Valproic acid | Side Effects, Dosage, Uses & More
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Generic Name:

valproic-acid, Oral capsule

All Brands

  • Depakene
SECTION 1 of 5

Highlights for valproic-acid

Oral capsule
1

Valproic acid is an oral drug that’s used to treat seizures.

2

This drug may cause serious and life-threatening liver problems. Children younger than 2 years are at the greatest risk.

3

Don’t stop taking valproic acid suddenly if you have epilepsy. Doing so may cause you to have seizures that don’t stop (status epilepticus).

4

Valproic acid can increase your risk of suicidal thoughts and behaviors. Tell your doctor right away if you have any new or worsening symptoms of depression, suicidal thoughts, or changes in your mood or behavior.

5

This drug may cause drowsiness and dizziness. It may also slow your thinking and motor skills. You shouldn’t drive, use machinery, or do similar tasks that require alertness until you know how valproic acid affects you.

IMPORTANT INFORMATION

FDA warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.

Liver problems warning. This drug may cause serious and life-threatening liver problems. This happens most often during the first 6 months of use. Children younger than 2 years have the greatest risk of liver problems. Children may have a higher risk if they:  

  • take more than one seizure medication
  • have a metabolic disorder, such as ornithine transcarbamylase deficiency or citrullinemia
  • have a severe seizure disorder with mental retardation
  • have organic brain disorders

You may have an increased risk of liver failure if you have a genetic liver problem caused by a mitochondrial disorder, such as Alpers disease. Your doctor may give you a genetic test to check for this liver problem before you start taking this drug. You shouldn’t take this drug if you have a mitochondrial disorder without talking to your doctor.

Call your doctor right away if you have signs of liver problems. Symptoms include:

  • tiredness
  • weakness
  • loss of appetite
  • upset stomach
  • vomiting
  • swelling of your face

Birth defects warning. This drug can cause birth defects if you take it during pregnancy. It can also cause your child to have a lower IQ. Use effective birth control while you’re taking this drug. Tell your doctor right away if you become pregnant.

Inflammation of the pancreas warning. This drug can cause serious inflammation of your pancreas (pancreatitis). This can happen right after you start taking the drug or years after you start taking it. Call you doctor right away if you have symptoms of this condition. Symptoms include:

  • stomach pain
  • upset stomach
  • vomiting
  • loss of appetite

Suicidal thoughts

This drug can increase your risk of suicidal thoughts and behaviors. Tell your doctor right away if you have any new or worsening symptoms of depression, suicidal thoughts, or changes in your mood or behavior.

Low platelet counts

This drug can cause low blood platelet counts. This risk increases as your dose increases. Tell your doctor if you have these symptoms:

  • red or purple spots on your skin
  • pain and swelling into your joints
  • bleeding from your nose or mouth
  • unexplained bruising

Low body temperature

Taking this drug can cause you to have low body temperature. This risk increases if you’re also taking the drug topiramate. Low body temperature may be a sign of low levels of ammonia in your blood. You may need to stop taking this drug if you have the following symptoms:

  • body temperature below 95°F (35ºC)
  • tiredness
  • confusion
  • coma

Drug features

This drug is a prescription drug. It’s available as an oral capsule and oral syrup. It’s also available as a generic drug. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand-name version. Talk to your doctor to see if the generic will work for you.

This drug may be used as part of a combination therapy. That means you need to take it with other medications.

Why it's used

This drug can be used alone or with other medications to treat complex partial seizures in adults and children 10 years of age and older. It can also be used to treat simple and complex absence seizures, with or without other seizure types.

How it works

This drug belongs to a class of drugs called antiepileptic medications. A class of drugs refers to medications that work similarly. They’re often used to treat similar conditions.

More Details

How it works

This drug belongs to a class of drugs called antiepileptic medications. A class of drugs refers to medications that work similarly. They’re often used to treat similar conditions.

It isn’t known exactly how this drug works to control seizures. It may be due to increased concentration of a chemical called gamma-aminobutyric acid in the brain. This chemical reduces the activity of neurons in the brain, which makes it harder for you to have a seizure.

