What is Divalproex?

Divalproex sodium is a stable coordination compound used to treat manic episodes associated with bipolar disorder, epilepsy, and migraine headaches, consisting of sodium valproate and valproic acid. The following different brand names are available for Divalproex sodium: Depakote, Depakote ER, and Depakote Sprinkles.

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Divalproex Uses

This medication is used for the treatment of seizure disorders, certain psychiatric conditions, and for the prevention of migraine headaches (manic phase of bipolar disorder). It works by restoring the balance of certain substances in the brain that are natural (neurotransmitters).

Ways To Use Divalproex

Before you start taking divalproex sodium and each time you get a refill, read the Medication Guide and, if available, the Patient Information Leaflet that your pharmacist provides.
This medication is generally taken by mouth. If a stomach upset occurs, you can take it with food. Swallow the whole tablet. Do not crush or chew a tablet that might irritate the throat or mouth.
The dosage depends on your age, weight, medical condition, treatment response and other medications that you might be taking. To get the most benefits from it, use this medication regularly.
Do not stop taking this medication without consulting your doctor if it is used for seizures. If the drug is stopped suddenly, your condition may become worse. Your dose may need to be lowered progressively.
Acute migraine headaches are not relieved by Divalproex sodium. Take other drugs for acute attacks as advised by your physician.

Divalproex Side Effects

Common Side Effects

Nausea
Headache
Weakness/lack of energy
Vomiting
Drowsiness
Tremor (shaking)
Dizziness
Abdominal pain
Diarrhea
Loss of appetite
Vision changes
Flu syndrome
Infection
Indigestion/heartburn

Neurological and Psychological Side Effects

Loss of control of bodily movements
Rapid, involuntary eye movements
Fever
Mood swings
Thinking abnormal
Hair loss
Weight loss/weight changes
Constipation
Memory problems (amnesia)
Unusual or unpleasant taste in your mouth
Worsening depression
Suicidal thoughts or behavior
Unusual changes in mood or behavior
Behavioral changes
Irritability

Respiratory and Digestive Side Effects

Reproductive and Hormonal Side Effects

Changes in menstrual periods
Enlarged breasts
Elevated testosterone level
Hyperandrogenism

Dermatological Side Effects

Hair texture change
Hair color change
Photosensitivity
Erythema multiforme
Toxic epidermal necrolysis
Stevens-Johnson syndrome
Nail bed disorders

Weight-Related Side Effects

Weight gain
Weight loss

Precautions To Be Taken:

Allergies: Inform your doctor if you are allergic to divalproex sodium, valproic acid, sodium valproate, or any other allergies. Inactive ingredients in the medication may cause allergic reactions or other issues.
Use of Sharp Objects and Sport Activities: Be cautious with sharp objects (e.g., razors, nail cutters) and avoid activities that could result in cuts, bruises, or injuries, such as contact sports.
Surgery: Inform your doctor and pharmacist about all the medications you are taking before undergoing surgery.
Dizziness and Drowsiness: This medication may cause dizziness, drowsiness, or blurred vision. Alcohol and marijuana (cannabis) can exacerbate these effects. Avoid alcoholic beverages and discuss marijuana use with your doctor.
Older Adults: Elderly individuals may be more prone to side effects such as sleepiness, dizziness, unsteadiness, or trembling, increasing the risk of falls.
Pregnancy: This medication is not safe to use during pregnancy as it can harm an unborn baby.
Breastfeeding: The drug passes into breast milk. Although no specific research has shown harm to breastfeeding infants, consult your doctor before breastfeeding.

Interactions for Divalproex Sodium

Drug Interactions:

This medication can interact with several other drugs, including:

Antidepressants: nortriptyline, amitriptyline, phenelzine
Antibiotics: doripenem, carbapenem, imipenem
Chemotherapy drug: irinotecan
Weight loss medication: orlistat
Antimalarial: mefloquine
Other seizure medications: phenytoin, ethosuximide, rufinamide, lamotrigine, topiramate
Tuberculosis treatment: rifampin
Blood thinner: warfarin
Cancer treatment: vorinostat
HIV treatment: zidovudine

Low-Dose Aspirin:

Continue taking low-dose aspirin (81-325 mg daily) if prescribed by your doctor for heart attack or stroke prevention. Consult your doctor or pharmacist if you take aspirin occasionally.

