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In this Article

• What is divalproex sodium (Depakote ER)?
• What are the possible side effects of divalproex sodium (Depakote ER)?
• What is the most important information I should know about divalproex sodium (Depakote ER)?
• What should I discuss with my healthcare provider before taking divalproex sodium (Depakote ER)?
• How should I take divalproex sodium (Depakote ER)?
• What happens if I miss a dose (Depakote ER)?
• What happens if I overdose (Depakote ER)?
• What should I avoid while taking divalproex sodium (Depakote ER)?
• What other drugs will affect divalproex sodium (Depakote ER)?
• Where can I get more information?

What should I discuss with my healthcare provider before taking divalproex sodium (Depakote ER)?

In rare cases, divalproex sodium has caused life-threatening liver failure, especially in children younger than 2 years old. Children of this age may be at even greater risk for liver problems if they use more than one seizure medication, if they have a metabolic disorder, or if they have a brain disease causing mental impairment (such as Creutzfeldt-Jacob disease, Huntington disease, multiple sclerosis, or a brain injury or infection).

Divalproex sodium has also caused rare cases of life-threatening pancreatitis (inflammation of the pancreas). Pancreatitis can come on suddenly and symptoms may start even after you have been taking divalproex sodium for several years.

Do not take divalproex sodium if you have liver disease or a urea cycle disorder.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take divalproex sodium.

• a bleeding or blood clotting disorder;
• a history of head injury, brain disorder, or coma;
• a family history of a urea cycle disorder;
• a family history of infant deaths with unknown cause; or
• HIV or CMV (cytomegalovirus) infection.

You may have thoughts about suicide while taking this medication. Tell your doctor if you have new or worsening depression or suicidal thoughts during the first several months of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

FDA pregnancy category D. This medication can cause harm to an unborn baby. Do not use divalproex sodium without your doctor's consent if you are pregnant. Tell your doctor if you become pregnant during treatment. Divalproex sodium can cause birth defects. Use an effective form of birth control while you are using this medication.

Divalproex sodium passes into breast milk and could harm a nursing infant. Do not take divalproex sodium without telling your doctor if you are breast-feeding a baby.

How should I take divalproex sodium (Depakote ER)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the instructions on your prescription label.

Drink plenty of water while you are taking this medication. Your dose may need to be changed if you do not get enough fluids each day.

To be sure this medication is not causing harmful effects, your liver function will need to be tested. It is important that you not miss any scheduled visits to your doctor.

Do not stop taking the medication even if you feel better. It is important to take divalproex sodium regularly to prevent seizures from recurring. Get your prescription refilled before you run out of medicine completely. Call your doctor promptly if this medicine does not seem to be working as well in preventing your seizures.

Do not crush, chew, break, or open a delayed-release or extended-release tablet or capsule. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time.

You may open the divalproex sodium sprinkle capsule and sprinkle the medicine into a spoonful of pudding or applesauce to make swallowing easier. Swallow this mixture right away without chewing. Do not save the mixture for later use. Discard the empty capsule.

Carry an ID card or wear a medical alert bracelet stating that you are taking divalproex sodium, in case of emergency. Any doctor, dentist, or emergency medical care provider who treats you should know that you are taking divalproex sodium.

Store divalproex sodium at room temperature away from moisture and heat.