Stavzor (Valproic Acid)
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Valproic Acid Information
(val proe' ik)Divalproex sodium, valproate sodium, and valproic acid, are all similar medications that are used by the body as valproic acid. Therefore, the term valproic acid will be used to represent all of these medications in this discussion. Valproic acid may cause serious or life-threatening damage to the liver that is most likely to occur within the first 6 months of therapy. The risk of developing liver damage is greater in children who are younger than 2 years of age and are also taking more than one medication to prevent seizures, have certain inherited diseases that may prevent the body from changing food to energy normally, or any condition that affects the ability to think, learn, and understand. Tell your doctor if you have a certain inherited condition that affects the brain, muscles, nerves, and liver (Alpers Huttenlocher Syndrome), urea cycle disorder (an inherited condition that affects the ability to metabolize protein), or liver disease. Your doctor will probably tell you not to take valproic acid. If you notice that your seizures are more severe or happen more often or if you experience any of the following symptoms, call your doctor immediately: excessive tiredness, lack of energy, weakness, pain on the right side of your stomach, loss of appetite, nausea, vomiting,, dark urine, yellowing of your skin or the whites of your eyes, or swelling of the face. Valproic acid can cause serious birth defects (physical problems that are present at birth), especially affecting the brain and spinal cord and can also cause lower intelligence and problems with movement and coordination, learning, communication, emotions, and behavior in babies exposed to valproic acid before birth. Tell your doctor if you are pregnant or plan to become pregnant. Women who are pregnant or who are able to become pregnant and are not using effective birth control must not take valproic acid to prevent migraine headaches. Women who are pregnant should only take valproic acid to treat seizures or bipolar disorder (manic-depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods) if other medications have not successfully controlled their symptoms or cannot be used. Talk to your doctor about the risks of using valproic acid during pregnancy. If you are a woman of childbearing age, including girls from the start of puberty, talk to your doctor about using other possible treatments instead of valproic acid. If the decision is made to use valproic acid, you must use effective birth control during your treatment. Talk to your doctor about birth control methods that will work for you. If you become pregnant while taking valproic acid, call your doctor immediately. Valproic acid can harm the fetus. Valproic acid may cause serious or life-threatening damage to the pancreas. This may occur at any time during your treatment. If you experience any of the following symptoms, call your doctor immediately: ongoing pain that begins in the stomach area but may spread to the back nausea, vomiting, or loss of appetite. Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to valproic acid. Talk to your doctor about the risks of taking valproic acid or of giving valproic acid to your child.
Before taking valproic acid,
- tell your doctor and pharmacist if you are allergic to valproic acid, any other medications, or any of the ingredients in the type of valproic acid that has been prescribed for you. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: acyclovir (Zovirax), anticoagulants ('blood thinners') such as warfarin (Coumadin), amitriptyline, aspirin, carbamazepine (Tegretol), cholestyramine (Prevalite), clonazepam (Klonopin), diazepam (Valium), doripenem (Doribax), ertapenem (Invanz), ethosuximide (Zarontin), felbamate (Felbatol), certain hormonal contraceptives (birth control pills, rings, patches, implants, injections, and intrauterine devices), imipenem and cilastatin (Primaxin), lamotrigine (Lamictal),medications for anxiety or mental illness, meropenem (Merrem), nortriptyline (Pamelor), phenobarbital, phenytoin (Dilantin), primidone (Mysoline), rifampin (Rifadin), rufinamide (Banzel), sedatives, sleeping pills, tolbutamide, topiramate (Topamax),tranquilizers,and zidovudine (Retrovir). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had episodes of confusion and loss of ability to think and understand, especially during pregnancy or childbirth; coma (loss of consciousness for a period of time); difficulty coordinating your movements; human immunodeficiency virus (HIV); or cytomegalovirus (CMV; a virus that can cause symptoms in people who have weak immune systems).
- tell your doctor if you are breastfeeding.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking valproic acid.
- you should know that valproic acid may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
- remember that alcohol can add to the drowsiness caused by this medication.
- you should know that valproic acid can cause extreme drowsiness that may cause you to eat or drink less than you normally would, especially if you are elderly. Tell your doctor if you are not able to eat or drink as you normally do.
- you should know that your mental health may change in unexpected ways and you may become suicidal (thinking about harming or killing yourself or planning or trying to do so) while you are taking valproic acid for the treatment of epilepsy, mental illness, or other conditions. A small number of adults and children 5 years of age and older (about 1 in 500 people) who took anticonvulsants such as valproic acid to treat various conditions during clinical studies became suicidal during their treatment. Some of these people developed suicidal thoughts and behavior as early as one week after they started taking the medication. There is a risk that you may experience changes in your mental health if you take an anticonvulsant medication such as valproic acid, but there may also be a risk that you will experience changes in your mental health if your condition is not treated. You and your doctor will decide whether the risks of taking an anticonvulsant medication are greater than the risks of not taking the medication. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: panic attacks; agitation or restlessness; new or worsening irritability, anxiety, or depression; acting on dangerous impulses; difficulty falling or staying asleep; aggressive, angry, or violent behavior; mania (frenzied, abnormally excited mood); talking or thinking about wanting to hurt yourself or end your life; withdrawing from friends and family; preoccupation with death and dying; giving away prized possessions; or any other unusual changes in behavior or mood. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own.
- changes in appetite
- weight changes
- back pain
- mood swings
- abnormal thinking
- uncontrollable shaking of a part of the body
- problems with walking or coordination
- uncontrollable movements of the eyes
- blurred or double vision
- ringing in the ears
- hair loss
- unusual bruising or bleeding
- tiny purple or red spots on the skin
- difficulty breathing or swallowing
- swollen glands
- swelling of face, eyes, lips, tongue, or throat
- peeling or blistering skin
- drop in body temperature
- weakness or swelling in the joints