Side effect of depakote er

Frequently asked questions (FAQs) | Depakote® (divalproex sodium)

A: Common side effects experienced with Depakote include drowsiness, nausea, abdominal pain, diarrhea, vomiting, low platelet count, tremors, tiredness, and hair loss. The side effects may be mild to moderate, but they may also be signs of a more serious condition. You should talk to your doctor about any side effects you may experience. Please see Full Prescribing Information with Medication Guide for the complete list of side effects.

A: The following serious side effects are associated with Depakote:

Serious liver damage that can cause death, especially in children younger than 2 years old. Risk of serious liver damage is more likely to occur within the first 6 months of treatment, and may continue despite discontinued use of the drug. Call your doctor right away if you experience any of the following symptoms:

Nausea or vomiting that does not go away
Loss of appetite
Pain on the right side of your stomach (abdomen)
Dark urine
Swelling of your face
Yellowing of your skin or the whites of your eyes

Inflammation of your pancreas that can cause death. Call your healthcare provider right away if you have any of these symptoms:

Severe stomach pain that you may also feel in your back
Nausea or vomiting that does not go away

Taking Depakote during pregnancy can harm your unborn baby; increasing the risk of serious birth defects [e.g. brain, spinal cord (spina bifida), heart, head, arms, legs and penis] and the risk of your child having a lower IQ. Call your doctor if you are pregnant or become pregnant.

Women taking Depakote should use an effective birth control and talk with their doctor about the best birth control method for them.

Suicidal thoughts or actions in a very small number of people, about 1 in 500. Call a healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you:

Thoughts about suicide or dying
Attempts to commit suicide
New or worse depression
New or worse anxiety
Feeling agitated or restless
Panic attacks
Trouble sleeping (insomnia)
New or worse irritability
Acting aggressive, being angry, or violent
Acting on dangerous impulses
An extreme increase in activity and talking (mania)
Other unusual changes in behavior or mood

Overall, pay attention to any symptom changes, especially sudden changes in mood, behaviors, thoughts, or feelings. Keep all follow-up visits with your doctor as scheduled, and call between visits as needed, especially if you are worried about symptoms. Please see Full Prescribing Information with Medication Guide for the complete list of side effects.

A: Depakote can have potentially important interactions with certain medicines. Talk to your doctor or pharmacist if you have concerns about Depakote and other medications you are currently taking, including those without a prescription, vitamins, and herbal products. Please see Full Prescribing Information with Medication Guide for the complete list of side effects.

A: As with all medications, Depakote should be kept in a safe place, tightly closed, and out of reach of children. Depakote should be stored at room temperature. Depakote should not be stored above 86° F. Do not keep it in the refrigerator. The pharmacy bottle or pillbox should be protected from light or moisture. Do not store it in a damp place like a bathroom medicine cabinet. Please see Full Prescribing Information with Medication Guide for the complete list of side effects.

A: If you forget to take your daily dose of medicine at the scheduled time, go ahead and take it as soon as you remember. However, if it’s almost time for you to take your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take a double dose. If you have any questions, please call your doctor. Please see Full Prescribing Information with Medication Guide for the complete list of side effects.

Depakote ER Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Warnings:

Rarely, this medication has caused serious (sometimes fatal) liver problems, usually within the first 6 months of starting treatment. Laboratory tests should be performed before you start treatment and periodically during treatment, especially within the first 6 months, to monitor this side effect.

The risk of serious liver problems is increased in children younger than 2 years, especially if they have an inherited metabolic disorder, severe seizure disorder with mental retardation, organic brain disease, or if they take more than one seizure medication. Talk with the doctor about the risks and benefits of using this medication in children younger than 2 years.

Due to an increased risk for liver problems, people with certain inherited metabolic disorders (such as Alpers-Huttenlocher syndrome) should not use this medication. Children younger than 2 years who might have these disorders should not use this medication. Children older than 2 years who might have these disorders should be closely monitored during treatment with divalproex sodium. Talk to your doctor for details.

