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Serum liver tests should be performed prior to therapy and at frequent intervals thereafter, especially during the first six months. The list is not exhaustive, since new interactions are continuously being reported. Concomitant antiepilepsy drugs topiramate, phenobarbital, carbamazepine, phenytoin, and lamotrigine were evaluated that induce the cytochrome P isozyme system did not significantly alter valproate bioavailability when converting between Depakote and Depakote ER.
These are not all of the possible side effects of Depakote or Depakene. Valproate has been found to be a weak inhibitor of some P isozymes, epoxide hydrase, and glucuronosyltransferases.
Patients on multiple anticonvulsants, children, those with congenital metabolic disorders, those with severe seizure disorders accompanied by mental retardationand those with organic brain disease may be at particular risk. ArrhythmiaHypertensionHypotensionPostural Hypotension. The relationship between plasma concentration and clinical response is not well documented.
Sinusitiscough increased, pneumoniaepistaxis. Get helpful advice on your cases from a community of physicians. Understand Immunotherapy Painful Knees? The following list provides information about the potential for an influence of valproate coadministration on the pharmacokinetics or pharmacodynamics of several commonly prescribed medications. Hyperammonemia should also be considered in patients who present with hypothermia [see Hypothermia ].
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Mean plasma clearance and volume of distribution for total valproate are 0. Starting doses in the elderly lower than mg can only be achieved by the use of Depakote.
Number of times cited: Thus, patients on monotherapy will generally have longer half-lives and higher concentrations than patients receiving polytherapy with antiepilepsy drugs.
The following adverse reactions have been identified during post approval use of Depakote.
Seek emergency medical attention if the person taking this medicine has nausea, vomiting, upper stomach pain, or loss of appetite, low fever, dark urine, clay-colored stools, or jaundice yellowing of the skin or eyes. The concomitant use of valproate and clonazepam may induce absence status in patients with a history of absence type seizures.
Comparison of the bioavailability of and mg divalproex sodium extended-release tablets in healthy volunteers. Patients who experience G. The recommended starting dose is mg once daily for 1 week, thereafter increasing to mg once daily.
Based on a placebo-controlled trial of adjunctive therapy for treatment of complex partial seizures, Depakote was generally well tolerated with most adverse reactions rated as mild to moderate in severity. One contributing factor is the nonlinear, concentration dependent protein binding of valproate which affects the clearance of the drug. Mean valproate concentrations were In the remaining patients, platelet counts normalized with continued treatment.
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