(Legend)

Generic Name

• Divalproex sodium [Valproate]
  T½ = 5–20 h
  Pregnancy category D

Trade Name

• Depakote
• Depakote ER
• Epival

Dose Range/Adult Daily Dose

• Range: 500–1500 mg/d po [up to 4000 mg/d]
  Initially: 750 mg/d in divided doses, titrated to clinical effect/plasma levels; ER: Single dose at bedtime

Use/Common Side Effects (CSE)

• Use: Bipolar, acute mania & prophylaxis
  CSE: Nausea, vomiting, indigestion, HEPATOTOXICITY, PANCREATITIS

Geriatric & Dose Considerations

• Caution with renal impairment, organic brain disease, assess for excessive somnolence

Classification

• Anticonvulsant/mood stabilizer

Assessment Cautions

• Contraindicated: Hepatic impairment; Monitor LFTs, serum ammonia before and throughout Rx Hyperammonemia: D/C VA.
  Caution: Renal/bleeding disorders; bone marrow depression; teratogenicity; need VA levels (50–100 µg/mL)