This medication has rarely caused severe (sometimes fatal) disease of the pancreas (pancreatitis). This may occur at any time during treatment and can quickly worsen.

Tell your doctor right away if you develop symptoms of liver problems or pancreatitis such as nausea/vomiting that doesn't stop, unusual tiredness, weakness, swelling of the face, stomach/abdominal pain, loss of appetite, dark urine, or yellowing eyes/skin.

Taking this medication during pregnancy can cause birth defects, may lower your child's IQ, and may increase the risk of your child having certain brain/mental disorders (such as autism, attention deficit/hyperactivity disorder). Women of childbearing age should discuss the risks and benefits of this medication, other treatment options, and use of reliable forms of birth control with their doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately talk to your doctor. If you are taking divalproex sodium only to prevent migraine headaches, this medication must not be used during pregnancy. If you are taking divalproex sodium to treat seizures or mental/mood problems (such as bipolar disorder), do not stop taking this medication unless directed by your doctor. Untreated seizures and mental/mood problems (such as bipolar disorder) are serious conditions that can harm both a pregnant woman and her unborn baby.

Warnings:

This medication has rarely caused severe (sometimes fatal) disease of the pancreas (pancreatitis). This may occur at any time during treatment and can quickly worsen.

Uses

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

How to use Depakote ER

Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking divalproex sodium and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth once daily or as directed by your doctor. You may take it with food if stomach upset occurs. Do not crush or chew extended-release tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.

The dosage is based on your age, weight, medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). 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 may 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

Precautions

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: certain antidepressants (such as amitriptyline, nortriptyline, phenelzine), certain antibiotics (carbapenems such as imipenem), irinotecan, mefloquine, orlistat, other medications for seizure (such as ethosuximide, lamotrigine, phenytoin, rufinamide, topiramate), rifampin, vorinostat, warfarin, zidovudine.

Low-dose aspirin, as prescribed by your doctor for specific medical reasons such as heart attack or stroke prevention (usually 81-162 milligrams a day), should be continued. Consult your doctor or pharmacist if you are using aspirin for any reason.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), and opioid pain relievers (such as codeine, hydrocodone).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

This drug may affect certain lab tests (such as urine ketones). Make sure laboratory personnel and your doctors know you use this medication.

Does Depakote ER interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: excessive drowsiness, coma, irregular/slow heartbeat.

Do not share this medication with others.

Laboratory and/or medical tests (such as drug levels, liver function tests, complete blood counts, clotting tests) should be performed before you start treatment, periodically to monitor your progress, or to check for side effects. Consult your doctor for more details.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

Depakote ER 500 mg tablet,extended release

Color: grayShape: ovalImprint: logo and HC

This medicine is a gray, oval, tablet imprinted with "logo and HC".

Depakote ER 500 mg tablet,extended release

Color: grayShape: ovalImprint: HC

This medicine is a gray, oval, tablet imprinted with "logo and HC".

Depakote ER 250 mg tablet,extended release

Color: whiteShape: ovalImprint: HF

This medicine is a gray, oval, tablet imprinted with "logo and HC".

Depakote ER 250 mg tablet,extended release

Color: whiteShape: ovalImprint: logo and HF

This medicine is a gray, oval, tablet imprinted with "logo and HC".

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Valproic Acid and Derivatives: Pediatric Medication

Pediatric Medicine

Provided by Lexicomp ^® , this document contains all the information you need to know about this medicine, including indications, directions for use, side effects, and when your healthcare provider should be contacted.

