What is the most important information I should know about valproic acid?

• In rare cases, valproic acid has caused liver failure, sometimes resulting in death. Children younger than 2 years of age, especially those taking multiple seizure medicines, those with metabolic diseases, those with mental retardation, and those with organic brain disease are at the highest risk of liver failure. Notify your doctor immediately if you develop loss of seizure control, weakness, fatigue, swelling of the face, vomiting, or loss of appetite. These symptoms may be early signs of liver damage.
  
  
• In rare cases, valproic acid has also caused severe, even fatal, cases of pancreatitis (inflammation of the pancreas). Some of the cases have progressed rapidly from initial symptoms to death. Cases have been reported soon after starting treatment with valproic acid, as well as after several years of use. Notify your doctor immediately if you develop nausea, vomiting, abdominal pain, or loss of appetite. These symptoms may be early signs of pancreatitis.
  
  
• Do not stop taking the medication even if you feel better. It is important to continue taking valproic acid to prevent the seizures from recurring.
  
  
• Do not crush, chew, or break the capsules because they may hurt the mouth or throat. Swallow them whole.
  
  
• Carry or wear a medical identification tag to let others know that you are taking this medicine in the case of an emergency.
  
  
• Valproic acid may interact with other drugs that cause drowsiness, including alcohol, antidepressants, antihistamines, pain relievers, anxiety medicines, and muscle relaxants. Dangerous sedation, dizziness, or drowsiness may occur if valproic acid is taken with alcohol or any of these medications. Talk to your doctor before taking valproic acid in combination with alcohol or any other medicines.

What is valproic acid?

• Valproic acid affects chemicals in the body that may be involved in causing seizures. The exact way that it works is unknown.
  
  
• Valproic acid is used to treat various types of seizure disorders.
  
  
• Valproic acid may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking valproic acid?

• Do not take valproic acid if you have liver disease.
  
  
• Valproic acid is known to be harmful to an unborn baby. Malformations of the face and head, heart, and nervous system have been reported. Do not take valproic acid without first talking to your doctor if you are pregnant or could become pregnant.
  
  
• Valproic acid passes into breast milk and may affect a nursing infant. Do not take valproic acid without first talking to your doctor if you are breast-feeding a baby.
  
  
• Extreme caution must be used if valproic acid is used to treat seizures in a child younger than 2 years of age due to the increased risk of liver damage.

How should I take valproic acid?

• Take valproic acid exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
  
  
• Take each dose with a full glass of water.
  
  
• Take valproic acid with food if it causes stomach upset.
  
  
• Do not crush, chew, or break the capsules because they may hurt the mouth or throat. Swallow them whole
  
  
• Measure the liquid form of valproic acid with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.
  
  
• Your doctor may want you to have blood tests during treatment. It is important for your doctor to know how much medication is in the blood and how well your liver is working.
  
  
• Carry or wear a medical identification tag to let others know that you are taking this medicine in the case of an emergency.
  
  
• Do not stop taking the medication even if you feel better. It is important to continue taking valproic acid to prevent the seizures from recurring.
  
  
• Store valproic acid at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

• Seek emergency medical attention.
  
  
• Symptoms of a valproic acid overdose include unconsciousness, sleepiness or drowsiness, faint or no heartbeat, decreased breathing, or stopped breathing.

What should I avoid while taking valproic acid?

• Valproic acid may interact with other drugs that cause drowsiness, including alcohol, antidepressants, antihistamines, pain relievers, anxiety medicines, and muscle relaxants. Dangerous sedation, dizziness, or drowsiness may occur if valproic acid is taken with alcohol or any of these medications. Talk to your doctor before taking valproic acid in combination with alcohol or any other medicines.
  
  
• Use caution when driving, operating machinery, or performing other hazardous activities. Valproic acid may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

What are the possible side effects of valproic acid?

• In rare cases, valproic acid has caused liver failure, sometimes resulting in death. Children younger than 2 years of age, especially those taking multiple seizure medicines, those with metabolic diseases, those with mental retardation, and those with organic brain disease are at the highest risk of liver failure. Notify your doctor immediately if you develop loss of seizure control, weakness, fatigue, swelling of the face, vomiting, or loss of appetite. These symptoms may be early signs of liver damage.
  
  
• In rare cases, valproic acid has also caused severe, even fatal, cases of pancreatitis (inflammation of the pancreas). Some of the cases have progressed rapidly from initial symptoms to death. Cases have been reported soon after starting treatment with valproic acid, as well as after several years of use. Notify your doctor immediately if you develop nausea, vomiting, abdominal pain, or loss of appetite. These symptoms may be early signs of pancreatitis.
  
  
• If you experience any of the following serious side effects, stop taking valproic acid and seek emergency medical attention or contact your doctor immediately:
  
  
  
  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
    
    
  • a rash;
    
    
  • hallucinations;
    
    
  • loss of coordination or difficulty walking;
    
    
  • unusual bleeding or bruising; or
    
    
  • double vision or back-and-forth movements of the eyes.
  
  
• Other, less serious side effects may be more likely to occur. Continue to take valproic acid and notify your doctor if you experience
  
  
  • tremor (shaking);
    
    
  • weight gain;
    
    
  • menstrual changes;
    
    
  • hair loss;
    
    
  • drowsiness or weakness;
    
    
  • depression or other psychiatric changes;
    
    
  • headache; or
    
    
  • low red blood cells (anemia).
  
  
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect valproic acid?

• Other drugs used to treat seizures such as phenytoin (Dilantin), carbamazepine (Tegretol), phenobarbital (Luminal, Solfoton), felbamate (Felbatol), lamotrigine (Lamictal), clonazepam (Klonopin), and others may increase or decrease the effects of valproic acid and may themselves have increased or decreased effectiveness. Tell your doctor about all other medications that you are taking.
  
  
• Before taking valproic acid, tell your doctor if you are taking warfarin (Coumadin) or aspirin. Valproic acid may interact with these medications and affect clotting of the blood. You may require a dosage adjustment or special monitoring during treatment if you are taking either of these drugs.
  
  
• Valproic acid may interact with other drugs that cause drowsiness, including alcohol, antidepressants, antihistamines, pain relievers, anxiety medicines, and muscle relaxants. Dangerous sedation, dizziness, or drowsiness may occur if valproic acid is taken with alcohol or any of these medications. Talk to your doctor before taking valproic acid in combination with alcohol or any other medicines.
  
  
• Drugs other than those listed here may also interact with valproic acid. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

Disclaimer

The materials contained on the Epilepsy Newfoundland and Labrador website are to provide general information about epilepsy to the public. The information presented is not intended as medical or legal advice. Epilepsy Newfoundland and Labrador, its employees, board members, medical advisors, volunteers, agents and sponsors do not assume responsibility for inaccuracies or omissions or for the consequences from the use of the information obtained over this site or any links accessed through this site. Epilepsy Newfoundland and Labrador is not liable for any outcome or damages resulting from information in either a direct or indirect form. We recognize that each individual's experience of epilepsy is different. Consult your physician and/or neurologist with any questions you have.