likely to respond well to the medication
3. Guiding dosage decisions based on genetic factors affecting drug metabolism
4. Reducing the trial-and-error approach to finding the right medication and dosage

While still in its early stages, this field holds promise for improving the safety and efficacy of Depakote and similar medications in the future.

Depakote and Depakote ER Interactions: Other Drugs and More

Depakote and Depakote ER (divalproex sodium) are prescription drugs that are used to:

• treat certain types of seizures in adults and some children
• treat bipolar disorder in adults
• prevent migraine headaches in adults

Like other drugs, Depakote and Depakote ER may have interactions.

Some interactions occur because one substance causes another substance to have a different effect than expected. For example, sometimes alcohol, another drug, or a supplement can affect how a drug acts in your body. Interactions can also occur if you have certain health conditions.

Keep reading to learn about possible interactions with these drugs, including what you should not take with Depakote or Depakote ER. And for more information about Depakote and Depakote ER, including details about its uses, see this article.

Certain health conditions or other factors could raise your risk of harm if you take Depakote or Depakote ER. In such cases, your doctor may not prescribe Depakote or Depakote ER for you. These are known as contraindications. The list below includes contraindications of Depakote and Depakote ER.

If you have liver problems. Depakote and Depakote ER can cause severe liver damage, which can be life threatening. In some cases, liver damage can interfere with how these drugs work to manage seizures. Due to this risk, it’s not recommended that you take Depakote or Depakote ER if you have liver problems or have had them in the past.

If you have mitochondrial disorders. Mitochondrial disorders are rare conditions caused by gene mutations affecting the mitochondria. Having certain mitochondrial disorders can raise your risk of liver damage from Depakote or Depakote ER. Due to this risk, doctors typically will not prescribe these drugs if you have certain mitochondrial disorders.

If you have urea cycle disorders. With urea cycle disorders, your body doesn’t get rid of urea as well as usual. (Urea is a chemical made from ammonia.) Depakote and Depakote ER can cause ammonia to build up in your body. Taking Depakote or Depakote ER if you have urea cycle disorders can raise your risk of having high ammonia levels. High ammonia level can harm your brain function. Because of this, your doctor may not prescribe these medications if you have this kind of condition.

If you’re pregnant. Depakote and Depakote ER can cause harm to a fetus if taken during pregnancy. Due to this risk, these drugs should not be taken during pregnancy.

If you take topiramate (Topamax). Taking topiramate (Topamax) with Depakote or Depakote ER has been known to cause high blood ammonia level, which may harm your brain function. Taking these drugs together may also cause hypothermia (dangerously low body temperature).

If you’ve had an allergic reaction. If you have had an allergic reaction to Depakote or Depakote ER or any of its ingredients, your doctor likely won’t prescribe Depakote and Depakote ER. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

Before you start taking Depakote and Depakote ER, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Depakote and Depakote ER are safe for you to take.

Depakote and Depakote are not known to interact with alcohol. But your doctor might recommend that you avoid alcohol while taking either of these drugs. This is because drowsiness or dizziness are side effects of Depakote, Depakote ER, and alcohol. So, combining alcohol with either of these drugs may make any drowsiness or dizziness that you experience worse.

If you drink alcohol, talk with your doctor to learn how much alcohol, if any, may be safe to consume during your treatment with Depakote or Depakote ER.

Before you start taking Depakote or Depakote ER, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Depakote and Depakote ER interact with supplements, herbs, and vitamins, see the “Are there other interactions with Depakote and Depakote ER?” section below.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The chart below lists drugs that may interact with Depakote and Depakote ER. Keep in mind that this chart does not include all drugs that may interact with these drugs. For more information about some of these interactions, see the “Drug interactions explained” section below.