Trade names: USA

Depacon [DSC]; Depakene [DSC]; Depakote; Depakote ER; Depakote Sprinkles

Trade names: Canada

APO-Divalproex; APO-Valproic Acid; Depakene; epival; MYLAN-Divalproex; PMS-Valproic; PMS-Valproic Acid; SANDOZ Valproic [DSC]; TEVA-Divalproex [DSC]

Warning

All Forms:

The use of this drug was accompanied by violations of the liver. In some cases, these violations have led to death. In most cases, liver problems occurred within the first 6 months after starting this drug. Call your child's doctor right away if your child shows signs of liver problems such as dark urine, fatigue, lack of appetite, nausea or abdominal pain, light-colored stools, vomiting, yellowing of the skin or eyes. In patients suffering from seizures, there may be a loss of control over seizures. Do your child's blood test as directed by their doctor.
The risk of life-threatening liver problems is increased in children under 2 years of age. The risk is highest in patients taking more than 1 anti-seizure drug or who have a metabolic disorder, severe epilepsy with mental retardation, or congenital brain disease. Consult your doctor.
Patients with a genetic liver disorder are at an increased risk of developing liver failure due to a mitochondrial disorder such as Alpers-Huttenlocher syndrome. Your child may need genetic testing to detect this condition. If a child has or may have a mitochondrial disorder, do not give this drug without consulting your doctor.
This drug can cause serious and sometimes deadly problems with the pancreas (pancreatitis). Such a violation can occur in children at any time during treatment with this drug. Symptoms of pancreatitis include abdominal pain, nausea, vomiting, or decreased appetite. If your child develops any of these symptoms, contact their doctor immediately.

If your child is or may be sexually active:

If your daughter is pregnant or may become pregnant, check with her doctor to make sure this drug is right for her. She must use birth control while taking this drug to prevent pregnancy.

If your daughter is pregnant or likely to be pregnant:

This drug can cause serious birth defects if taken during pregnancy. It can also lower a child's IQ and may increase the risk of autism or ADHD. If your daughter becomes pregnant while taking this drug, call her doctor right away.
Do not give this migraine prevention drug to your daughter if she is pregnant or not using birth control to prevent pregnancy.

All oral preparations:

This drug comes with a separate patient information leaflet called Patient Drug Information. Read it carefully each time you take this drug. If you have any questions about this drug, ask your doctor, pharmacist, or other health care professional.

What is this drug used for?

Used to treat seizures.
It is used to prevent migraine.
This medicine is used to treat bipolar disorder.
This drug can be given to children for other indications. Consult your doctor.

What do I need to tell the doctor BEFORE my child takes this drug?

If your child has an allergy to this drug, any of its ingredients, other drugs, foods, or substances. Tell the doctor about the allergy and how it manifested itself in the child.
If your child suffers from any of the following: liver disease or a urea cycle disorder.

This list of drugs and conditions that may interact with this drug is not exhaustive.

Talk to your doctor or pharmacist about all medicines your child is taking (prescription and over-the-counter, natural, and vitamins) and any health problems. You need to make sure that this drug is safe to use for your child's illnesses and in combination with other drugs he or she is already taking. Do not start, stop taking, or change the dosage of any drug your child is taking without the doctor's approval.

What do I need to know or do while my child is taking this drug?

For all uses of this drug:

Tell all health care providers who care for your child that your child is taking this drug. These are your child's doctors, nurses, pharmacists and dentists.
Have your child avoid tasks or activities that require attention until you see how this drug works for your child. This includes cycling, playing sports, or using items such as scissors, lawn mowers, electric scooters, toy cars, or motorized vehicles.
Perform blood tests as directed by your doctor. Consult with your doctor.
Alcohol can interact with this drug. Make sure your child does not drink alcohol.
Check with your child's doctor before using marijuana, other forms of cannabis, or prescription or over-the-counter drugs that may slow your child's progress.
This drug may affect the results of some lab tests. Tell all health care workers and laboratory workers who provide your child's health care that your child is taking this drug.
If your child is unable to eat or drink as usual, check with their healthcare provider. These situations include illness, fasting, certain procedures or surgery.
Some brands of this drug contain peanut butter. If your child is allergic to peanuts, ask your pharmacist to check the peanut butter content of your child's brand of peanut butter.
Your child may become more prone to bleeding. Make sure your child is careful to avoid injury. Make sure your child uses a soft toothbrush.
This drug has been associated with increased levels of ammonia in the blood. This can lead to certain brain disorders. Some fatalities. Consult your doctor.
In some individuals, certain brain disorders were not accompanied by an increase in the level of ammonia in the blood. In some cases, these brain disorders resolved after discontinuation of treatment with this drug. However, in some cases they did not go completely. Consult your doctor.
There was a serious reaction that could be deadly. In most cases, this reaction was accompanied by symptoms such as fever, rash, inflammation of the lymph nodes, and dysfunction of various organs such as the liver, kidneys, blood, heart, muscles, joints and lungs. If you have any questions, please consult your doctor.
This drug may affect a man's ability to have a child. Consult your doctor.

