Epilim withdrawal side effects


Valproic Acid Withdrawal Help | Properly Managed Cessation

Alternative to Meds News & Blog Articles

What is Valproic Acid Prescribed For?

Valproic acid is prescribed to treat:
  • psychosis
  • sleep issues
  • migraine headaches
  • mania related to bipolar disorder
  • epilepsy
  • seizure disorders

Side Effects of Valproic Acid Treatment

The FDA black box warning states that various symptoms of abdominal distress may indicate immediate intervention is needed for possible hemorrhage, pancreatitis, or other life-threatening events stemming from valproic acid use. Side effects of valproic acid are diverse and well-documented in the medical literature. 1,10-17

Side effects of valproic acid may include:
  • Hepatoxicity – liver damage
  • Mitochondrial toxicity – damage to or reduction of the number of mitochondria, the parts of the cell that generate energy
  • Hyperammonemic encephalopathy – raised ammonia levels leading to coma, death, or other adverse outcomes
  • Hypersensitivity syndrome reactions – lowered white blood cell levels, inflamed muscles, kidneys, and liver, cell death, immune system overload, fever, skin rash
  • Neurological toxicity – injures and kills neurons
  • Metabolic adverse effects – glucose intolerance, diabetes, weight gain
  • Endocrine adverse effects – abnormalities in the thyroid, gonadal and other glands, dysregulation of hormones
  • Teratogenicity – major birth defects at a rate 3X the norm including autism symptoms, deformation of limbs, decreased intelligence, verbal communication skills
  • Thrombocytopenia – heavy menstrual bleeding, lowered platelets, other bleeding events
  • Depression
  • Myalgia – aching muscles

The Alternative to Meds Center Program for Valproic Acid Withdrawal

For over ten years, the center has provided medication discontinuation programs and has helped many thousands of clients to reach their goals with success. Our program uses a multi-phase approach to ensure a gentle, safe experience. The speed of withdrawal from Valproic Acid will depend on individual factors, such as tolerance level, general health, dosage, how long a person took the drug, and many other factors. In most cases though, clients are typically able to get to zero within eight weeks. Where more time is needed, (no one is pushed faster than they are comfortable with) the client is given instructions to coordinate with their doctor so that they can continue and complete the rest of their withdrawal steps when they get back home under medical supervision.

Safe, Holistic Treatment for Valproic Acid Withdrawal

Clients arrive at the center, are welcomed, and are settled in comfortably. Then, they can proceed with the lab testing segment of the program. These tests, along with the intake assessment interviews, provide essential information allowing the clinical staff to plan and start the client’s tailored treatment. Each client will have been asked to bring their medication with them and will continue taking their usual meds until the withdrawal process when they will begin to be adjusted. However, before dose reduction begins, ten days of toxin removal is the next step. This sequence of steps gives the client some significant advantages. Clients typically start seeing improvements in sleep, appetite, energy, and general feelings of well-being, which will make starting the withdrawal process much more comfortable.

A wealth of therapies during each phase of the program provides physical, emotional, spiritual, and healing support.

Rehabilitation of neurochemistry benefits from such adjunctive treatments as massage, mineral baths, low-temperature sauna, nebulized glutathione treatments, Reiki, yoga, cranial-sacral massage as well as learning relaxation techniques, and other tools for life.

Also, a clean, mostly organic diet, accompanied by targeted nutritional supplements, and IV nutrient therapy provides a solid foundation for healing.

Many Therapies for Assisting Valproic Acid Withdrawal

Counseling sessions of many different genres are also available: CBT, DBT, Adventure therapy, art therapy, Rational Emotive Behavior therapy, and addiction counseling represent a few favorite examples.

Life Coaching is another highly beneficial endeavor, where a person is encouraged to design a meaningful, enjoyable, and satisfying life.

In a safe, comfortable, and compassionate setting, one can freely discuss and begin to resolve the barriers that prevented success in areas of life that may have needed some resolution and TLC. When making major changes to your lifestyle, as you are when coming off valproic acid, you can benefit from the support to be gained from both private counseling sessions and peer group support.4

Equine-Assisted Therapy at Alternative to Meds Center

Our clients can opt for participation in Equine-assisted therapy, which is highly popular with clients. In a controlled, safe atmosphere a person can develop improved physical balance and movement, but also a sense of personal confidence and the capacity to care for and relate to these gentle creatures.2,6,7

The horses used in equine therapy have been hand-selected for their quiet and affectionate dispositions. The therapeutic value of connecting and interacting with animals can have many positive effects both emotionally and physically.

Equine-assisted therapy has begun to emerge internationally as a positively impacting form of holistic therapy for mental health. Alternative to Meds Center is pleased to offer this option to clients.

Education in Orthomolecular, Nutritional, and Environmental Medicine

Alternative to Meds Center also offers a wide range of orthomolecular/biochemistry/nutrition classes as part of the valproic acid withdrawal program. These classes are extremely popular, and help educate program participants about the protocols and therapies used during their stay. The curriculum covers an exceptional set of training videos and other training tools that the founder, Lyle Murphy, created for clients who are in treatment for withdrawal from valproic acid and other medications.

