DEPAKOTE ER

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Generic Name for DEPAKOTE ER Divalproex sodium 250mg, 500mg; ext-rel tabs. Legal Classification: Rx Manufacturer of DEPAKOTE ER Abbott Laboratories

Indications for DEPAKOTE ER

Absence seizures. Complex partial seizures.

Adults and Children:

Take once daily. Swallow whole. <10yrs: not recommended. ≥10yrs: Absence seizures: initially 15mg/kg per day. Complex partial: initially 10–15mg/kg per day. Both: may increase weekly if needed by 5–10mg/kg per day; usual max 60mg/kg per day. Converting from other forms: see literature.

Also:

Contraindications for DEPAKOTE ER

Hepatic disease. Significant hepatic dysfunction. Urea cycle disorders.

Warnings/Precautions for DEPAKOTE ER

Discontinue if hepatic dysfunction, pancreatitis, thrombocytopenia, or hyperammonemic encephalopathy occurs. History of liver disease. Increased hepatotoxicity risk with congenital metabolic disorders, multiple AEDs, severe seizure disorders with mental retardation, organic brain disorders, in children <2 years of age. Monitor liver function and symptoms (esp. 1^st 6 months). Follow-up if symptoms of hyperammonemia occur. Suicidal tendencies (monitor). Depakote ER is not bioequivalent to delayed-release tabs on mg/mg basis. Avoid abrupt cessation. Monitor platelets, bleeding time (at baseline, before surgery, and in pregnancy); reevaluate periodically. May affect HIV or CMV viral load (in vitro). Elderly (monitor fluid and nutritional intake, and for somnolence). Pregnancy (Cat.D): apprise females of childbearing potential of risks to fetus (eg, neural tube defects). Nursing mothers: not recommended.

Interactions for DEPAKOTE ER

Monitor levels of valproate, ethosuximide, other anticonvulsants, and whenever an enzyme inducer is added or withdrawn. Potentiates carbamazepine, diazepam, ethosuximide, lamotrigine, phenobarbital, phenytoin, tolbutamide, warfarin, zidovudine, amitriptyline, nortriptyline. Potentiated by aspirin, felbamate. Levels reduced by rifampin, phenytoin, carbamazepine, phenobarbital. CNS depression with alcohol, other CNS depressants. Clonazepam may induce absence status in patients with history of absence seizures. May interfere with urine ketone and thyroid tests. Others: see literature.

Adverse Reactions for DEPAKOTE ER

Dizziness, headache, GI upset; dermatologic, CNS (esp. tremor, somnolence), and endocrine effects; weakness, blood dyscrasias, bone marrow suppression, hepatotoxicity, acute pancreatitis, thrombocytopenia, hyperammonemia, metabolic abnormalities, others.

How is DEPAKOTE ER supplied?

Tabs 125mg—100
Tabs 250mg, 500mg—100, 500
Sprinkle caps—100
ER 250mg—60
ER 250mg, 500mg—100, 500

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