Overdosage with valproate may result in somnolence, heart block, deep coma, and hypernatremia. Fatalities have been reported; however patients have recovered from valproate levels as high as 2,120 mcg/mL.
In overdose situations, the fraction of drug not bound to protein is high and hemodialysis or tandem hemodialysis plus hemoperfusion may result in significant removal of drug. The benefit of gastric lavage or emesis will vary with the time since ingestion. General supportive measures should be applied with particular attention to the maintenance of adequate urinary output.
Naloxone has been reported to reverse the CNS depressant effects of valproate overdosage. Because naloxone could theoretically also reverse the antiepileptic effects of valproate, it should be used with caution in patients with epilepsy.
- Depakote should not be administered to patients with hepatic disease or significant hepatic dysfunction [see WARNINGS AND PRECAUTIONS].
- Depakote is contraindicated in patients known to have mitochondrial disorders caused by mutations in mitochondrial DNA polymerase γ (POLG; e.g., Alpers-Huttenlocher Syndrome) and children under two years of age who are suspected of having a POLG-related disorder [see WARNINGS AND PRECAUTIONS].
- Depakote is contraindicated in patients with known hypersensitivity to the drug [see WARNINGS AND PRECAUTIONS].
- Depakote is contraindicated in patients with known urea cycle disorders [see WARNINGS AND PRECAUTIONS].
- Depakote is contraindicated for use in prophylaxis of migraine headaches in pregnant women [see WARNINGS AND PRECAUTIONS and Use in Specific Populations].
Last reviewed on RxList: 1/29/2016
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