Depakote (Divalproex)

Do's

• Take Depakote exactly as prescribed by your healthcare provider, as they may occasionally change your dose. Follow the directions on your prescription label and read all medication guides or instruction sheets. 
• Swallow the tablet whole and do not crush, chew, break, or open it.
• If you cannot swallow the capsule whole, open it and sprinkle the medicine into a spoonful of pudding or applesauce. 
• Swallow the mixture right away. 
• Take Depakote with plenty of water and maintain good hydration throughout the day. If stomach upset occurs, taking it with food or titrating the dosage more slowly may be advised by your healthcare provider.
• Use this medication regularly at the same time each day to keep the amount of medication in your blood constant.

Don'ts

• Do not crush, chew, break, or open Depakote tablets.
• Do not save the mixture of Depakote and pudding or applesauce for later use.
• Do not stop taking Depakote without consulting your healthcare provider, especially if it is used for seizures. Your condition may become worse if the drug is suddenly stopped.               

The dosage of Depakote is based on various factors including age, weight, medical condition, response to treatment, and other medications being taken.

Common Side Effects:

• Nausea, vomiting, stomach pain, diarrhea, constipation, dizziness, drowsiness, weakness, tremors, memory problems, and loss of appetite.
• Gastrointestinal (GI) side effects such as indigestion, loss of appetite, and abdominal pain.
• Digestive side effects including nausea, upset stomach, and vomiting.
• Other possible side effects may include
  • partial tablets in stool, which may occur in certain intestinal disorders, and should be reported to your healthcare provider.

Serious Side Effects:

• Low platelet count, hypothermia, high level of ammonia in the blood, depression, suicidal thoughts or behaviors, risk of liver damage, pancreatitis, fetal harm, severe allergic reactions, and bleeding problems.
• Other serious side effects that may require immediate medical attention include
  • chest pain,
  • easy bruising/unexplained bleeding,
  • fast/slow/irregular heartbeat,
  • swelling of hands/feet,
  • uncontrolled eye movement (nystagmus),
  • feeling cold/shivering,
  • rapid breathing, and loss of consciousness.

Not all individuals will experience these side effects, and the decision to use Depakote should be made in consultation with a healthcare provider. If you experience any concerning symptoms while taking Depakote, seek medical advice promptly.

Inform your healthcare provider if you are pregnant or plan to become pregnant. Divalproex sodium may harm an unborn baby, and if pregnancy occurs, discuss the risks and benefits of this medication with a healthcare provider.

Depakote should not be administered to patients with hepatic disease or significant hepatic dysfunction. It is also contraindicated in patients known to have mitochondrial disorders caused by mutations in mitochondrial DNA polymerase (POLG), children under two years of age suspected of having a POLG-related disorder, patients with known hypersensitivity to the drug, and patients with known urea cycle disorders.

There is an increased risk of liver damage associated with Depakote, which may be severe and, in rare cases, life-threatening. This risk is highest in people with mitochondrial disease and in children younger than 2 years old. Depakote is not approved for use in children younger than 10 years old. The drug also carries a boxed warning for the risk of liver damage. In addition, there is an increased risk of pancreatitis.

The information provided is not exhaustive. Consult a healthcare provider for comprehensive guidance on the warnings and precautions associated with Depakote.