We are excited that after decades of a kind of drug monopoly on treatment, the fields of natural medicine, orthomolecular medicine, and other subjects of holistic health treatment are becoming more widely available and implemented internationally. According to a 2019 survey of Norwegian psychiatric patients, half requested non-drug treatment. It is exciting to report that In Norway, since 2016, drug-free options for mental health treatment are now mandatory across all regions of the country. We continue to hope that other countries will soon begin implementing similar options for effective and humane non-drug psychiatric treatment options.3,8

In our program, the study of these materials also features question and answer modules, as well as open discussion periods. The course explains important details concerning safe, proper medication withdrawal and provides instruction and insights on how and why the removal of toxins can facilitate the process. Also provided is much highly practical information on how supplements work. In this way, clients are empowered and much better able to support and maintain their healthy neurotransmitter system during and after withdrawal from valproic acid, and well after leaving the program. Medical practitioners are invited and warmly welcomed to participate in our professional symposiums on request.

Find Out More About Valproic Acid Withdrawal at ATMC

It is easier than you might think to enroll in our program. We are located in Sedona, nestled near the magical Red Rock Mountains. There are plenty of opportunities for hiking, memorable photo ops, and leisure activities nearby.5

Please call the number on this page for more information on how you may benefit from a tailored holistic program for improving mental health naturally. If you are interested in insurance information, we can get you a quote from your provider, which typically will cover at least a percentage of the fees. Call today and start learning more about what health benefits are available to you or your loved one as a participant in our program for safe and gentle valproic acid withdrawal.

Sodium valproate: medicine to treat epilepsy and bipolar disorder

1. About sodium valproate

Sodium valproate is used to treat epilepsy and bipolar disorder.

It's occasionally used to prevent migraine headaches.

This medicine is only available on prescription. It comes as capsules, tablets and a liquid that you swallow. It also comes as granules that you mix with food or drink.

Sodium valproate can also be given by injection, but this is usually only done in hospital.

If taken during pregnancy, sodium valproate can cause problems for a baby's development, including birth defects and long term learning difficulties. For this reason, sodium valproate is not recommended if there's a chance that you could become pregnant.

For women and girls of childbearing age, if you do need to take sodium valproate then your doctor will put you on Prevent, the valproate pregnancy prevention programme.

Valproate pregnancy prevention programme

The valproate pregnancy prevention programme is very important.

You should be reviewed every year by your doctor or nurse. They will assess whether you need to continue taking sodium valproate or whether it is possible to change your medicine.

If you do need to continue sodium valproate then you must be using reliable contraception, even if you are not currently sexually active. Your doctor or nurse can advise you about reliable contraception. You will be asked to sign a form to say that you are using contraception and understand the risks of becoming pregnant while taking sodium valproate.

It's important to get advice as soon as possible if you think you are pregnant or might become pregnant while taking sodium valproate. However, do not stop taking your medicine suddenly without talking to your doctor first.

Updated: 18 October 2022

2. Key facts

  • You'll usually take sodium valproate once or twice a day. You can take it with or without food.
  • You'll usually start on a low dose. Your dose will gradually increase over a few days or weeks.
  • Valproic acid and semisodium valproate are similar to sodium valproate and work in the same way. However these medicines are used to treat different conditions and doses will vary.
  • There are also brands such as Epilim Chrono, Epilim Chronosphere and Dyzantil which contain mostly sodium valproate, with some valproic acid.
  • If you're pregnant, or there's a chance you could become pregnant, sodium valproate is not recommended for treating migraine. For epilepsy and bipolar disorder, your doctor will only prescribe sodium valproate for you if there are no other suitable treatments.

3. Who can and cannot take sodium valproate

Sodium valproate can be taken by adults and children to treat epilepsy or bipolar disorder.

It can be taken by adults (aged 18 and above) to help prevent migraine.

Sodium valproate is not suitable for girls or women who could become pregnant. However, in some cases it may be the only treatment option available, for example for epilepsy where other treatments have not worked. Girls and women who need to take sodium valproate must be on Prevent, the valproate pregnancy prevention programme.

To make sure sodium valproate is safe for you, tell your doctor if you:

  • have ever had an allergic reaction to sodium valproate or any other medicine
  • have liver problems
  • have a rare metabolic or genetic illness such as porphyria, urea cycle disorder or mitochondrial disorder

4.

How and when to take sodium valproate

Sodium valproate is a prescription medicine. It's important to take it as your doctor tells you.

Dosage

The usual dose for treating epilepsy in:

  • adults and older children (aged 12 years and over) – 600mg to 2,000mg a day, as 1 dose or split into 2 doses. Some people take a higher dose of 2,500mg a day
  • younger children (aged 1 month to 11 years) – the doctor will use your child's weight to work out the right dose for them

The usual dose for treating bipolar disorder in:

  • adults – 750mg to 2,000mg a day, as 1 dose or split into 2 doses
  • children – the doctor will work out the right dose for your child

The usual dose for preventing migraine in:

  • adults – daily doses vary from a single dose of 400mg to 1,500mg split into 2 doses

If your doctor tells you to take sodium valproate twice a day, you'll usually take half the dose in the morning and half in the evening (to make up your full daily dose).