Drug group or drug name	Drug examples	What can happen
aspirin	—	can raise your risk of side effects from Depakote or Depakote ER
carbapenem antibiotics	• ertapenem (Invanz) • meropenem (Merrem)	can make Depakote and Depakote ER less effective
estrogen-containing birth control	• ethinyl estradiol, levonorgestrel (Aviane, Nordette, Seasonique) • ethinyl estradiol, norethindrone (Balziva, Necon 0. 5/35, Loestrin) • ethinyl estradiol, norgestimate (Ortho-Tri-Cyclen, Ortho-Cyclen, Sprintec)	can make Depakote and Depakote ER less effective than usual
certain other seizure drugs	• phenytoin (Dilantin) • carbamazepine (Tegretol) • primidone (Mysoline)	can make Depakote and Depakote ER less effective
felbamate (Felbatol)	—	can increase your risk of side effects from Depakote or Depakote ER
lamotrigine (Lamictal)	—	can raise your risk of side effects from lamotrigine
topiramate (Topamax)	—	can increase your risk of side effects from Depakote or Depakote ER
rufinamide (Banzel)	—	can raise your risk of side effects from rufinamide
rifampin (Rifadin, Rimactane)		can make Depakote and Depakote ER less effective
tricyclic antidepressants	• amitriptyline • nortriptyline (Pamelor)	can increase your risk of side effects from amitriptyline and nortriptyline
clonazepam (Klonopin)	—	can cause prolonged seizures
diazepam (Valium)	—	can increase your risk of side effects from diazepam
propofol (Diprivan)	—	can raise your risk of side effects from propofol
warfarin (Jantoven)	—	can increase your risk of bleeding or make warfarin less effective than usual
lorazepam (Ativan)	—	can raise your risk of side effects from lorazepam

Learn more about certain drug interactions that can occur with Depakote and Depakote ER.

Interaction with Lamictal

Lamotrigine (Lamictal) can interact with Depakote and Depakote ER. Lamotrigine is a drug prescribed to treat bipolar disorder and certain kinds of seizures.

Doctors may prescribe lamotrigine along with Depakote or Depakote ER to treat these conditions.

What could happen

Depakote or Depakote ER can make your body get rid of lamotrigine more slowly. This can cause lamotrigine to build up in your body, which could raise your risk of serious side effects from lamotrigine. Examples include serious skin side effects such as Stevens-Johnson syndrome and toxic epidermal necrolysis.

For more information about lamotrigine’s skin-related side effects, see this article.

What you can do

It’s important to let your doctor know about all the medications you take before you start treatment with Depakote, Depakote ER, or lamotrigine.

If your doctor prescribes lamotrigine and you’re already taking Depakote or Depakote ER, they’ll likely prescribe a lower dose of lamotrigine. If you start Depakote or Depakote ER while you’re already taking lamotrigine, your doctor may need to adjust your lamotrigine dosage.

If you stop taking Depakote or Depakote ER during your lamotrigine treatment, you may need a lamotrigine dosage increase.

If you have questions about taking lamotrigine with Depakote, talk with your doctor or pharmacist.

Interaction with birth control that contains estrogen

Certain kinds of birth control have the hormone estrogen in them. Estrogen interacts with Depakote and Depakote ER.

Many birth control pills contain a combination of hormones, which may include a type of estrogen.

Examples of hormonal birth control pills with estrogen include

• ethinyl estradiol, levonorgestrel (Aviane, Nordette, Seasonique)
• ethinyl estradiol, norethindrone (Balziva, Necon 0.5/35, Loestrin)
• ethinyl estradiol, norgestimate (Ortho-Tri-Cyclen, Ortho-Cyclen, Sprintec)
• ethinyl estradiol, drospirenone (Gianvi, Ocella, Yasmin)

What could happen

Estrogen in birth control can lower the levels of Depakote or Depakote ER in your body. If this happens, Depakote or Depakote ER may be less effective. If you take these medications to manage seizures, taking birth control with estrogen may raise your risk of having seizures.

What you can do

Before you start treatment with Depakote or Depakote ER, tell your doctor if you take birth control. Also, let your doctor know if you start taking any new drugs, including birth control, while you’re taking Depakote or Depakote ER.

If you start taking birth control with estrogen during your Depakote or Depakote ER treatment, your doctor will likely monitor your levels of valproic acid (the active drug in Depakote and Depakote ER). They may adjust your Depakote or Depakote ER dosage if needed.

Interaction with certain other seizure drugs

Your doctor may prescribe other seizure medications with Depakote or Depakote ER to help manage your seizures. But some of these drugs may interact with Depakote or Depakote ER.

Interactions may increase your risk of side effects from either drug. They may also make Depakote and Depakote ER less effective.

What could happen

Some seizure medications can decrease the level of Depakote or Depakote ER in your body. This can make Depakote or Depakote ER less effective than usual.