If your daughter is breastfeeding:

Tell your doctor if your daughter is breastfeeding. You will need to be counseled about the possible risks to the child.

Anti-seizure:

Talk to your doctor if your seizures change or get worse after you start taking this drug.

What side effects should I report to my child's doctor right away?

WARNING/CAUTION: Although rare, this drug can cause very serious and sometimes deadly side effects in some people. Call your child's doctor right away or get medical help if your child has any of the following signs or symptoms that could be associated with a very bad side effect:

Signs of an allergic reaction, such as rash, hives, itching, red and swollen skin with blisters or peeling, possibly accompanied by fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue or throat.
Signs of infection, such as fever, chills, very bad pain in the throat, ear, or sinuses, cough, more sputum or change in color, pain when urinating, mouth sores, or a sore that doesn't heal.
Signs of high ammonia levels such as irregular heartbeat, trouble breathing, confusion, pale skin, bradycardia, seizures, sweating, vomiting, or muscle twitches.
Chest pain.
Swelling of the hands or feet.
Vision change.
Impairment or loss of memory.
Balance change.
Difficulties with walking.
Any unexplained bruising or bleeding.
The appearance of purple spots on the skin or redness of the skin.
Difficulty urinating or a change in the amount of urine produced.
Swelling of the gland.
Muscle pain or weakness.
Pain or inflammation in the joints.
Shiver.
Loss of control over eye movements.
Tinnitus.
Chills.
Like other seizure medicines, this medicine can rarely increase the risk of suicidal ideation or behavior. This risk may be higher in people who have tried or had suicidal thoughts in the past. Call your doctor right away if you develop or worsen symptoms such as depression, nervousness, anxiety, irritability, panic attacks, or other mood or behavioral disturbances. If you have suicidal thoughts or attempted suicide, contact your doctor immediately.

What are some other side effects of this drug?

Any drug can cause side effects. However, for many people, side effects are either minor or non-existent. Contact your child's doctor or seek medical attention if any of these or other side effects bother your child or if they persist:

Headache.
Constipation, diarrhea, abdominal pain, nausea, vomiting, or decreased appetite.
Increased appetite.
Feeling dizzy, tired or weak.
Sleep disorders.
Weight gain or loss.
Hair loss.
Nervous tension and agitation.
Flu-like symptoms.

This list of possible side effects is not exhaustive. If you have any questions about side effects, ask your child's doctor. Talk to your child's doctor about side effects.

You can report side effects to the National Health Board.

What is the best way to give this drug?

Give this drug to your child as directed by your doctor. Read all the information provided to you. Strictly follow all instructions.

All oral preparations:

Give this drug with or without food. If the drug causes stomach upset, give it with food.
Keep giving this drug as directed by your child's doctor or other health care provider, even if your child is feeling well.
Do not stop giving this drug to your child abruptly without talking to the doctor. This can increase the risk of seizures. If needed, this drug should be stopped gradually for your child as directed by the doctor.
If your child is taking cholestyramine, you may need to give it at a different time than this drug. Consult with a pharmacist.

Tablets and capsules:

Ask your child to swallow whole. Ask your child not to chew, break, or crush the tablet.
Give this drug with a full glass of water.
If your child has difficulty swallowing, check with your doctor.

Long acting tablets:

If you or your child see particles of this drug in your child's stool, contact your doctor.