If you're taking sodium valproate and have kidney problems, your doctor may prescribe a lower dose.

How to take it

Sodium valproate comes as slow release (prolonged or sustained release) tablets, capsules and granules, gastro-resistant tablets, crushable tablets, and as a liquid.

Slow release medicine passes into your body gradually.

Gastro-resistant tablets release the medicine as soon as it passes through your stomach. This means the sodium valproate is less likely to upset your stomach.

You can take sodium valproate with or without food, but it's best to stick to the same way each time. Do not take it with food some days and without food on other days.

How to take slow release tablets and capsules

Swallow these whole with a drink of water or juice. Do not chew them.

You'll usually take them once a day, unless you're on a high dose and your doctor tells you to take your medicine twice a day.

How to take slow release granules

Add the granules to a small drink, then stir and swallow it. If you prefer, sprinkle the granules onto any soft food that you can swallow whole. Do not chew the granules.

Your doctor will tell you to take these either once or twice a day.

How to take gastro-resistant tablets

Swallow these whole with a drink of water or juice. Do not chew them.

You'll usually take these twice a day.

How to take crushable tablets

Crush the tablets using the back of a spoon and mix the powder with some soft food that you can swallow whole. If you prefer, add the powder to a small drink, then stir and swallow it.

You'll usually take this medicine twice a day.

How to take liquid

Use the plastic syringe or spoon that comes with your medicine to measure the correct dose. If you do not have one, ask your pharmacist. Do not use a kitchen teaspoon as you will not get the right amount.

You'll usually take the liquid twice a day.

When to take sodium valproate

If you're taking sodium valproate once a day, you can choose a time that suits you. Just try to keep to the same time every day.

If you're taking sodium valproate twice a day, try to leave a gap of 10 to 12 hours between doses. For example you could take your first dose in the morning (between 7am and 8am) and your second dose in the evening (between 7pm and 8pm).

Will my dose go up or down?

To reduce the chance of side effects, your doctor will start you off on a low dose of sodium valproate. They will increase it gradually over a few days or weeks.

Once you find a dose that suits you, it will usually stay the same, unless your condition changes, or your doctor starts you on a new medicine that may affect sodium valproate.

What if I forget to take it?

If you've missed a dose, what you do next depends on whether you usually take your medicine once or twice a day.

If you take sodium valproate:

  • once a day – take the forgotten dose as soon as you remember unless it's within a few hours of the next dose. In this case, skip the missed dose and take your next dose at the usual time
  • twice a day – take the forgotten dose as soon as you remember unless it's within 2 hours of the next dose. In this case, skip the missed dose and take your next dose at the usual time

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you have epilepsy, it's important to take this medicine regularly. Missing doses can trigger a seizure.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

Taking too much sodium valproate can lead to symptoms such as:

  • feeling or being sick (nausea or vomiting)
  • headaches or feeling dizzy
  • muscle weakness
  • breathing problems
  • feeling confused, or changes to your normal behaviour
  • passing out

Urgent advice: Contact 111 for advice now if:

  • you take too much sodium valproate and feel unwell

Go to 111. nhs.uk or call 111.

If you need to go to A&E, take the sodium valproate packet or the leaflet inside it, plus any remaining medicine, with you.

5. Side effects

Like all medicines, sodium valproate can cause side effects, although not everyone gets them.

Common side effects

These common side effects may happen in more than 1 in 100 people. They're usually mild and go away by themselves.

Keep taking the medicine but talk to your doctor if these side effects bother you or do not go away:

  • stomach pain, feeling or being sick
  • diarrhoea
  • dry or sore mouth, or swollen gums
  • shakes (tremors) in a part of your body, or unusual eye movements
  • feeling tired or sleepy
  • headache
  • weight gain
  • thinning hair, or changes to the colour or texture of your hair
  • irregular or delayed periods

Serious side effects

It's unusual to have serious side effects after taking sodium valproate. Tell a doctor straight away if you have:

  • thoughts of harming or killing yourself – a small number of people taking sodium valproate have had suicidal thoughts
  • yellowing of the whites of your eyes or your skin, although this may be less obvious on brown or black skin, and dark pee – these may be signs of liver problems
  • long-lasting and severe nausea, vomiting or stomach pain – these may be signs of acute pancreatitis (an inflamed pancreas)
  • unusual bruises or bleeding – these may be signs of a blood disorder
Serious allergic reaction

In rare cases, sodium valproate may cause a serious allergic reaction (anaphylaxis).

