Drug Index

Valproic acid

 
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Synonym :

Sodium Valproate

Mechanism :

The mechanisms by which valproate exerts its therapeutic effects have not been established. It has been suggested that its activity in epilepsy is related to increased brain concentrations of gamma-aminobutyric acid (GABA).


Indication :

• Generalized tonic-clonic seizures

• Generalized absence seizures

• Generalized atonic seizures

• Generalized myoclonic seizures

• Photosensitive epilepsy

• Mania

• Choreoathetosis

• Infantile spasms


Contraindications :

Contraindicated in patients with known hypersensitivity to the drug, in patients with known urea cycle disorders, in active liver disease and family history of liver dysfunction, and in porphyria.


Dosing :

Oral: Start with 10-15 mg/kg/day in 2 divided doses and maintain at 30-60 mg/kg/day. Even doses of 30-40 mg/kg/day have been used in infantile spasms. Max dose: 60 mg/kg/day.

Status Epilepticus: Loading dose: 20 mg/kg IV, then 10 mg/kg/dose every 12 hours.


Adverse Effect :

Drowsiness, nausea, diarrhea, tremor, thrombocytopenia, weight gain, rarely weight loss, hair loss (usually transient within first 6 months). The risk of hepatotoxicity with sodium valproate appears to be greatest in children <3 years of age with severe epilepsy, other neurological problems and/or receiving at least one other antiepileptic.


Interaction :

Ethosuximide: Synergy in absence (typical and atypical) and myoclonic seizures
Lamotrigine: Synergistic in absence (typical and atypical), tonic-clonic and myoclonic seizures.
Phenytoin: May increase free phenytoin levels.
Antidepressants, Antipsychotics, Chloroquine and Mefloquine: Anti-convulsant effect may be antagonized.
Carbamazepine: Often lowers plasma concentration of sodium valproate.


07/18/2019 09:50:30 Valproic acid
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