Split capsule:

The child may swallow the capsule whole or mix the contents of the capsule with certain foods such as applesauce. Make sure the child takes the mixture immediately. Do not store for future use.
If you or your child see particles of this drug in your child's stool, contact your doctor.

Liquid:

Liquid doses should be measured with caution. Use the dispenser that comes with the medication. If the dispenser is not provided in the package, ask the pharmacist for a dosing agent for this drug.

Injection:

This drug is administered by infusion intravenously continuously for a certain time.

What if my child misses a dose of medication?

All oral preparations:

Give the missed dose as soon as possible.
If it is time for your child to take the next dose, do not take the missed dose and then go back to your child's normal schedule.
Do not give a double dose at the same time or additional doses.

Injection:

Contact your child's doctor to find out the next steps.

How do I store and/or discard this drug?

All oral preparations:

Store at room temperature in a dry place. Do not store in the bathroom.

Injection:

If you need to store this drug at home, check with your child's doctor, nurse, or pharmacist about how to store it.

All forms:

Keep all medicines in a safe place. Keep all medicines out of the reach of children and pets.
Dispose of unused or expired drugs. Do not empty into a toilet or sewer unless instructed to do so. If you have any questions about disposing of medicines, ask your pharmacist. Drug disposal programs may be in place in your area.

General information about medicines

If your child's symptoms or health problems do not improve, or worsen, contact your child's doctor.
Do not share your child's medicine with others and do not give anyone else's medicine to your child.
Some medicines may come with other patient information leaflets. If you have questions about this drug, talk with your child's doctor, nurse, pharmacist, or other health care professional.
If you think you have overdosed, call a poison control center or get medical help right away. Be prepared to tell or show what drug you took, how much, and when it happened.

Consumer Use of Information and Limitation of Liability

This summary information includes a summary of the diagnosis, treatment, and/or drug product. It is not intended to be a comprehensive source of data and should be used as a tool to help the user understand and/or evaluate potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a particular patient. It should not be considered medical advice or a substitute for medical advice, diagnosis or treatment provided by a physician based on a medical examination and assessment of the patient's specific and unique circumstances. Patients should consult with their physician for full information about their health, medical issues, and treatment options, including any risks or benefits regarding the use of medications. This information is not a guarantee that a treatment or drug is safe, effective, or approved for a particular patient. UpToDate, Inc. and its subsidiaries disclaim any warranties or liabilities related to this information or its use. The use of this information is subject to the Terms of Use found at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last revision date

2020-06-02

Copyright

Date last updated

Monday, December 12, 2022

Dosage Details for Depakote and Depakote ER - Drink-Drink

Introduction

If you have certain types of seizures, migraines, or mood disorders, your doctor may suggest Depakote or Depakote ER as a treatment option.

Depakote is a prescription medicine used to:

treat focal seizures with impaired consciousness (also called complex partial seizures) in adults and some children
treat absences in adults and some children
treat mania, associated with bipolar disorder in adults
prevent migraine attacks in adults

The active ingredient in Depakote and Depakote ER is divalproex sodium. (The active ingredient is what makes the medicine work.) These medicines belong to a group of medicines called anticonvulsants.

Depakote and Depakote ER are drugs that you swallow. Depakote is available as tablets as well as powdered capsules.* Depakote ER† is available as tablets.

This article describes Depakote and Depakote ER dosages, their strengths and how to take them. To learn more about Depakote and Depakote ER see this detailed article.

This article discusses the typical dosages of Depakote and Depakote ER as provided by the drug manufacturer. But when using Depakote or Depakote ER, always take the dosage prescribed by your doctor.

What is the dosage of Depakote and Depakote ER?

In this section, you will learn about the typical dosages of Depakote and Depakote ER. Dosage ranges for these drugs may vary. Your dosage will depend on your body weight and the condition you are using Depakote to treat.

What are the forms of Depakote and Depakote ER?