Immediate action required: Call 999 or go to A&E now if:

  • you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • you're wheezing
  • you get tightness in the chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of sodium valproate. For a full list, see the leaflet inside your medicine packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

6. How to cope with side effects of sodium valproate

What to do about:

  • stomach pain, feeling or being sick – take sodium valproate with or after a meal or snack. It may also help if you avoid rich or spicy food. Take small, frequent sips of water if you're being sick to avoid dehydration.
  • diarrhoea – drink plenty of fluids such as water or squash to avoid dehydration. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.
  • dry or sore mouth, or swollen gums – for a dry mouth try sugar-free gum or sweets, or sipping cold drinks. If this does not help, or you have mouth ulcers, talk to your pharmacist or doctor. If you're bothered by swollen gums or this symptom does not go away, talk to your doctor or dentist.
  • shakes (tremors) in a part of your body, or unusual eye movements – talk to your doctor if this is bothering you. These symptoms can be a sign that your dose is too high. Talk to your doctor as they may want to change your dose or suggest you take it at a different time.
  • feeling tired or sleepy – as your body gets used to sodium valproate, these side effects should wear off. If these symptoms do not get better within a week or two, your doctor may either reduce your dose or increase it more slowly. If that does not work, talk to your doctor as they may want to switch you to a different medicine.
  • headaches – make sure you rest and drink plenty of fluids. Try not to not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Talk to your doctor if your headaches last longer than a week or are severe.
  • weight gain – if you find you're putting on weight after taking sodium valproate, try to have a healthy balanced diet. Regular exercise will also help you keep your weight stable. Your doctor will usually monitor your weight while you're taking this medicine. Speak to them if you have any concerns.
  • thinning hair, or changes to the colour or texture of your hair – if these symptoms bother you, ask your doctor whether it's possible to lower your dose. Your hair may regrow after either reducing your dose or switching to a different medicine.
  • irregular or delayed periods – if you usually have regular periods, take a pregnancy test if your period is late, and speak to your doctor if the result is positive. As well as being a side effect of sodium valproate, a late period is a sign that you could be pregnant, and sodium valproate can be harmful for an unborn baby. Changes to your periods can also be a symptom of polycystic ovary syndrome (PCOS), a rare side effect of sodium valproate. Your doctor will be able to do some tests to check whether you have PCOS.

7. Pregnancy and breastfeeding

Sodium valproate and pregnancy

Sodium valproate is not recommended in pregnancy, as it can cause birth defects and problems with your baby's learning and behaviour.

If there's a chance you could become pregnant while taking this medicine, your doctor will put you on Prevent, the valproate pregnancy prevention programme.

If you think you might already be pregnant, contact your doctor or nurse as soon as possible.

If you're taking sodium valproate for epilepsy or bipolar disorder and you become pregnant, do not stop taking your medicine without talking to your doctor first. This is because your symptoms may get worse.

Your doctor may continue to prescribe sodium valproate, but only if there's no other suitable treatment for your epilepsy or bipolar disorder.

For pregnant women with recurrent migraine your doctor should offer you an alternative treatment to sodium valproate.

Information:

You must have a review of your treatment every year. Contact your doctor or specialist now if you have not had one.

Sodium valproate and breastfeeding

If your doctor or health visitor says your baby is healthy you can take sodium valproate while breastfeeding.

Sodium valproate passes into breast milk in small amounts but it's unlikely to harm your baby so you can continue breastfeeding if your doctor says you need to take it.

If there's a chance you could become pregnant while taking this medicine, your doctor will put you on Prevent, the valproate pregnancy prevention programme. Your doctor may still recommend sodium valproate if it is the only medicine that works for you.

Do not stop taking your medicine without talking to your doctor first as your symptoms may get worse. Breastfeeding will also benefit both you and your baby.

Talk to your health visitor, midwife, pharmacist or doctor as soon as possible if:

  • your baby is not feeding as well as usual
  • your baby is bruising more easily than usual
  • the whites of your baby's eyes turn yellow or your baby's skin turns yellow (this may be less obvious on brown or black skin), or your baby has dark pee or pale poo – these can be signs of jaundice

Non-urgent advice: Tell your doctor if you're:

  • trying to get pregnant
  • pregnant
  • breastfeeding

More information

  • Best Use of Medicines in Pregnancy (BUMPS) website – information about how sodium valproate can affect you and your baby during pregnancy
  • NHS England letter to all women and girls aged 12 to 55 taking sodium valproate, available in different languages
  • valproate pregnancy prevention programme patient guide: what women and girls need to know about valproate (PDF, 341kb)

8.

Cautions with other medicines

There are some medicines that may affect how sodium valproate works. Sodium valproate can also affect the way other medicines work.

Tell your doctor if you're taking any of these medicines:

  • any other medicines for epilepsy such as carbamazepine
  • medicines for preventing blood clots such as warfarin
  • aspirin for pain relief or low-dose aspirin
  • cimetidine, a medicine for stomach ulcers
  • medicines to treat HIV and AIDS such as ritonavir
  • antibiotics such as erythromycin
  • medicines for depression or other mental health problems such as venlafaxine, quetiapine or diazepam
  • cholesterol-lowering medicines such as cholestyramine
  • medicines to prevent malaria such as mefloquine or chloroquine

Mixing sodium valproate with herbal remedies or supplements

It's not possible to say whether complementary medicines and herbal supplements are safe to take with sodium valproate.