Examples of seizure drugs that may lower Depakote or Depakote ER levels include:

• phenytoin (Dilantin)
• carbamazepine (Tegretol)
• primidone (Mysoline)

Other seizure drugs, such as felbamate (Felbatol) and topiramate (Topamax), can interfere with how your body breaks down Depakote or Depakote ER. Taking these drugs together can raise the levels of Depakote or Depakote ER in your body. It could also raise your risk of side effects from Depakote or Depakote ER.

Depakote or Depakote ER can also increase the levels of certain other seizure drugs in your body. These include phenytoin (Dilantin), ethosuximide (Zarontin), and lamotrigine (Lamictal). To learn more about the interaction between Depakote or Depakote ER and lamotrigine, see the “Interaction with Lamictal” section above.

Taking Depakote or Depakote ER with phenytoin or lamotrigine may increase your risk of side effects from lamotrigine or phenytoin.

What you can do

Talk with your doctor about any medications you take before you start treatment with Depakote or Depakote ER. Also, let them know if you start or stop taking any other seizure medications during your treatment. Your doctor may adjust your dosages if needed.

Depakote and Depakote ER may have other interactions. They could occur with foods, supplements, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Depakote and Depakote ER.

Do Depakote and Depakote ER interact with food?

There are currently no reports of Depakote or Depakote ER interacting with food.

But caffeine, which is found in certain foods and drinks such as coffee, chocolate, and tea, may worsen some side effects of Depakote or Depakote ER.

These side effects can include:

• nervousness
• insomnia (trouble sleeping)
• tremor

Although there are no reported interactions between Depakote and caffeine, you may want to avoid foods and drinks with caffeine while you’re taking Depakote or Depakote ER.

If you have questions about consuming certain foods or drinks during your treatment with Depakote or Depakote ER, talk with your doctor.

Do Depakote and Depakote ER interact with supplements?

There aren’t any supplements that have been reported to interact with Depakote or Depakote ER. But it’s possible that interactions could be identified in the future.

Because of this, it’s important to talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take before you start taking Depakote or Depakote ER. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Depakote and Depakote ER and herbs

There are currently no reports of Depakote or Depakote ER interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Depakote or Depakote ER.

Depakote and Depakote ER and vitamins

There are currently no reports of Depakote and Depakote ER interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Depakote and Depakote ER.

Do Depakote and Depakote ER interact with vaccines?

Depakote and Depakote ER aren’t known to interact with vaccines. If you have questions about receiving vaccines while taking Depakote or Depakote ER, talk with your doctor or pharmacist.

Do Depakote and Depakote ER interact with lab tests?

Depakote and Depakote ER may affect the results of certain lab tests.

For example, your body clears Depakote or Depakote ER as a ketone product in your urine. High urine ketone level can be a sign of high blood sugar levels.

Urine ketone tests are often used to check blood sugar in people with diabetes. So, taking Depakote or Depakote ER may cause urine ketone test results to appear falsely positive for high blood sugar.

Depakote and Depakote ER may also affect the results of thyroid function tests. These are tests used to check how your thyroid is working.

In some cases, Depakote and Depakote ER may increase the amount of human immunodeficiency virus (HIV) or cytomegalovirus (CMV) present in a lab test. These lab tests are used to test how well drugs used to treat these conditions are working.

Do Depakote and Depakote ER interact with cannabis or CBD?

Cannabis (commonly called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Depakote and Depakote ER.

Cannabis can increase Depakote and Depakote ER levels in your body which may increase your risk of side effects from Depakote or Depakote ER. These side effects can include elevated liver enzyme levels, which can be a sign of liver damage.

Cannabis, Depakote, and Depakote ER can also cause drowsiness. Taking these drugs together may increase your risk of or worsen this side effect.

Before you start treatment with Depakote or Depakote ER, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions or other health factors may raise the risk of interactions with Depakote or Depakote ER. Before taking either of these drugs, talk with your doctor about your health history. They’ll determine whether Depakote or Depakote ER is right for you.

Health conditions or other factors that might interact with Depakote or Depakote ER include:

Liver problems. Depakote and Depakote ER can cause serious liver damage. Your risk may be higher if you’ve had liver problems in the past. The drugs have a boxed warning about this side effect. For more information, see the “Boxed warnings” section above.

