Generic Valproic Acid

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At our US pharmacy, you can purchase Valproic Acid 250 mg, 500 mg, and 750 mg delayed-release tablets without a prescription, with discreet and anonymous packaging delivered within 5-14 days across USA.
Valproic Acid is an anticonvulsant used to treat epilepsy, bipolar disorder, and to prevent migraine headaches. It belongs to a class of medications called mood stabilizers and works by calming overactive electrical signals in the brain. The medication helps control seizures, stabilize mood swings, and reduce the frequency of migraines.
The usual starting dose for adults and children 10 years and older is 15 mg/kg per day, taken in divided doses. Your doctor will increase the dose weekly by 5 to 10 mg/kg per day until seizures are controlled or side effects become bothersome. The usual maintenance range is 1,000 mg to 2,000 mg per day, and the maximum recommended dose is 60 mg/kg per day.
The administration form is delayed-release tablets in 250 mg, 500 mg, and 750 mg strengths. The 250 mg tablet is white and oval, engraved with "APO" on one side and "250" on the other. The 500 mg tablet is white and oval, engraved with "APO 500". The 750 mg tablet is white and oval, engraved with "APO 750". An oral solution (250 mg/5 mL) and sprinkle capsules are also available.
Valproic Acid does not work overnight. It may take several weeks of steady dosing before you notice the full benefit for seizures, mood stabilization, or migraine prevention. Do not stop taking it just because you do not feel an effect in the first few days.
Alcohol should be avoided during treatment. It adds to the drowsiness and dizziness that Valproic Acid can cause, and it can increase the risk of liver damage and pancreatitis.
The most common side effects are nausea, vomiting, diarrhea, abdominal pain, and increased appetite. Weight gain, hair loss, and tremor are also common with this medication.
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Common Use Valproic Acid

Valproic Acid is a carboxylic acid derivative with broad-spectrum antiepileptic activity. Its exact mechanism is not fully understood, but researchers believe it works by increasing the levels of gamma-aminobutyric acid (GABA), the brain's main inhibitory neurotransmitter. This dampens the excessive electrical activity that causes seizures. It may also block voltage-gated sodium channels and affect the metabolism of certain neurotransmitters. Health Canada has approved Valproic Acid for use as sole or adjunctive therapy in the treatment of simple and complex absence seizures, including typical absences, and as adjunctive therapy in patients with multiple seizure types that include absence seizures. It is also indicated for the treatment of manic episodes associated with bipolar disorder, and for prophylaxis of migraine headaches. Valproic Acid is not approved for use in children under 2 years of age for the treatment of epilepsy due to an increased risk of fatal hepatotoxicity, and it should not be used to prevent migraine headaches in pregnant women or women of childbearing potential who are not using effective contraception.

Basic Valproic Acid Information

• INN (International Nonproprietary Name): Valproic acid (also known as valproate sodium or divalproex sodium)
• Brand names available in Canada: Depakene® (BGP Pharma ULC); generics include Apo-Valproic Acid, Teva-Valproic Acid, Sandoz Valproic Acid, pms-Valproic Acid, Jamp Valproic Acid, Mar-Valproic Acid, Mint-Valproic Acid, and others. Divalproex sodium is sold as Epival® (BGP Pharma ULC) and generics including Apo-Divalproex, Teva-Divalproex, and others.
• ATC Code: N03AG01
• Forms and dosages: Delayed-release tablets – 250 mg, 500 mg, and 750 mg. Oral solution – 250 mg/5 mL. Sprinkle capsules – 125 mg. Enteric-coated tablets of divalproex sodium – 125 mg, 250 mg, and 500 mg.
• Manufacturers in Canada: BGP Pharma ULC (Depakene, Epival), Apotex Inc. (Apo-Valproic Acid, Apo-Divalproex), Teva Canada Limited (Teva-Valproic Acid, Teva-Divalproex), Sandoz Canada Inc. (Sandoz Valproic Acid), Pharmascience Inc. (pms-Valproic Acid, pms-Divalproex), Jamp Pharma Corporation (Jamp Valproic Acid), Marcan Pharmaceuticals Inc. (Mar-Valproic Acid), Mint Pharmaceuticals Inc. (Mint-Valproic Acid), and others.
• Registration status in Canada: Approved by Health Canada. Multiple DINs exist, including 02238069 (Valproic Acid Oral Solution, Apotex), 00596434 (Epival 500 mg, BGP Pharma), 02140047 (Ratio-Valproic 250 mg, Teva Canada), 02238817 (DOM-Valproic Acid, Dominion Pharmacal, cancelled after market), and 02238370 (Apo-Valproic Acid Oral Solution, Apotex, status dormant).
• OTC / Rx classification: Prescription only (Rx) – not legally sold over-the-counter in Canadian pharmacies