Depakote is available in the following formulations:

Delayed Release (DR) Tablets
Powdered Capsules DR

These forms are called delayed because they will not dissolve until they have passed through the stomach. This allows the medication to reach the right levels in the body and helps prevent stomach irritation.

Depakote ER is available as:

extended release (ER) tablets

ER tablets release the drug slowly in the body over 24 hours. This helps to maintain a constant level of the drug throughout the day. And that means you will only need to take this form of the drug once a day. Dosing the DR form usually requires more frequent dosing throughout the day.

All forms of Depakote and Depakote ER are taken by mouth. You will swallow the tablets whole. As for the capsules, they can either be swallowed whole or opened and poured onto soft food.

What are the strengths of Depakote and Depakote ER?

Depakote and Depakote ER have the following strengths:

Depakote tablets

• 125 milligrams (mg)

• 250 mg

20003

Depakote and Depakote ER dosages are often based on body weight in kilograms (kg). * For example, if your Depakote dose is 10 mg/kg, you will be taking 10 mg of the drug for every kilogram of your weight.

Your doctor will usually start with a low starting dose. They will then slowly increase your dosage, either until your condition is manageable or until you reach the maximum dose that is safe to take.

The maximum dose of drugs varies depending on the condition you are treating. But the maximum dose of Depakote is usually the same as the maximum dose of Depakote ER. The dose you take may be slightly different from the dose your doctor calculates for you. This is because these drugs are only available in certain dosages.

The information below describes dosages that are commonly used or recommended for adults. But be sure to take the dosage prescribed by your doctor. Your doctor will determine the best dosage for your needs.

For pediatric dosage information, see What is the Pediatric (Pediatric) Dosage of Depakote and Depakote ER? below.

Dosage for episodes of mania associated with bipolar disorder

Depakote (tablets only) and Depakote ER are used to treat mania associated with bipolar disorder. Mania is a hyperactive, euphoric mood.

For this application, the initial doses of these drugs are:

Depakote: 750 mg per day divided into several doses
Depakote ER: 25 mg/kg once a day

Manufacturer recommends rapidly increasing the dose

to a high enough level to cope with the mania. The maximum dose of both drugs is 60 mg/kg per day.

Seizure dosages

The following are the dosages of Depakote (tablets and capsules) and Depakote ER for the types of seizures they treat: seizures with focal impairment of consciousness (also called complex partial seizures) and absence seizures.

The manufacturer notes that these drugs should not be stopped abruptly. This can lead to more severe seizures that can be life-threatening.

You can take Depakote or Depakote ER alone or with another anticonvulsant for this seizure.

If you are taking more than 250 mg of Depakote daily, you will split this dose into smaller doses to take throughout the day. But if you have been prescribed Depakote ER, you can take the entire daily dose at one time.

Recommendations for daily starting dose, dose escalation and maximum dose are the same for both Depakote and Depakote ER. Your doctor will likely increase your dose every week until it is high enough to control your seizures.

The table below lists the usual doses of these drugs for focal seizures with impaired consciousness. It also gives an example of what daily doses might be for a person who weighs 60 kg (about 132 pounds).

3.600 mg

For the treatment of this type of seizure, the recommendations for daily starting dose, dose escalation and maximum dose are the same for both Depakote and Depakote ER.

Your starting dose will be 15 mg/kg per day. Each week your doctor may increase your daily dose by 5 mg/kg up to 10 mg/kg. The maximum daily dose of Depakote and Depakote ER for the treatment of absences is 60 mg/kg.

Prophylactic dosage for migraine

Depakote (tablets only) and Depakote ER are used to prevent migraine symptoms such as severe headaches.

For this application, the initial doses of these drugs are:

Depakote: 250 mg twice a day
Depakote ER: 500 mg once a day

What is the pediatric (pediatric) dose of Depakote and Depakote ER?

Depakote and Depakote ER can be used to treat focal conscious seizures and absences in children 10 years of age and older. (Seizures with focal impairment of consciousness are also called complex partial seizures.)