They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Medicine safety

Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.

9. Common questions about sodium valproate

How does sodium valproate work?

Sodium valproate is an anticonvulsant (or anti-epileptic) medicine. It prevents epileptic seizures by reducing excessive electrical activity in your brain.

It's not fully understood how this medicine works for treating bipolar disorder. However, sodium valproate is thought to reduce or prevent manic episodes by increasing the amount of a chemical called gamma-aminobutyric acid (GABA) in the brain. GABA blocks transmission across nerves in the brain and has a calming effect.

It's not clear how sodium valproate prevents migraine. It may limit how your nerves transmit pain signals in the brain.

When will I feel better?

It takes a few weeks for sodium valproate to work properly. You may still have symptoms during this time.

How long will I take it for?

Once your condition is under control, you'll usually need to keep taking sodium valproate for many years.

Can I get addicted to sodium valproate?

Sodium valproate is not known to be addictive.

Is it safe to take it for a long time?

Many people can take sodium valproate safely for many months or years.

However, there are potential side effects that can happen over a long time. Long-term treatment with sodium valproate can cause osteoporosis and osteopenia (increasing your risk of breaking a bone).

Your doctor can arrange for tests to check the strength of your bones. Regular exercise and a good diet can also help to keep your bones strong.

Can I get epilepsy medicines for free?

If you have epilepsy, you're entitled to free prescriptions for all of your medicines (not just your epilepsy ones).

To claim your free prescriptions you'll need a medical exemption certificate.

The application form for the medical exemption certificate is called FP92A. You can get this from your doctor's surgery. You will need to fill in the form, then your doctor will sign it and send it off.

Are there similar medicines to sodium valproate?

Valproic acid and semisodium valproate are very similar to sodium valproate. They work in the same way but these medicines are sometimes given at different doses for different conditions.

If you decide to try valproic acid or semisodium valproate instead, your doctor will explain how to come off sodium valproate safely.

How does it compare with other medicines for epilepsy?

There are many different medicines for treating epilepsy. It's not possible to say that one works better than the others. It varies from person to person and depends on the type of seizures and how often you have them.

Before prescribing a medicine, your doctor will also take into account your age and sex, the medicines you're already taking and any other health problems you have.

It's usual to try to treat epilepsy using a single medicine. If this medicine is not working well, or you're getting side effects, your doctor will try you on a different one.

If a single medicine is not preventing your seizures, then your doctor may recommend taking 2 or more anti-epileptic medicines at the same time.

Sodium valproate works for several different types of epilepsy. If it's giving you side effects, or you're worried it is not suitable for you, ask your doctor or specialist to recommend a different medicine.

Other anti-epileptic medicines include:

  • carbamazepine
  • clobazam
  • ethosuximide
  • gabapentin
  • lamotrigine
  • levetiracetam
  • phenytoin
  • pregabalin
  • topiramate
How does it compare with other medicines for migraine?

For many people topiramate, propranolol and amitriptyline work better than sodium valproate at preventing migraines. These medicines are likely to cause fewer side effects, so your doctor or specialist will usually prescribe one of these first.

Sodium valproate is not used as often for preventing migraine. However, your doctor may recommend it if these other medicines are causing side effects or are not working for you.

Your doctor may also prescribe sodium valproate if you have a health problem that means you cannot take other migraine medicines.

How does sodium valproate compare with other medicines for treating bipolar disorder?

If you have bipolar disorder, there are several types of medicine to prevent mood swings and treat mania. It's not possible to say that one works better than another and it varies from person to person.

Lithium is commonly used for bipolar disorder, as well as anti-epileptic medicines like sodium valproate and antipsychotic medicines like olanzapine. You can take sodium valproate instead of lithium, or together with lithium, depending on what your doctor recommends.

Your doctor or specialist will find the medicines that work best for you. It depends on your mood swings, how often they happen, how severe they are and how well you cope with a medicine.

Do I need to stick to the same brand of sodium valproate?

Once you're on a dose of sodium valproate that suits you, you're likely to keep taking the same type or brand. This is because it can be a problem to swap from modified release to gastro-resistant tablets.

Some people may change brands to try a different type of sodium valproate. For example they may want to try the granules instead of the tablets. If you need to change brand your doctor or pharmacist will explain how to do so safely.

However, if your epilepsy has been difficult to control in the past and the brand you're taking is working well for you, your doctor may recommend staying on the same one.

What will happen when I come off it?

Do not stop taking sodium valproate suddenly, unless your doctor tells you to.

You're unlikely to get any extra symptoms when you stop taking this medicine. However, if you're taking sodium valproate for epilepsy, it's possible that you'll get seizures again once you stop taking it. You can prevent these withdrawal seizures by reducing your dose of sodium valproate gradually.

If you're taking it for bipolar disorder or to prevent migraine, your condition could get worse for a short time after you stop taking the medicine.