Urea cycle disorders. Taking Depakote or Depakote ER if you have a urea cycle disorder can raise your risk of having elevated ammonia levels. Because of this, doctors typically will not prescribe Depakote or Depakote ER if you have this condition. To learn more, see the “When should I avoid Depakote or Depakote ER?” section above.

Mitochondrial disorders. Certain mitochondrial disorders can increase your risk of liver damage from Depakote or Depakote ER. (Mitochondrial disorders are rare conditions caused by gene mutations affecting the mitochondria.) Due to this risk, doctors typically don’t prescribe Depakote or Depakote ER if you have this kind of condition. For more details, see the “When should I avoid Depakote or Depakote ER?” section above.

Problems with your digestive system. If you have problems with your digestive system, including having a colostomy, ileostomy, or diarrhea, talk with your doctor before taking Depakote or Depakote ER. Having these conditions may prevent your body from fully absorbing the drug, which could make it less effective. Talk with your doctor if you notice part of the tablet or capsule in your stool.

Older age. The risk of certain side effects, such as sleepiness, may be higher in people 65 years or older taking Depakote or Depakote ER. Due to this risk, doctors will likely prescribe a lower dosage of either drug for people in this age group.

Pregnancy. Depakote and Depakote ER are not safe to take during pregnancy. These drugs have a boxed warning about the risk of fetal harm. To learn more, see the “Boxed warnings” section above.

Breastfeeding. It’s not known whether it’s safe to take Depakote or Depakote ER while breastfeeding. But these drugs can pass into breast milk and may cause side effects in a breastfed child. If you’re breastfeeding or planning to breastfeed, talk with your doctor before taking Depakote or Depakote ER. They can discuss your options with you.

Allergic reaction. If you’ve had an allergic reaction to Depakote or Depakote ER or any of its ingredients, your doctor will likely not prescribe these drugs. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Depression and other mental health conditions. Taking Depakote or Depakote ER can increase your risk of suicidal thoughts or behaviors. If you already have a mental health condition, such as depression, taking these drugs may raise your risk of having suicidal thoughts or behaviors. Or it could make this side effect worse if you do experience it.

Talk with your doctor about your health history before you start treatment with Depakote or Depakote ER. They can determine whether the drug is safe for you to take.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

• Call the 988 Suicide and Crisis Lifeline at 988.
• Text HOME to the Crisis Textline at 741741.
• Not in the United States? Find a helpline in your country with Befrienders Worldwide.
• Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

Was this helpful?

Find answers to some frequently asked questions about possible interactions with Depakote and Depakote ER.

Can you take ibuprofen with Depakote or Depakote ER?

Yes. There have been no reports of interactions between Depakote or Depakote ER and ibuprofen (Advil, Motrin).

But it’s important to note that aspirin, another nonsteroidal anti-inflammatory drug (NSAID) similar to ibuprofen, can interact with Depakote and Depakote ER. Taking aspirin with Depakote or Depakote ER can raise the level of Depakote or Depakote ER in your body. This may increase your risk of having side effects from Depakote or Depakote ER or make side effects worse if you experience them.

Always check with your doctor or pharmacist before taking any over-the-counter medications, including aspirin, ibuprofen, and other NSAIDs. They’ll let you know if these drugs are safe to take with Depakote or Depakote ER.

Can you take lithium and Depakote together?

In many cases, yes. Doctors may prescribe lithium and Depakote together to treat bipolar disorder.

There are no reported interactions between lithium and Depakote or Depakote ER. But these drugs may have some similar side effects. Taking them together can raise your risk of having these side effects or make the side effects worse if you experience them.

They can include:

• dizziness
• nausea
• blurry vision

If you have concerns about taking lithium and Depakote together, talk with your doctor. They’ll let you know if these medications are safe for you to take together.

Does Depakote or Depakote interact with Wellbutrin?

No. There have not been any reported interactions between bupropion (Wellbutrin) and Depakote or Depakote ER.

But it’s important to note that Wellbutrin should not be prescribed for people who’ve had seizures before. This is because taking Wellbutrin can increase your risk of having seizures. So, if you take Depakote or Depakote ER to treat seizures, your doctor may not prescribe Wellbutrin for you.

If you take Wellbutrin and Depakote or Depakote ER to treat bipolar disorder, tell your doctor right away if you have a seizure while taking these medications. They may have you stop taking Wellbutrin and switch to a different treatment.

