Valproate semisodium

Synonyms / Brand Names: Divalproex sodium, Valproate semisodium, Depakote, Depakote CP, Depakote ER, Depakote Sprinkle, Epival

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Dosing and Administration

Migraine
DEPAKOTE tablets are administered orally. The recommended starting dose is 250 mg twice daily. Some patients may benefit from doses up to 1000 mg/day. In the clinical trials, there was no evidence that higher doses led to greater efficacy.

Mania
For mania, the recommended initial dose is 750 mg daily in divided doses. The maximum recommended dosage is 60 mg/kg/day. For epilepsy, patients should initiate therapy at 10 to 15 mg/kg/day. No recommendation regarding the safety of valproate for use at doses above 60 mg/kg/day can be made. For migraines, the recommended starting dose is 250 mg twice daily. Some patients may benefit from doses up to 1000 mg/day.

Complex Partial Seizures
For adults and children 10 years of age or older. Monotherapy (Initial Therapy): DEPAKOTE has not been systematically studied as initial therapy. Patients should initiate therapy at 10 to 15 mg/kg/day. The dosage should be increased by 5 to 10 mg/kg/week to achieve optimal clinical response. Ordinarily, optimal clinical response is achieved at daily doses below 60 mg/kg/day. If satisfactory clinical response has not been achieved, plasma levels should be measured to determine whether or not they are in the usually accepted therapeutic range (50 to 100 μg/mL). No recommendation regarding the safety of valproate for use at doses above 60 mg/kg/day can be made. The probability of thrombocytopenia increases significantly at total trough valproate plasma concentrations above 110 μg/mL in females and 135 μg/mL in males. The benefit of improved seizure control with higher doses should be weighed against the possibility of a greater incidence of adverse reactions.

For more information on dosing please refer to Instructions for administration

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