Will recreational drugs affect it?

Sodium valproate can affect recreational drugs like cannabis and heroin.

If you use recreational drugs alongside sodium valproate, you may be more likely to have side effects like panic attacks, anxiety and memory loss.

Can I drink alcohol with it?

Drinking alcohol while taking sodium valproate may make you feel sleepy or tired. It's best to stop drinking alcohol during the first few days, until you see how the medicine affects you.

Will it affect my fertility?

Sodium valproate can reduce fertility in both men and women. Once you stop taking this medicine, your fertility will return.

In men sodium valproate has been reported to cause infertility. However, this is rare.

In women it can change your menstrual cycle, causing delayed or missed periods. Sodium valproate has also been reported to cause polycystic ovary syndrome (PCOS), though this happens rarely.

Talk to your doctor if you're concerned about how sodium valproate may affect your fertility.

Sodium valproate is not recommended if there's a chance you could become pregnant. If you're taking sodium valproate and want to start a family, it's important to talk your doctor as soon as possible. This is because taking sodium valproate while pregnant can harm your baby.

Will it affect my contraception?

Sodium valproate does not affect any type of contraception, including the combined pill and emergency contraception.

If there's a chance you could become pregnant while taking sodium valproate you must use contraception. Your doctor will put you on Prevent, the valproate pregnancy prevention programme.

Speak to a pharmacist or your doctor if you have any questions about this programme.

Can I drive or ride a bike?

You may feel sleepy, tired or dizzy when you first start taking sodium valproate. This may also happen if your dose has increased. If you're affected, do not drive or ride a bike until you feel more alert.

If you have epilepsy, you're not allowed to drive until you've had no seizures for 1 year (or only have seizures while you're asleep).

If you change your epilepsy medicine, your doctor will tell you whether you need to stop driving and for how long.

Information:

Driving rules if you change or withdraw your medicine, Epilepsy Action

Epilepsy and driving information, GOV. UK

Combined oral contraceptive (COC) withdrawal syndrome

Table of contents

  • How to take contraceptives
  • When to take the tablets?
  • How do combined oral contraceptives affect a woman's body
  • Reasons for not taking oral contraceptives, how to do it right
  • The effect of the abolition of COCs - what is it manifested in
  • Myths and reality about the abolition of FGM
  • How to support the body during the refusal of oral contraceptives
  • Rebound effect after discontinuation of the drug

How to take contraceptives

The main indication for taking COCs is to prevent unwanted pregnancy.

COCs are two-component pills containing two different hormones, most often taken for 21 days (this is the number of hormone pills in the package), and then a 7-day break begins (taking placebo pills or just skipping pills), during which menstruation-like occurs reaction. There is another regimen - 28 tablets in a blister, which are taken all 28 days in a row without the need for breaks. As a rule, the first tablet is taken on the first day of the menstrual cycle, but the doctor may prescribe a different method of use.

Each tablet should be taken at the same time each day for 21 days. You also need to pay attention that most COCs have a minimum course of admission - 3 months.

When should I take the tablets?

To reduce the risk of nausea, vomiting or malaise, it is best to take the tablets before bed or during dinner, at the same time. However, deviations of 2-3 hours do not affect the effectiveness of the drug.

If you missed a pill, you should take it as soon as possible, but first you need to determine the number of hours - how much time has passed since the last pill was taken. The next steps depend on this:

  • Late appointment up to 4 hours: take the missed tablet. Such a short period of time does not affect the effectiveness of contraception.
  • Late up to 12 hours: take a tablet as soon as possible. A delay of up to 12 hours is acceptable, but should not be repeated thereafter.
  • More than 12 hours: take the forgotten tablet immediately. Then, for the next 7 days, additionally use barrier methods of contraception.

In a situation where a woman decides to use the combined oral contraceptive as a form of pregnancy prevention, the gynecologist must take into account many factors in order to choose the best drug. Unfortunately, just because a close friend praises a drug doesn't mean it will be safe and effective for others. In addition to the gynecological examination, breast examination and blood pressure measurement, the doctor asks the patient about her general health. In this case, it is especially important to exclude liver dysfunction and problems with the blood coagulation system. When it turns out that there are no contraindications to the use of hormone therapy, the gynecologist selects the most optimal drug.

How combined oral contraceptives affect a woman's body

Combination birth control pills contain two types of female sex hormones: progestin and estrogen. The first suppresses ovulation and reduces the permeability of mucus to sperm, prevents the transport of the egg to the uterine cavity and changes the lining of the uterus so that implantation of the embryo becomes impossible. Estrogen, in turn, stops the maturation of the follicle in the ovary.

Unfortunately, not all women can use this method of contraception. Contraindications are overweight, obesity, and diabetes. It should be borne in mind that estrogen in birth control pills can contribute to easier blood clotting. If a woman suffers from thrombosis (or has a predisposition to it), hypertension and diseases of the cardiovascular system, drugs such as COCs are often not recommended. Estrogen in this group of women may increase the risk of deep vein thrombosis, pulmonary embolism, stroke, and heart attack. Another side effect of COCs can be the development of depression, and it may seem to a woman that life has lost its colors. Although, this phenomenon is not so common.

