Valproic Acid and Derivatives

(val PROE ik AS id & dah RIV ah tives)

Brand Names: U.S.

  • Depacon®
  • Depakene®
  • Depakote®
  • Depakote® ER
  • Depakote® Sprinkle
  • Stavzor™

Brand Names: Canada

  • Apo-Divalproex®
  • Apo-Valproic®
  • Depakene®
  • Dom-Divalproex
  • Epival®
  • Mylan-Divalproex
  • Mylan-Valproic
  • Novo-Divalproex
  • Nu-Divalproex
  • PHL-Divalproex
  • PHL-Valproic Acid
  • PHL-Valproic Acid E.C.
  • PMS-Divalproex
  • PMS-Valproic Acid
  • PMS-Valproic Acid E.C.
  • ratio-Valproic
  • ratio-Valproic ECC
  • Rhoxal-valproic
  • Sandoz-Valproic

What key warnings do I need to know about before giving this drug to my child?

  • This drug may cause very bad and sometimes deadly liver problems. This most often happens within the first 6 months of using this drug. Call your child's doctor if your child has dark urine, is feeling tired, is not hungry, has an upset stomach, is throwing up, or has yellowing of the skin or eyes. In patients who have seizures, loss of seizure control may happen. Have your child's blood work checked. Talk with your child's doctor.
  • Children under 2 years old may be at greater risk of liver problems. Those who take more than 1 seizure drug, have a metabolic disorder, have a very bad seizure disorder along with mental retardation, or have organic brain disease are at the highest risk. Talk with the doctor.
  • There is a greater risk of liver failure and death in patients who have a genetic liver problem caused by a mitochondrial disorder like Alpers-Huttenlocher syndrome. Your child may need to have a genetic test to check for this health problem. If your child has or may have mitochondrial disorders do not give this drug before talking with your child's doctor.
  • This drug may cause very bad birth defects if your child takes it while your child is pregnant. It can also cause the baby to have a lower IQ. Do not give this drug to prevent migraine headaches if your child is pregnant. If your child is pregnant and takes this drug for seizures or bipolar disorder, talk to your child's doctor to see if your child needs to keep taking this drug.
  • If your child is able to get pregnant, she must use birth control that she can trust while taking this drug. If your child gets pregnant while taking this drug, call your child's doctor right away.
  • This drug may cause very bad and sometimes deadly pancreas problems (pancreatitis). This could happen in children at any time during care. Signs of pancreatitis include belly pain, upset stomach, throwing up, or not feeling hungry. Call your child's doctor right away if your child has any of these signs.
  • This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled.

Is it safe for my child to take this drug?

  • Not if your child has an allergy to valproic acid or any other part of this drug.
  • Be sure to let the doctor know if your child has any allergies or side effects to drugs, foods, or dyes. Make sure to tell about the allergy and what signs your child had. This includes telling about rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
  • Not if your child has liver disease.

Why does my child need this drug?

  • It is used to stop or control seizures.
  • It is used to treat problems with how one acts.
  • It is used to treat manic low mood (depression).

How is this drug given?

  • Oral:
  • Give as you have been told, even if your child is feeling better.
  • Give this drug with food.
  • Have your child swallow long-acting products whole. Do not let your child chew, break, or crush.
  • You may sprinkle contents of capsule on applesauce, pudding, or mashed potatoes. Have your child swallow without chewing.
  • Have your child swallow capsule whole. Do not let your child chew, break, or crush.
  • There is a liquid (syrup) if your child cannot swallow pills.
  • Children who have feeding tubes may also use the liquid. Flush the feeding tube before and after this drug is given.
  • Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, get an oral syringe, a dropper, a spoon, or a cup (only for older children) from your pharmacist.
  • Have your child drink lots of noncaffeine liquids every day unless told to drink less liquid by your child's doctor.
  • Shot:
  • It is given as a shot into a vein.

How long does this drug take to work?

  • It may take a few days to see the full effect.

What do I do if my child misses a dose?

