Drug Name - Divalproex Sodium
Brand Name - Depakote

WARNING: This medication has rarely caused serious (sometimes fatal) liver
problems. Children less than 2 years old are more likely to develop severe
liver problems, especially if they have metabolic problems, severe seizures
with mental retardation, brain disease (organic) or if they take more than
one drug for seizures. If divalproex sodium is being used in patients with
these conditons, then it ahould not be taken with additional anti-seizure
medications. Liver function tests should be performed before and during
treatment.
Early signs of serious liver problems include vomiting, unusual
tiredness, swelling of the face or loss of seizure control in patients with
seizure disorder. Tell your doctor immediately if you develop any of these
symptoms.
This medication has rarely caused severe (sometimes fatal) disease of
the pancreas (pancreatitis). This problem may occur at any time during
therapy and may worsen quickly. Tell your doctor immediately if you
experience stomach/abdominal pain, nausea, vomiting, and loss of appetite
while taking this medication.
This medication can cause birth defects. Read the patient information
leaflet provided with this medication. Consult your doctor of pharmacist
for more information.

USES: This medication is used to treat seizure disorders, certain
psychiatric conditions (manic phase of bipolar disorder), and to prevent
migraine headaches. It works by restoring the balance of certain natural
substances (neurotransmitters) in the brain.

OTHER USES: This drug may also be used for other mental disorders (e.g.,
schizophrenia).

HOW TO USE: Take this medication by mouth as directed by your doctor. You
may take it with food if stomach upset occurs. Swallow the tablet whole. Do
not crush or chew the tablet, shich can irritate the mouth or throat.
Dosage is based on your weight, medical condition, and response to
therapy. Use this medication regularly in order to get the most benefit
from it. Remember to use it at the same time each day to keep the amount of
medication in your blood constant.
If this medication is used for seizures, do not stop taking it without
consulting your doctor. Your condition may become worse if the drug is
suddenly stopped. Your dose me need to be gradually decreased.
Divalproex sodium does not relieve acute migraine headaches. Take
other medications as directed by your doctor for acute attacks.
Inform your doctor if your condition does not improve.

SIDE EFFECTS: Diarrhea, dizziness, drowsiness, hair loss, blurred/double
vision, change in menstrual periods, ringing in the ears, shakiness
(tremor), unsteadiness, weight changes may occur. If any of these
effectspersist or worsen, notify your doctor or pharmacist promptly.
Tell your doctor immediately if any of these serious side effects
occur: mental/mood changes, signs of infection (e.g., fever, persistant
sore throat).
Tell your doctor immediately if any of these unlikely but serious side
effects occur: chest pain, easy bruising/unexplained bleeding,
fast/irregular heartbeat, swelling of hands/feet, uncontrolled eye movement
(nystagmus).
Tell your doctor immediately if any of these highly unlikely but very
serious side effects occur: dark urine, persistant nausea/vomiting, severe
stomach/abdominal pain, yellowing eyes or skin.
Severe (sometimes fatal) brain disorder (encephalopathy) has rarely
occured, particularly in patients with certain metabolic disorders (urea
cycle disorders). Tell your doctor immediately if you develop unexplained
weakness and vomiting or sudden mental changes.
A serious allergic reaction to this drug is unlikely, but seek
immediate medical attention if it occurs. Symptoms of a serious allergic
reaction include: rash, itching, swelling, severe dizziness, trouble
breathing.
If you notice other effects not listed above, contact your doctor or
pharmacist.

PRECAUTIONS: Before taking divalproex sodium, tell your doctor or
pharmacist if you are allergic to it; or to valproic acid or valproate
sodium; or if you have any other allergies.
This medication should not be used if you have certain medical
conditions. Before using this drug, consult your doctor or pharmacist if
you have: liver disease, pancreatitis, certain metabolic disorders (urea
cycle disorders).
Before using this medication, tell your doctor or pharmacist your
medical history, especially of: alcohol abuse, bleeding problems, brain
disease (dementia), kidney disease, low body water (dehydration), poor
nutrition.
Before having surgery, tell your doctor or dentist that you are taking
this medication.
This drug may cause you to be dizzy, drowsy, or cause blurred vision.
Use caution engaging in activities requiring alertness or clear vision such
as driving or using machinery. Do not engage in such activities until you
know how this medication affects you. Limit alcoholic beverages.
Caution is advised when using this drug in the elderly because they
may be more sensitive to its side effects, especially drowsiness or tremor.
Divalproex sodium can cause birth defects. This medication is not
recommended for use during pregnancy. Discuss the risks and benefits with
your doctor. If you become pregant while taking this drug, contact your
doctor immediately. If you are pregnant, prenatal care including tests for
spinal cord defects is recommended.
This medication passes into breast milk. While there have been no
reports of harm to nursing infants, consult your doctor before
breast-feeding.

DRUG INTERACTIONS: Before using this medication, tell your doctor or
pharmacist of all prescription and nonprescription/herbal products you may
use, especially of: certain antidepressants (e.g.,amitriptyline,
nortriptyline, phenelzine), certain benzodiazepines (e.g., clonazepam,
diazepam), mefloquine, other medications for seizure (e.g., carbamazepine,
ethosuximide, felbamate, lamotrigine, phenobarbital, phenytoin), rifampin,
warfarin, zidovudine.
Low-dose aspirin, as prescribed by your doctor for specific medical
reasons such as heart attack or stroke prevention (usually these doses are
81-325 mg per day), should be continued. Consult your doctor or pharmacist
if you are using aspirin for any reason.
Tell your doctor or pharmacist if you also take drugs that cause
drowsiness such as: antihistamines that cause drowsiness (e.g.,
diphenhydramine), medicine for sleep (e.g., sedatives), muscle relaxants,
narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g.,
phenothiazines such as chlorpromazine), tranquilizers.
Check the labels on all your medicines (e.g., cough-and-cold products)
because they may contain ingredients that cause drowsiness. Ask your
pharmacist about the safe use of those products.
This drug may affect certain lab tests (e.g., urine ketones). Make
sure laboratory personnel and your doctors know you use this medication.
Do not start or stop any medicine without doctor or pharmacist
approval.

OVERDOSE: If overdose is suspected, contact your local poison control
center or emergency room immediately. US residents can call the US national
poison hotline at 1-800-222-1222. Canadian residents should call their
local poison control center directly. Symptoms of overdose may include:
excessive drowsiness, coma, irregular/slowed/skipped heart beats (heart
block).

NOTES: Do not share this medication with others.
Laboratory and/or medical tests (e.g., drug levels, liver function
tests, complete blood counts, clotting tests) should be performed
periodically to minitor your progress or check for side effects. Consult
your docto for more details.

MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is
near the time for the next dose, skip the missed dose and resume your usual
dosing schedule. Do not double the dose to catch up.




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