Hypothermia Hypothermia has been reported during valproate therapy with or without associated hyperammonemia.
Hyperammonemia and hyperammonemic encephalopathy measure ammonia level if unexplained lethargy and vomiting or changes in mental status, and also with concomitant topiramate use consider discontinuation of valproate therapy ( 5.6, 5.9, 5.10).
Bleeding and other hematopoietic disorders monitor platelet counts and coagulation tests ( 5.8).
Suicidal behavior or ideation Antiepileptic drugs, including Depakote ER, increase the risk of suicidal thoughts or behavior ( 5.7).
Pancreatitis Depakote ER should ordinarily be discontinued ( 5.5).
Birth defects, decreased IQ, and neurodevelopmental disorders following in utero exposure should not be used to treat women with epilepsy or bipolar disorder who are pregnant or who plan to become pregnant or to treat a woman of childbearing potential unless other medications have failed to provide adequate symptom control or are otherwise unacceptable ( 5.2, 5.3, 5.4).
Hepatotoxicity evaluate high risk populations and monitor serum liver tests ( 5.1).
Migraine: The recommended starting dose is 500 mg/day for 1 week, thereafter increasing to 1,000 mg/day ( 2.3).
The maximum recommended dosage is 60 mg/kg/day ( 2.1, 2.2).
Absence Seizures: Start at 15 mg/kg/day, increasing at 1 week intervals by 5 to 10 mg/kg/day until seizure control or limiting side effects ( 2.2).
#VALMOD PACK 7 DAYS DO NOT HAVE RESOURCES FULL#
Complex Partial Seizures: Start at 10 to 15 mg/kg/day, increasing at 1 week intervals by 5 to 10 mg/kg/day to achieve optimal clinical response if response is not satisfactory, check valproate plasma level see full prescribing information for conversion to monotherapy ( 2.2).
Mania: Initial dose is 25 mg/kg/day, increasing as rapidly as possible to achieve therapeutic response or desired plasma level ( 2.1).
Depakote ER should be swallowed whole and should not be crushed or chewed ( 2.1, 2.2).
Depakote ER is intended for once-a-day oral administration.