When using hormonal drugs, one must not only be vigilant about the risk of possible side effects, but also pay attention to situations in which their effectiveness may decrease. Most often, this occurs as a result of interactions with other drugs: antibiotics, antifungals, antivirals, and some drugs to treat epilepsy attacks.

Reasons for not taking oral contraceptives, how to do it correctly

The reasons for stopping the pill can be different - mainly the desire to conceive a child or the transition to other methods of contraception. Also, a common reason for withdrawal in girls is the fear that long-term use of hormones can adversely affect the reproductive system. That is why it is important to regularly consult with a gynecologist to monitor possible reasons for stopping COC use.

Taking COCs can reduce libido, many women report a decrease in desire for sexual intercourse, as well as the appearance of vaginal dryness. Often, this is what causes the abolition of oral contraceptives.

What happens after the withdrawal of COC? In fact, when it comes to stopping COC use after a year of use or longer, a healthy woman usually does not experience withdrawal symptoms. Another thing is when before taking contraceptives there were skin problems, PMS symptoms, painful periods, an irregular menstrual cycle - all this can return after a while. While taking COCs, these conditions are successfully controlled by masking the problem, but the main solution should be to correct them regardless of the use of hormonal contraception.

Naturally, it is necessary to stop taking COCs by finishing the already started package of the drug, in no case throwing it in the middle of the menstrual cycle. In a good way, both the appointment and the abolition of such contraception should be under the supervision of a gynecologist.

The effect of COC withdrawal - how it manifests itself

It must be remembered that the body, accustomed to the fact that every day receives a constant dose of hormones, after stopping the use of birth control pills can "rebel". The consequences of stopping birth control pills are individual for each woman. However, they are all the result of changes in the functioning of the endocrine system. Therefore, the abolition of hormonal contraceptives can cause the following consequences:

  • Periodic menstrual disorders
  • Deterioration of hair condition
  • The appearance of acne (if it was already there)
  • Return of dysmenorrhea (especially if the problem existed before starting hormonal contraception)
  • Mood swings
  • Breast reduction

Of the positive effects that can be observed after the abolition of COCs:

  • Return of libido
  • Reducing mood swings
  • Disappearance of vaginal dryness

Important: the decision to stop using hormonal contraceptives should be made in consultation with the gynecologist, which will minimize the negative consequences of stopping the use of birth control pills.

Myths and reality about the withdrawal of COCs

  • After the withdrawal of COCs, the menstrual cycle is disturbed, menstruation may stop

A similar phenomenon can occur and be diagnosed by a doctor as ovarian hyperinhibition syndrome, which is expressed in the form of secondary amenorrhea.

  • Pregnancy after COC withdrawal is impossible

This statement only partially makes sense. Indeed, after the withdrawal of drugs, there may be a problem with conception, especially with prolonged use of COCs. However, in some cases, such a problem with a favorable outcome is independently resolved against the background of normalization of ovarian function.

  • COCs cause depression and mood swings

Indeed, some women report a deterioration in mood and the development of depression at the time of using COCs.

How to support the body during withdrawal from oral contraceptives

  1. Adequate nutrition Compliance with even the simplest diet (do not overeat, increase the consumption of fruits, vegetables, seafood) will help the body during the period of COC withdrawal. Diet can help maintain a healthy body weight and thus keep body fat at an appropriate level. Normal weight plays a huge role in maintaining hormonal balance, and therefore in the problem of how to support the body after contraception.
  2. Vitamin supplements It is recommended to take B vitamins that improve the functioning of the nervous and circulatory system. It also regulates the menstrual cycle, improves the condition of the skin and hair. In addition, the intake of magnesium, which is the basis for the proper functioning of the whole organism, will not interfere.
  3. Correct daily cycle. The secretion of hormones in the body is largely dependent on the correct circadian cycle. The recovery of the body after the withdrawal of COCs requires regulated secretion of the hormone FSH and LH, which, together with estrogen and progesterone, control the correct cycle of menstruation. The appropriate circadian rhythm - early sleep and early awakening - allows you to regulate the production of hormones in the body and is another answer to the question of how to support the body after contraception.
  4. Holidays for the health of the endocrine system In order to restore the hormonal balance in the body, you can choose a special cleansing program under the supervision of professionals. This takes into account a properly balanced cleansing diet, mental rest, as well as physical activity. Thanks to a comprehensive program, any side effects of contraception disappear faster, and the body acquires a good physical and mental condition.

Rebound effect after drug withdrawal

The rebound effect in gynecology consists in the temporary "turning off" of ovarian function, followed by the abolition of COCs to obtain ovulation and increase the chances of pregnancy. After the completion of the COC intake, the hormonal background begins to recover, and in an enhanced form. As a result, superovulation sets in - two eggs capable of fertilization mature. Thus, the rebound effect is considered as one of the methods of infertility treatment.

