VALPROIC ACID (Dipropylacetic Acid)

Brand & Generic Names

Dalpro
Depa
Depakene
Myproic Acid

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Anticonvulsant

Uses

• Controls petit mal (absence) seizures in treatment of epilepsy.
• Treatment for manic-depressive illness.

Dosage & Usage Information

How to take:
Capsule or syrup--Swallow with liquid or food to lessen stomach irritation.

When to take:
Once a day.

If you forget a dose:
Take as soon as you remember. Don't ever double dose.

What drug does:
Increases concentration of gamma aminobutyric acid, which inhibits nerve transmission in parts of brain.

Time lapse before drug works:
1 to 4 hours.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Coma

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• If patient is unconscious and not breathing, give mouth-to- mouth breathing. If there is no heartbeat, use cardiac massage and mouth-to-mouth breathing (CPR). Don't try to make patient vomit. If you can't get help quickly, take patient to nearest emergency facility.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

In case of overdose, see Overdose section.

Common:

Menstrual irregularities, nausea, vomiting, abdominal cramps, diarrhea, tremor, weight gain.

Infrequent:

• Rash, blood spots under skin, hair loss, bleeding (heart and lungs), easy bruising.
• Sleepiness, weakness, easily upset emotionally, depression, psychic changes, headache, incoordination, appetite change, constipation.

Rare:

• Double vision, unusual movements of eyes (nystagmus), swelling of feet, ankles and abdomen; jaundice; increased bleeding tendency.
• Anemia (paleness, fatigue).

Warnings & Precautions

Don't take if:
You are allergic to valproic acid.

Before you start, consult your doctor:

• If you have blood, kidney or liver disease.
• If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons.

Pregnancy:
Risk to unborn child exists. Don't use.

Breast-feeding:
Unknown effect. Consult doctor.

Infants & children:
Under close medical supervision only.

Prolonged use:
Request periodic blood tests, liver and kidney function tests.

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes, such as antihistamines, tranquilizers, sedatives, pain medicine, narcotics and mind-altering drugs.

Discontinuing:
Don't discontinue without consulting doctor. Dose may require gradual reduction if you have taken drug for a long time. Doses of other drugs may also require adjustment.

Others:
No problems expected.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Anticoagulants*	Increased chance of bleeding.
Aspirin	Increased chance of bleeding.
Carbamazepine	Decreased valproic acid effect.
Central nervous	Increased sedative
system (CNS)	effect.
Clonazepam	May prolong seizure.
Clozapine	Toxic effect on bone marrow.
Didanosine	Increased risk of pancreatitis.
Dipyridamole	Increased chance of bleeding.
Felbamate	Increased side effects and
	adverse reactions.
Flecainide	Possible decreased blood cell
	production in bone marrow.
Hepatotoxics*	Increased risk of liver toxicity.
Isoniazid	Increased risk of liver damage.
Levocarnitine	Decreased levocarnitine. Patients
	taking valproic acid may need to
	take the supplement levocarnitine.
MAO inhibitors*	Increased sedative effect.
Mefloquine	Decreased valproic acid effect.
Nabilone	Greater depression of central
	nervous system.
Phenobarbital	Increases chance of toxicity.
Phenytoin	Unpredictable. Dose may require
	adjustment.
Primidone	Increased chance of toxicity.
Sertraline	Increased depressive effects
	of both drugs.
Sodium benzoate	May reduce effect of sodium benzoate
& sodium phenylacetate	& sodium phenylacetate.
Sulfinpyrazone	Increased chance of bleeding.
Tiopronin	Increased risk of toxicity to bone
	marrow.
Tocainide	Possible decreased blood cell
	production in bone marrow.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Deep sedation. Avoid.
Beverages:	No problems expected.
Cocaine:	Increased brain sensitivity. Avoid.
Foods:	No problems expected.
Marijuana:	Increased brain sensitivity. Avoid.
Tobacco:	Decreased valproic acid effect.