Does Depakote or Depakote ER interact with Zyprexa?

No, there are no reported interactions between olanzapine (Zyprexa) and Depakote or Depakote ER.

But these drugs can cause similar side effects, such as the following:

• nausea
• headache
• weight gain

Taking these medications together can raise your risk of these side effects or make the side effects worse if you experience them.

Talk with your doctor or pharmacist if you have questions about taking Depakote or Depakote ER with Zyprexa.

Taking certain steps can help you avoid interactions with Depakote or Depakote ER. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

• Whether you drink alcohol or use cannabis.
• Other medications you take. Your doctor or pharmacist can help you fill out a medication list.
• What to do if you start taking a new drug during your Depakote or Depakote ER treatment.

It’s also important to read Depakote or Depakote ER’s label and other paperwork that may come with the drug. You may see colored stickers on the label that describe interactions. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Depakote and Depakote ER, ask your pharmacist to print a copy for you.) If you need help understanding this information, your doctor or pharmacist can help.

Taking Depakote or Depakote ER exactly as prescribed can also help prevent interactions.

If you still have questions about possible interactions with Depakote or Depakote ER, talk with your doctor.

Questions you may want to ask your doctor include:

• Does my risk of interactions depend on my dosage of Depakote or Depakote ER?
• Do I need to space out when I take my medications throughout the day to avoid interactions?
• Does lithium have similar interactions to Depakote and Depakote ER?

To learn more about Depakote and Depakote ER, see these articles:

• Depakote and Depakote ER (divalproex sodium)
• Side Effects of Depakote and Depakote ER: What You Need to Know
• Dosage Details for Depakote and Depakote ER

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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

Valproic Acid and Derivatives | Memorial Sloan Kettering Cancer Center

Adult Medication

Share

Provided by Lexicomp ^® , this document 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 interact with this drug is not exhaustive.

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. It should not be considered medical advice or a substitute for medical advice, diagnosis or treatment provided by a physician based on a medical examination and assessment of the patient’s specific and unique circumstances. Patients should consult with their physician for full information about their health, medical issues, and treatment options, including any risks or benefits regarding the use of medications. This information is not a guarantee that a treatment or drug is safe, effective, or approved for a particular patient. UpToDate, Inc. and its subsidiaries disclaim any warranties or liabilities related to this information or its use. The use of this information is subject to the Terms of Use found at https://www. wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last revision date

2023-03-22

Copyright

© UpToDate, Inc. and its affiliates and/or licensors, 2023. All rights reserved.

Date last updated

Monday, December 12, 2022

Valproic Acid and Derivatives: Pediatric Medication

Pediatric Medicine

Share

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

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 child’s doctor right away if your child shows 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. Your child may need genetic testing to detect this disease. If a child has or may have a mitochondrial disorder, do not give this drug without consulting your doctor.
• This drug can cause serious and sometimes deadly problems with the pancreas (pancreatitis). Such a violation can occur in children at any time during treatment with this drug. Symptoms of pancreatitis include abdominal pain, nausea, vomiting, or decreased appetite. If your child develops any of these symptoms, contact their doctor immediately.

If your child is or may be sexually active:

• If your daughter is pregnant or may become pregnant, check with her doctor to make sure this drug is right for her. She must use birth control while taking this drug to prevent pregnancy.

If your daughter is pregnant or likely to be pregnant:

• This drug can cause serious birth defects if taken during pregnancy. It can also lower a child’s IQ and may increase the risk of autism or ADHD. If your daughter becomes pregnant while taking this drug, call her doctor right away.
• Do not give this migraine prevention drug to your daughter if she is pregnant or not using birth control to prevent pregnancy.

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 can be given to children for other indications. Consult your doctor.

What do I need to tell the doctor BEFORE my child takes this drug?

• If your child has an allergy to this drug, any of its ingredients, other drugs, foods, or substances. Tell the doctor about the allergy and how it manifested itself in the child.
• If your child suffers from any of the following: liver disease or a urea cycle disorder.

This list of drugs and conditions that may interact with this drug is not exhaustive.

Talk to your doctor or pharmacist about all medicines your child is taking (prescription and over-the-counter, natural, and vitamins) and any health problems. You need to make sure that this drug is safe to use for your child’s illnesses and in combination with other drugs he or she is already taking. Do not start, stop taking, or change the dosage of any drug your child is taking without the doctor’s approval.