Dosage & Direction

Take Valproic Acid exactly as your doctor prescribes. The dose depends on what is being treated, your age, and your body weight. For epilepsy in adults and children 10 years and older, the recommended starting dose is 15 mg/kg per day, taken in divided doses. Your doctor will increase the dose weekly by 5 to 10 mg/kg per day until seizures are controlled or side effects become bothersome. The usual maintenance range is 1,000 mg to 2,000 mg per day. The maximum recommended dose is 60 mg/kg per day. For bipolar disorder, the starting dose is usually 750 mg per day, divided into two or three doses, and increased gradually. For migraine prevention, the usual dose is 250 mg twice daily, though higher doses may be needed. Take the tablet with food or milk to reduce stomach upset. Swallow the tablet whole. Do not crush or chew it, because the delayed-release coating protects your stomach from irritation. If you are taking the oral solution, use the measuring device provided. Do not use a household spoon. If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed one and continue with your regular schedule. Do not take two doses at once. Do not stop taking Valproic Acid suddenly without talking to your doctor. Stopping abruptly can cause seizures to return or mood symptoms to worsen. Your doctor will taper the dose gradually over weeks or months.

Precautions

Valproic Acid carries a boxed warning about life-threatening adverse reactions, including hepatotoxicity, pancreatitis, and fetal risk. Hepatotoxicity, including fatalities, usually occurs during the first 6 months of treatment. Children under the age of two years and patients with mitochondrial disorders are at higher risk. Your doctor should check your liver function before you start treatment and at frequent intervals thereafter. Call your doctor right away if you develop signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, vomiting, or yellow skin or eyes. Pancreatitis, including fatal hemorrhagic cases, has been reported with Valproic Acid. Stop the medication and seek medical attention if you develop severe abdominal pain, nausea, vomiting, or loss of appetite. Valproic Acid can cause serious skin reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis, which can be life-threatening. If you develop a rash, blisters, peeling skin, or sores in your mouth or eyes, stop the medication and get emergency care. Hyperammonemia, a buildup of ammonia in the blood, can occur with Valproic Acid, even when liver function tests are normal. Symptoms include unexplained drowsiness, vomiting, or changes in mental status. Your doctor may check your ammonia levels if these occur. Valproic Acid can cause low body temperature (hypothermia), especially in older adults. Tell your doctor if you feel unusually cold or have difficulty staying warm. The medication can cause thrombocytopenia, a low platelet count, which increases the risk of bleeding. Your doctor should monitor your platelet count, especially before surgery. Valproic Acid can cause weight gain and increased appetite. Your doctor should monitor your weight during treatment. It can also cause hair loss, which is usually temporary. Valproic Acid is not recommended during pregnancy. It has a high teratogenic potential, and babies exposed in the womb have a high risk of congenital malformations and neurological developmental disorders. Women who could become pregnant should use effective contraception and discuss the risks with their doctor. It passes into breast milk, so breastfeeding is not recommended without medical advice. Valproic Acid should not be used in children under 2 years of age for epilepsy due to an increased risk of fatal hepatotoxicity. Older adults may be more sensitive to the side effects of Valproic Acid and may need lower doses. Tell your doctor if you have kidney disease, liver disease, or a urea cycle disorder.

Contraindications

Do not take Valproic Acid if you have had an allergic reaction to valproic acid, divalproex sodium, or any of the inactive ingredients in the tablet or solution. Valproic Acid is contraindicated in patients with hepatic disease or significant hepatic dysfunction. It should not be used in patients with known mitochondrial disorders caused by mutations in the mitochondrial DNA polymerase gamma (POLG) gene, or in children under 2 years of age with suspected POLG-related disorders. Valproic Acid is contraindicated in patients with urea cycle disorders, because it can cause severe hyperammonemia. Do not use it in patients with known hypersensitivity to the drug. Valproic Acid is contraindicated for the prophylaxis of migraine headaches in pregnant women and in women of childbearing potential who are not using effective contraception. It should not be used during pregnancy for epilepsy or bipolar disorder unless other medications have failed to provide adequate symptom control or are otherwise unacceptable. Do not take Valproic Acid if you have a history of pancreatitis. It is contraindicated in patients with severe thrombocytopenia or bleeding disorders. If you are unsure whether any of these apply to you, check with your doctor or pharmacist.