Stopping birth control pills usually does not cause unpleasant side effects, since the latest generation of pills minimize the risk of negative effects on the body. However, the hormonal background of each woman reacts differently, and each body needs time to recover.

Pay attention! During the period of taking COCs, as such, there is no classic menstruation, withdrawal bleeding is observed. Withdrawal bleeding occurs during the period when a woman is not taking hormonal pills, it is less profuse and does not last long.

However, do not be afraid to cancel COCs: physical activity, being under the supervision of a doctor, a balanced diet and positive emotions will help restore hormonal levels faster and return a normal menstrual cycle.

  • Hormonal contraception. Prilepskaya, Mezhevitinova, Nazarova // Ed. V. Prilepskaya. - 2011. - 296 p.
  • Modern contraception. New opportunities, safety criteria, basics of counseling. Podzolkova N.M., 2019. - 128 p.
  • Drug therapy in the practice of an obstetrician-gynecologist. Pestrikova, Yurasova, Yurasov // Ed. N. Mitrokhina., 2011. - 512 p.
  • Modern contraception. New opportunities and safety criteria: a guide for physicians. Podzolkova, Rogovskaya, Kolodka // Ed. E. Bakalina - 2013. - 128 p.

RUS2175440 (v1.0)

Epilim Infusion Solution in English - Product

Epilim Infusion Solution in English - Product - Medication.net

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Overview

Epilim Infusion Solution / Epilim Infusion Solutions are prescribed for the treatment of epilepsy, alcohol withdrawal, mental illness and other states.

Epilim Infusion Solution contains Sodium Valproate as an active ingredient. Available in solution form.

Detailed information regarding the use, composition, dosage, side effects of Epilim Infusion Solution / Epilim Infusion Solution, as well as user reviews are provided below:

Benefits the following diseases, conditions and symptoms:

  • Epilepsy
  • Alcohol withdrawal
  • Mental illness

Learn more: Benefits

Side effects

The following is a list of possible side effects that may occur from the ingredients of Epilim Infusion Solution. This list is not final. These side effects have been recorded previously, but are not always recorded when using the drug. Some of these side effects may be extremely rare, but have incredibly severe consequences. If you notice any side effects, contact your doctor immediately. Especially in the case of observing side effects for a long time.

  • Night incontinence of urine
  • A decrease in the number of white blood cells
  • Disorders that affects the blood
  • ,
  • pancreatic inflammation
  • TREED
  • stomach disorders
  • MODICAL DISCOUNSIONS caused by medicines
  • 9000)
  • Blood platelet deficiency
  • Bone marrow depression
  • Liver injury
  • Hair loss
  • Weight gain

If you experience side effects not listed above, please contact your healthcare provider for advice. In addition, you can report side effects to your local Food and Drug Administration.

Precautions

Before taking this drug, tell your doctor about any medications you are taking, dietary supplements (such as vitamins, natural supplements, etc. ), allergies, existing medical conditions, and current health conditions (such as pregnancy, upcoming surgery, and etc.). The side effects of the drug may be more pronounced depending on the condition of your body. Take this medicine as directed by your doctor, or follow the directions for use that come with your medicine. The dosage of the drug depends on your condition. Tell your doctor if there is no change or if your condition worsens. Important points to discuss with your healthcare provider are listed below.

  • Be careful in patients with liver disease or urea cycle disorder or porphyria
  • Consult your doctor if you have an organic brain disease or severe seizure disorders, HIV or cytomegalovirus infection, impaired kidney function or lupus

If you use other drugs or over the counter products at the same time, the effects of Epilim Infusion Solution may change. Tell your healthcare provider about all medications, vitamins, and supplements you use. Your doctor will be able to make the right plan for taking the drug, which will avoid negative interactions. Epilim Infusion Solution may interact with the following drugs and products:

Packages available for Epilim Infusion Solution: 400mg

FAQ

  • Is it safe to drive or operate heavy machinery while using this product?

    If you experience drowsiness, dizziness, hypotension or a headache as side-effects when using Epilim Infusion Solution medicine then it may not be safe to drive a vehicle or operate heavy machinery. You should stop driving if taking this medicine makes you drowsy, dizzy, or hypotensive. Doctors recommend that you stop drinking alcohol with such drugs, because. alcohol greatly increases the side effects and drowsiness. Please check for these effects on your body when using Epilim Infusion Solution. Be sure to consult your doctor for advice based on the characteristics of your body and general health.

  • Is this drug (product) addictive or addictive?

    Most drugs are not habit-forming or addictive. In most cases, the state classifies drugs that can be addictive as controlled dispensing drugs. For example, schedule H or X in India and schedule II-V in the USA. Please check the information on the drug packaging to make sure that this drug is not in the controlled category. Also, do not self-medicate or accustom your body to medications without consulting your doctor.

  • Can I stop using this product immediately or do I need to slowly stop using it?

    Some medications need to be stopped gradually due to a rebound effect. Be sure to consult your healthcare provider for advice based on your body, general health, and other medications you may be taking.

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