oral contraceptive, intrauterine device, subdermal etonogestrel). For Child 1 month–11 years. Sodium valproate (Epilim) was first introduced as an anti-epileptic in 1964 1. --A specialist experienced in the management of epilepsy, should reassess valproate therapy and consider alternative treatment options. Sodium valproate is a prescription medicine. The following paragraphs provide guidance on the withdrawal of valproate-containing medicines, in women of childbearing potential pregnant. It's important to take it as advised by your doctor. Some people may take a higher dose of 2,500mg a day. It is currently indicated for treatment of primary generalised epilepsy, partial (focal) epilepsy, and bipolar disease. 14. Epilim is contraindicated in pregnancy due to the risk of congenital malformations and developmental effects. valproate: but if a pregnancy should nevertheless occur, the drug should be stopped and if continued pharmacological treatment is needed, an alternative medicine should be prescribed. At the time of publication 3 formulations of valproate were available in the UK: sodium valproate and valproic acid (licensed for the treatment of epilepsy) and semi‑sodium valproate (licensed for the treatment of acute mania and continuation treatment in people whose mania responds to … Valproate has an increased risk of major congenital malformations and poor cognitive outcomes compared to other antiepileptic drugs.
Sodium valproate should not be used in female children, in female adolescents, in women of child-bearing potential and pregnant women unless alternative treatments are ineffective or not tolerated because of its high teratogenic potential and risk of developmental disorders in infants exposed in utero to valproate. --Every effort should be made to switch to appropriate alternative treatment prior to conception, and before contraception is discontinued.

If pregnancy is planned, and the valproate dose is below the threshold, no further action is needed. In the Australian categorisation system valproate is in pregnancy category D, so women of childbearing age should use effective contraception (e.g.

If ultimately there is no alternative but to use higher valproate doses, the patient must be made aware of the potential fetal hazards and the degree of risk, based on data such as that contained in Figure 2. Divalproex sodium Breastfeeding Warnings This drug is the chemical combination of 2 valproic acid molecules resulting in valproic acid in the bloodstream. This drug has not been specifically studied during breastfeeding but is expected to act like valproic acid, therefore, the information provided refers to valproic acid.

The usual dose for treating: epilepsy in adults and older children (aged 12 years and over): 600mg to 2,000mg a day, taken as either 1 or 2 doses. This article will explore the benefits and harms of sodium valproate and its alternatives in current or planned pregnancy in the context of a tightening regulatory system for this drug. Initially 10–15 mg/kg daily in 1–2 divided doses (max. Sodium valproate is a highly effective medicine for the treatment of epilepsy. However, taking sodium valproate during pregnancy carries a high risk of harm to the developing baby (2 out of 5 babies are affected). per dose 600 mg); maintenance 25–30 mg/kg daily in 2 divided doses, doses up to 60 mg/kg daily in 2 divided doses may be used in infantile spasms; monitor clinical chemistry and haematological parameters if dose exceeds 40 mg/kg daily. Contraception is therefore essential to protect against pregnancy. By mouth using immediate-release medicines. Valproate . In pregnancy, valproate is contraindicated and an alternative treatment should be decided on, with appropriate specialist consultation, for women planning pregnancy; however, there may be a small number of women with epilepsy for whom there is no suitable alternative treatment to valproate and who should be appropriately supported and counselled.