Possible Side Effects

More than 5% of people experience abdominal pain, hair loss, blurred vision, amnesia, anorexia, weakness, ataxia (loss of coordination), constipation, depression, diarrhea, dizziness, double vision, upset stomach, shortness of breath, bruising, emotional instability, fever, flu-like symptoms, headache, increased appetite, and infection. These effects are often most noticeable when starting treatment or increasing the dose. Some people notice tremor, weight gain, and changes in mood. These effects may fade as your body adjusts, but if they persist or bother you, tell your doctor. Serious side effects require immediate medical attention. Liver injury can cause jaundice, dark urine, and abdominal pain. Pancreatitis can cause severe stomach pain, nausea, and vomiting. Severe skin reactions can cause rash, blisters, peeling skin, and sores in the mouth or eyes. Hyperammonemia can cause confusion, drowsiness, and vomiting. Low platelet count can cause easy bruising or unusual bleeding. Hypothermia can cause shivering, confusion, and difficulty speaking. If you develop any of these serious effects, stop the medication and seek medical help right away. Antiepileptic drugs, including Valproic Acid, increase the risk of suicidal thoughts or behaviour. If you notice worsening mood or new thoughts of self-harm, contact your doctor immediately.

Drug Interaction

Valproic Acid interacts with several medications. Pivalate-conjugated drugs, such as cefditoren pivoxil, adefovir dipivoxil, pivmecillinam, and pivampicillin, should be avoided with Valproic Acid. Concurrent use of Valproic Acid and clozapine can increase the risk of neutropenia and clozapine-induced myocarditis. Valproic Acid inhibits the glucuronidation of zidovudine, which can increase its levels and toxicity. It can potentiate the effects of psychotropic drugs such as neuroleptics, MAO inhibitors, antidepressants, and benzodiazepines. Carbamazepine toxicity has been reported when used with Valproic Acid, as Valproic Acid can increase carbamazepine levels. Rifampicin can reduce Valproic Acid serum concentrations, and the dose may need adjustment. Salicylates should be avoided in children under 3 years of age due to the risk of liver toxicity. Valproic Acid can increase the levels of lamotrigine, increasing the risk of a serious rash. Acetazolamide and Valproic Acid together can increase the risk of hyperammonemia and encephalopathy. Methotrexate can reduce Valproic Acid serum concentrations. Cimetidine, fluoxetine, and other drugs that inhibit liver metabolism can increase Valproic Acid levels. Tell your doctor and pharmacist about every medication you take, including over-the-counter products, vitamins, and herbal supplements.

Missed Dose

If you miss a dose of Valproic Acid, take it as soon as you remember. If it is almost time for your next dose, skip the missed one and continue with your regular schedule. Do not take two doses at once to make up for a missed one. If you miss several doses in a row, contact your doctor before restarting. Missing doses can increase the risk of seizures or mood destabilization, so try to take the medication at the same times each day.

Overdose

Overdose with Valproic Acid is a medical emergency. Symptoms include severe drowsiness, confusion, coma, and respiratory depression. The medication can cause cerebral edema (swelling of the brain), which can lead to seizures and permanent neurological damage. There is no specific antidote. Treatment is supportive and may include activated charcoal if the overdose was recent, intravenous fluids, and monitoring of vital signs. Hemodialysis and hemoperfusion may be used in severe cases to remove Valproic Acid from the blood. Naloxone has been reported to reverse the CNS depressant effects of Valproic Acid overdose in some cases. Contact a poison control centre or go to an emergency department immediately if you or someone else has taken too much. Do not try to manage an overdose at home.

Storage

Store Valproic Acid tablets at room temperature between 15 and 30 degrees Celsius (59 and 86 degrees Fahrenheit). Keep the container tightly closed and protect it from light and moisture. Do not store in the bathroom or near a sink. Keep out of reach of children and pets. Do not use after the expiry date on the label. Dispose of unused medication according to local guidelines. Do not flush Valproic Acid down the toilet or pour it down the sink.

Disclaimer

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

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