Doses for the treatment of certain seizures in children aged 10 years and older are similar to those for adults. See Dosage for Seizures for details. The doctor will prescribe the optimal dosage for your child.

These drugs are not safe for children under 10 years of age. But your child's doctor may prescribe them off-label under certain conditions. Off-label drug use is when a drug approved by the Food and Drug Administration (FDA) is prescribed for a purpose other than the one for which it is approved.

In children under 10 years of age, dose adjustment of Depakote may be required. In children under 2 years of age, Depakote can cause serious liver damage.

If you have questions about the dosage of Depakote or Depakote ER for your child, talk to your doctor or pharmacist.

Are Depakote and Depakote ER used for a long time?

Yes, Depakote and Depakote ER are usually used for long-term treatment. If you and your doctor determine that Depakote or Depakote ER is safe and effective for you, it is likely that you will use it for a long time.

Dosage adjustment

Your doctor may adjust the dosage of Depakote or Depakote ER if you are taking another medicine that may interact with these medicines. They may change the dosage of another medicine or Depakote or Depakote ER. Tell your doctor about any other medicines you are taking before starting treatment.

If you experience abnormal fatigue (low energy) or loss of concentration, your dosage may need to be adjusted. Your dosage may also need to be adjusted if there are changes in how much you eat or drink.

The manufacturer recommends that older people start at lower doses.

Frequently Asked Questions

Below are answers to some frequently asked questions about Depakote and Depakote ER.

Can Depakote and Depakote ER be used to treat anxiety, depression, agitation or dementia? If so, what dosages are recommended?

The Food and Drug Administration (FDA) has not approved the use of Depakote and Depakote ER for the treatment of anxiety, depression, agitation, or dementia.

But your doctor may prescribe these drugs for non-FDA-approved uses. This is called off-label use. When the drug is not prescribed for its intended purpose, the manufacturer does not recommend specific dosages.

If you have any questions about off-label use of Depakote and Depakote ER, talk to your doctor or pharmacist.

Is Depakote or Depakote ER usually prescribed at a dose of 1,500 mg?

It is possible that your doctor may prescribe any drug at this dose.

Your doctor can calculate the dose of Depakote or Depakote ER based on your weight in kilograms (kg). For example, if your doctor recommends a dose of 15 mg/kg and you weigh 100 kg (about 220 pounds), your dose would be 1,500 mg.

The maximum dose for some conditions is 60mg/kg, so you can take doses of Depakote or Depakote ER that are well over 1,500mg. For additional dosage information, see "What are the usual dosages for Depakote and Depakote ER?" section above.

Although a daily dose of 1,500 mg is possible with these drugs, be sure to take the dose prescribed by your doctor.

What is a loading dose and is it required by Depakote or Depakote ER?

Loading dose generally refers to a larger starting dose that decreases over time. Loading doses are used when a high dose of medication is needed to quickly relieve the symptoms of a condition.

Unlike drugs that require a loading dose, Depakote and Depakote ER doses usually start low and increase slowly over time. This gives your body a chance to get used to the drug.

Is Depakote or Depakote ER available in liquid form for intravenous administration?

Depakote and Depakote ER are only supplied as medicines that you take by mouth.

A similar drug, sodium valproate, is available as an intravenous (IV) solution (injected into a vein over a period of time). This drug is only used to treat certain seizures. It is not used to treat mania associated with bipolar disorder or to prevent migraines.

If you are interested in learning more about sodium valproate, talk to your doctor.

What factors can affect my dosage?

The amount of Depakote or Depakote ER you are prescribed may depend on several factors. This includes:

the type and severity of the condition you are using Depakote or Depakote ER to treat
your age
the form of Depakote or Depakote ER you are using
whether you have any side effects from taking any drug
other medicines you may be taking
other conditions you may have (see "Dose Adjustment" under "What is the dosage of Depakote and Depakote ER?")

How do I take Depakote and Depakote ER?