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

For all uses of this drug:

• Tell all health care providers who care for your child that your child is taking this drug. These are your child’s doctors, nurses, pharmacists and dentists.
• Have your child avoid tasks or activities that require attention until you see how this drug works for your child. This includes cycling, playing sports, or using items such as scissors, lawn mowers, electric scooters, toy cars, or motorized vehicles.
• Perform blood tests as directed by your doctor. Consult with your doctor.
• Alcohol can interact with this drug. Make sure your child does not drink alcohol.
• Check with your child’s doctor before using marijuana, other forms of cannabis, or prescription or over-the-counter drugs that may slow your child’s progress.
• This drug may affect the results of some lab tests. Tell all health care workers and laboratory workers who provide your child’s health care that your child is taking this drug.
• If your child is unable to eat or drink normally, check with their healthcare provider. These situations include illness, fasting, certain procedures or surgery.
• Some brands of this drug contain peanut butter. If your child is allergic to peanuts, ask your pharmacist to check the peanut butter content of your child’s brand of peanut butter.
• Your child may become more prone to bleeding. Make sure your child is careful to avoid injury. Make sure your child uses a soft toothbrush.
• 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.
• This drug may affect a man’s ability to have a child. Consult your doctor.

If your daughter is breastfeeding:

• Tell your doctor if your daughter is breastfeeding. You will need to be counseled about the possible risks 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 child’s doctor right away?

WARNING/CAUTION: Although rare, this drug can cause very serious and sometimes deadly side effects in some people. Call your child’s doctor right away or get medical help if your child has any of the following signs or symptoms that could be associated with a very bad side effect:

• 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 drug can cause side effects. However, for many people, side effects are either minor or non-existent. Contact your child’s doctor or seek medical attention if any of these or other side effects bother your child or if they persist:

• Headache.
• Constipation, diarrhea, abdominal pain, nausea, vomiting, or decreased appetite.
• Increased appetite.
• Feeling dizzy, 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, ask your child’s doctor. Talk to your child’s doctor about side effects.

You can report side effects to the National Health Board.

What is the best way to give this drug?

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

All oral preparations:

• Give this drug with or without food. If the drug causes stomach upset, give it with food.
• Keep giving this drug as directed by your child’s doctor or other health care provider, even if your child is feeling well.
• Do not stop giving this drug to your child abruptly without talking to the doctor. This can increase the risk of seizures. If needed, this drug should be stopped gradually for your child as directed by the doctor.
• If your child is taking cholestyramine, you may need to give it at a different time than this drug. Consult with a pharmacist.

Tablets and capsules:

• Ask your child to swallow whole. Ask your child not to chew, break, or crush the tablet.
• Give this drug with a full glass of water.
• If your child has difficulty swallowing, check with your doctor.

Long acting tablets:

• If you or your child see particles of this drug in your child’s stool, contact your doctor.

Split capsule:

• The child may swallow the capsule whole or mix the contents of the capsule with certain foods such as applesauce. Make sure the child takes the mixture immediately. Do not store for future use.
• Do not let your child chew the mixture.
• If you or your child see particles of this drug in your child’s 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 my child misses a dose of medication?

All oral preparations:

• Give the missed dose as soon as possible.
• If it is time for your child to take the next dose, do not take the missed dose and then go back to your child’s normal schedule.
• Do not give a double dose at the same time or additional doses.

Injection:

• Contact your child’s doctor to find out the next steps.

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 child’s doctor, nurse, or pharmacist about how to store it.

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 child’s symptoms or health problems do not improve, or worsen, contact your child’s doctor.
• Do not share your child’s medicine with others and do not give anyone else’s medicine to your child.
• Some medicines may come with other patient information leaflets. If you have questions about this drug, talk with your child’s 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. It should not be considered medical advice or a substitute for medical advice, diagnosis or treatment provided by a physician based on a medical examination and assessment of the patient’s specific and unique circumstances. Patients should consult with their physician for full information about their health, medical issues, and treatment options, including any risks or benefits regarding the use of medications. This information is not a guarantee that a treatment or drug is safe, effective, or approved for a particular patient. UpToDate, Inc. and its subsidiaries disclaim any warranties or liabilities related to this information or its use. The use of this information is subject to the Terms of Use found at https://www.