Medications Causing Drowsiness:

Inform your doctor or pharmacist if you are taking other medications that cause drowsiness, including:

Alcohol
Marijuana (cannabis)
Antihistamines: cetirizine, diphenhydramine
Sleep or anxiety medications
Muscle relaxants
Opioid pain relievers

Over-the-Counter Products: Check all your medications for ingredients that may cause drowsiness, such as those in allergy or cough and cold products.
Lab Tests: This medication may affect certain lab tests (e.g., urine ketones). Ensure laboratory staff and your doctors know you are taking this drug.

Dosage Instructions for Divalproex Use

Divalproex and Hesperidin Combination Dosage:

For Internal Hemorrhoid Treatment:
- Initial Dosage:
  - 1350 mg of Divalproex plus 150 mg of hesperidin twice daily for 4 days.
  - Followed by 900 mg of Divalproex and 100 mg of hesperidin twice daily for 3 days.
- Alternative Dosage:
  - 600 mg of Divalproex three times a day for 4 days.
  - Followed by 300 mg of Divalproex twice a day for 10 days, in combination with 11 grams of psyllium daily.
  - Note: The lower dose of Divalproex may not be as effective.
For Prevention of Recurrence of Internal Hemorrhoids:
- 450 mg of Divalproex plus 50 mg of hesperidin twice daily for 3 months.
For Treatment of Leg Wounds due to Blood Flow Issues (Venous Stasis Ulcers):
- 900 mg of Divalproex and 100 mg of hesperidin daily for up to 2 months.

Dosage Forms To Be Taken Care:

Expressed as Equivalents of Valproic Acid:
- Tablet, extended-release (Depakote ER):
  - 125 mg
  - 250 mg
  - 500 mg
- Capsule (Depakote Sprinkles):
  - 250 mg
  - 500 mg

Missed Dose:

If you forgot to take a dose, take it as soon as you remember.

Overdose:

Do not take too much.
It may cause severe health issues.
Do not take two doses at one time; maintain the time gap between the doses.

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Divalproex vs Lamictal (Lamotrigine)

Divalproex	Lamictal (Lamotrigine)
Lowers the frequency of seizures, especially in the absence of seizures or complicated partial seizures.	Efficient in decreasing seizure frequency in persons with epilepsy or Lennox-Gestaut syndrome.
Depakote (Divalproex) is the first-line medication for people with bipolar disorder to improve their mood.	Usually used for serious seizure disorders alongside other drugs.
For the prevention of chronic migraines, Depakote (Divalproex) is beneficial.	Works well for seizures with partial, tonic-clonic, and absence.
If you have a difficult time swallowing, the sprinkle pill can be swallowed whole or can be opened up and combined with applesauce.	Care for first-line bipolar disorder. Efficient long-term It prevents both depressive and manic episodes, but the effect on depression reduction is greater mood stabilization therapy.
As a generic, Depakote (Divalproex) is available.	They don't need regular blood checks.
Dosage forms Pill Extended-release pill Delayed-release pill	Forms available Pill Extended-release Chewable tablet Dissolving tablet

Citations

Efficacy of Divalproex vs Lithium and Placebo in the Treatment of Mania

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Frequently Asked Questions

1. What is divalproex used for?

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

2. Does divalproex make you sleepy?

Yes, divalproex sodium can cause drowsiness and dizziness. Until you know how this medication affects you, avoid driving, operating machinery, or performing tasks that require alertness. This drug may also cause other side effects.

3. Is divalproex used for anxiety?

Divalproex sodium has been found to be effective in treating patients with panic disorder and mood instability, particularly when they have not responded well to traditional treatments. It has shown a statistically and clinically significant reduction in panic attacks and improvement in quality of life.

4. Is divalproex addictive?

Divalproex (commonly known as Depakote) is not considered habit-forming or addictive. However, it is important not to stop using the medication without consulting your doctor, as this can lead to a return of symptoms.

5. Is divalproex an antidepressant?

While divalproex is primarily used to treat seizures and bipolar disorder, it also has antidepressant properties, especially within the same dosage range used to treat mania.

6. What does divalproex do to the brain?

Divalproex sodium increases the amount of gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter that helps to calm nerve activity, and increasing its levels can help stabilize mood and prevent seizures.

Disclaimer: The information provided herein is accurate, updated and complete as per the best practices of the Company. Please note that this information should not be treated as a replacement for physical medical consultation or advice. We do not guarantee the accuracy and the completeness of the information so provided. The absence of any information and/or warning to any drug shall not be considered and assumed as an implied assurance of the Company. We do not take any responsibility for the consequences arising out of the aforementioned information and strongly recommend you for a physical consultation in case of any queries or doubts.