Depakote is available as tablets and powdered capsules, while Depakote ER is available as tablets. To take these medicines, you swallow them whole. You can take them with or without food. If you notice abdominal pain after taking any medication, try taking it with meals.

You can open the Depakote capsules for dusting and sprinkle them on soft foods such as applesauce. If you are taking the capsule in this way, make sure you drink the entire contents of the capsule. You should also eat right away and not chew on sprinkles.

If you have trouble swallowing capsules or tablets, see this article for tips on how to take this form of medication.

How often you take your dose depends on which drug your doctor prescribes. You would take Depakote ER once a day. You must take Depakote tablets or capsules several times a day.

Your dose will probably be increased at the beginning until your symptoms are gone. Your doctor may also ask you to take blood tests to make sure your blood levels of Depakote are within a safe range.

For information on expiration, storage and disposal of Depakote and Depakote ER see this article.

Available drug containers and labels

Tell your doctor or pharmacist if you have difficulty reading a prescription label. Some pharmacies may provide drug labels that:

large print or Braille
have a code that you can scan with your smartphone to change the text to sound

Your doctor or pharmacist can recommend pharmacies that offer these special features if your current pharmacy They are not here.

Tell your pharmacist if you have problems opening medicine bottles. They can supply Depakote or Depakote ER in an easy-to-open container. Your pharmacist can also give you some tips to help make opening the medicine container easier.

What if I miss a dose?

If you miss a dose of Depakote or Depakote ER, take it as soon as you remember. If it's almost time for your next dose, skip the missed dose and take your next dose. Do not take two doses at one time.

If you need help remembering to take your Depakote or Depakote ER dose on time, try using the Medication Reminder. This may include setting an alarm or using a timer. You can also download a reminder app on your phone.

What to do in case of an overdose?

Do not take more Depakote or Depakote ER than your doctor has told you to. Using more can lead to serious side effects.

Symptoms of an overdose

Symptoms caused by an overdose may include:

Thirst
Consecration
Tipping muscles
Feeling of extreme fatigue

Call your doctor right away if you think you have taken too much Depakote or Depakote ER. You can also call 800-222-1222 to contact the American Association of Poison Control Centers or use their online resource. But if you have severe symptoms, call 911 (or your local emergency number) immediately or go to the nearest emergency room.

What should I ask the doctor?

The sections above describe typical dosages provided by the drug manufacturer. If your doctor recommends Depakote or Depakote ER for you, they will prescribe the dosage that is right for you.

Remember that you should not change the dosage of Depakote or Depakote ER without your doctor's advice. Take only Depakote and Depakote ER exactly as directed. Talk to your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you can ask your doctor:

How quickly will my Depakote dose be increased?
Which soft foods can be used with Depakote capsules?
Will my benzodiazepine dose change when I start taking Depakote?
Will a higher dose of Depakote mean I will be taking a lower dose of other anticonvulsants?
Which is better for my condition, Depakote or Depakote ER?

If you have bipolar disorder, consider subscribing to the Drink-Drink newsletter for advice on mood management and mental health.

Drink-Drink also has a Migraine Fact Sheet, which has treatment recommendations delivered to your mailbox. And if you want to join the supportive community of people living with migraines, check out Bezzy Migraine.

Ask a pharmacist

Q:

I was prescribed Depakote to prevent migraine attacks. Why is my dose so low?

Anonymous

A:

To prevent migraine episodes, your doctor will prescribe a lower dose of Depakote based on drug studies.

The dose for this purpose does not depend on the weight of the person, as for other purposes. The initial dose of Depakote tablets for the prevention of migraine attacks is 250 mg twice a day. Your doctor may increase it to a maximum daily dose of 1,000 mg. Similarly, the starting dose for Depakote ER tablets is 500mg per day for 1 week. Your dose may then be increased up to a maximum of 1,000 mg.

If you have any questions about changing your dose of Depakote, be sure to talk to your doctor.

Melissa Badowski, PharmD, MPH, FCCP Answers represent the views of our medical experts. All content is for informational purposes only and should not be considered medical advice.

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