  • Oral:
  • Give a missed dose as soon as you think about it.
  • If it is close to the time for your child's next dose, skip the missed dose and go back to your child's normal time.
  • Do not give 2 doses or extra doses.
  • Do not change the dose or stop your child's drug. Talk with your child's doctor.

What safety measures do I need to take when my child is using this drug?

  • Do not run out of this drug.
  • Have your child wear disease medical alert ID (identification).
  • Children younger than 2 years of age have more chance of liver disease.
  • If your child has been taking this drug for many weeks, talk with your child's doctor before stopping. You may want to slowly stop this drug.
  • Have your child's blood work checked. Talk with your child's doctor.
  • Check all drugs your child is taking with your child's doctor. This drug may not mix well with some other drugs.
  • Keep a list of all your child's drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your child's doctor.
  • Avoid giving your child other drugs and natural products that may slow your child's actions.
  • This drug may cause your child to be less alert. Have your child avoid tasks or actions that call for alertness. These include playing (for example, riding a bicycle, rollerblading, sports) or using items that call for your child to have focus or coordination (for example, scissors, lawnmower, electric scooters, or toy cars). Your child's actions will be closely watched until you see how this drug affects him/her. School work may be hard for your child to focus on and get done.

What are some side effects of this drug?

  • Feeling dizzy. Have your child get up slowly over a few minutes when sitting or lying down. Have your child be extra careful climbing stairs.
  • Feeling lightheaded, sleepy, having blurred eyesight, or a change in thinking clearly. Have your child avoid tasks or actions that call for him/her to be alert or have clear eyesight until you see how this drug works.
  • Headache.
  • Upset stomach or throwing up. Many small meals and good mouth care may help. Older children may suck hard, sugar-free candy.
  • Loose stools (diarrhea).
  • Belly pain.
  • Hair loss.
  • Muscle weakness.
  • Twitching.
  • Not able to sleep.

When do I need to call my child's doctor?

  • If any of this news causes you to be worried, any of the unwanted side effects happen, or if your child is not better after taking this drug.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
  • If your child shows signs of a very bad reaction, call your child's doctor or the ER right away. These include wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; swelling of face, lips, tongue, or throat; or if your child is not acting normal.
  • If your child shows signs of low mood (depression), thoughts of killing him/herself, nervousness, emotional ups and downs, thinking that is not normal, anxiety, or lack of interest in life.
  • If your child has a change in balance.
  • If your child's seizures are worse or not the same after starting this drug.
  • If your child is feeling very tired or weak.
  • If your child has a very bad upset stomach or is throwing up.
  • If your child has very bad belly pain.
  • If your child has any bruising or bleeding.
  • If your child is not able to eat.
  • If your child has dark urine or yellow skin or eyes.
  • If your child gets a rash.
  • If your child’s health problem does not get better or if you believe your child’s health problem is worse.

How do I store and/or throw out this drug?

  • Oral:
  • Store at room temperature.
  • Store in a dry place. Do not store in a bathroom.
  • Shot:
  • The shot will be given to your child in a hospital or doctor's office. You will not store it at home.

General drug facts

  • If your child has a very bad allergy, he/she needs to wear an allergy ID at all times.
  • You may get this drug by drug order only. If there are refills, call your pharmacy. If your child does not have refills left, you may need to call your child's doctor.
  • Get rid of this drug when your child no longer needs it or if the drug is outdated.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, pharmacist, or other health care provider.
  • In Canada, take any unused drugs to the pharmacy. Also, visit http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/disposal-defaire-eng.php#th to learn about the right way to get rid of unused drugs.http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/disposal-defaire-eng.php#th to learn about the right way to get rid of unused drugs.
  • Do not share your child's drug with others and do not give anyone else's drug to your child.
  • Keep all drugs out of the reach of children and pets.
  • Keep a list of all your child's drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your child's doctor.
  • These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
  • Talk with the doctor before giving your child any new drug, including OTC, natural products, or vitamins.
  • If you do not use a drug the right way, it may not be safe. Follow what your child’s doctor tells you.