section name header

Pronunciation

divalproex sodium: dye-val-PROE-ex SOE-dee-um

valproate sodium: val-PROE-ate SOE-dee-um

valproic acid: val-PROE-ik AS-id

Classifications

Therapeutic Classification: anticonvulsants, vascular headache suppressants

Indications

REMS


Divalproex sodium only

Action

  • Increase levels of GABA, an inhibitory neurotransmitter in the CNS.
Therapeutic effects:
  • Suppression of seizure activity.
  • Decreased manic episodes.
  • Decreased frequency of migraine headaches.

Pharmacokinetics

Absorption: Well absorbed following oral administration; divalproex is enteric-coated, and absorption is delayed. Extended-release form produces lower blood levels. IV administration results in complete bioavailability.

Distribution: Rapidly distributed into plasma and extracellular water. Cross blood-brain barrier.

Protein Binding: 80–90% ( in neonates, elderly, renal impairment, or chronic hepatic impairment).

Metabolism/Excretion: Mostly metabolized by the liver; minimal amounts excreted unchanged in urine.

Half-Life: Adults: 9–16 hr.

Time/Action Profile

(onset = anticonvulsant effect; peak = blood levels)

ROUTEONSETPEAKDURATION
PO—liquid2–4 days15–120 min6–24 hr
PO—capsules2–4 days1–4 hr6–24 hr
PO—delayed-release products2–4 days3–5 hr12–24 hr
PO—extended-release products2–4 days7–14 hr24 hr
IV2–4 daysend of infusion6–24 hr





Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

Interactions

Drug-drug:

Route/Dosage

Seizure Disorders

Bipolar Disorder

Migraine Prevention

Availability

Valproic Acid

(Generic available)

Valproate Sodium

(Generic available)

Divalproex Sodium

(Generic available)

Assessment

Lab Test Considerations:

Toxicity and Overdose:

Implementation

IV Administration:

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

divalproex sodium: Depakote, Depakote ER, Depakote Sprinkle,

valproate sodium: Depacon,

valproic acid: Depakene

Canadian Brand Names

divalproex sodium: Epival