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SECTION 2 of 5

valproic-acid Side Effects

Oral capsule

More common side effects

The more common side effects of valproic acid can include:

  • nausea

  • headaches

  • sleepiness

  • vomiting

  • weakness

  • tremor

  • dizziness

  • stomach pain

  • blurry or double vision

  • diarrhea

  • increased appetite

  • weight gain

  • hair loss

  • loss of appetite

  • problems with walking or coordination

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Liver damage. Symptoms can include:

    • nausea and vomiting that doesn’t go away
    • loss of appetite
    • pain on right side of your stomach
    • dark-colored urine color
    • swelling of your face
    • yellowing of your skin or the whites of your eyes
  • Swelling of your pancreas (pancreatitis). Symptoms can include:

    • severe stomach pain that may go through to your back
    • nausea or vomiting
  • Suicidal thoughts. Symptoms can include:

    • thoughts of suicide or dying
    • attempts to commit suicide
    • new or worse depression
    • new or worse anxiety
    • feeling agitated or restless
    • panic attacks
    • trouble sleeping
    • new or worse irritability
    • acting aggressive or violent or being angry
    • extreme increase in activity and talking
    • unusual changes in behavior or mood
  • Bleeding problems. Symptoms can include:

    • red or purple spots on your skin
    • bruising more easily than normal
    • blood in urine
    • nosebleeds
  • High ammonia levels in your blood. Symptoms can include:

    • fatigue
    • vomiting
    • confusion
  • Low body temperature (hypothermia). Symptoms can include:

    • drop in your body temperature to less than 95°F (35ºC)
    • tiredness
    • confusion
    • coma
    • slow, shallow breathing
    • weak pulse
    • slurred speech
  • Multiorgan hypersensitivity reactions. Symptoms can include:

    • fever
    • rash
    • swollen lymph nodes
    • muscle and joint pain
    • skin rash
    • severe tiredness or weakness
    • frequent infections or an infection that doesn’t go away
    • loss of appetite
    • nausea or vomiting
    • decrease in urine output
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug may cause drowsiness and dizziness. It can also slow your thinking and motor skills. You shouldn’t drive, use machinery, or do similar tasks that require alertness until you know how this drug affects you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

valproic-acid May Interact with Other Medications

Oral capsule

Valproic acid can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Alcohol interaction

You shouldn’t drink alcohol while taking valproic acid. Alcohol can make your sleepiness or dizziness worse.

Medications that might interact with this drug

Anxiety drugs

Taking valproic acid and diazepam can increase levels of diazepam in your body. This can cause more side effects.

Other seizure drugs

If you have a history of absence seizures and take clonazepam to treat them, taking valproic acid can increase your risk of absence status epilepticus. This is when you have a continuous absence seizure for at least 30 minutes.

Drugs to treat blood clots

Taking valproic acid and warfarin can increase levels of warfarin in your body. This can cause more side effects.

Carbamazepine

Taking carbamazepine with valproic acid can decrease levels of carbamazepine in your body. This means that it may not work as well as it should.

Depression drugs

These drugs can increase the amount of valproic acid in your body. This may cause more side effects. Your doctor may adjust the dose of these medications or monitor you more closely for side effects. Examples of these drugs include:

  • amitriptyline
  • nortriptyline 

These drugs can increase the amount of valproic acid in your body. This may cause more side effects. Your doctor may adjust the dose of these medications or monitor you more closely for side effects.

Diabetes drugs

Taking valproic acid and tolbutamide can increase levels of tolbutamide in your body. This can cause more side effects.

Felbamate

Felbamate can increase the amount of valproic acid in your body. This may cause more side effects.

Human immunodeficiency virus (HIV) drugs

Taking valproic acid and zidovudine can increase levels of zidovudine in your body. This can cause more side effects.

Drugs to treat infections

These drugs can lower the levels of valproic acid in your body. This means that it won’t work as well to treat your seizures. Examples of these drugs include:

  • ertapenem
  • imipenem
  • meropenem

Pain drugs

Taking valproic acid and aspirin can increase levels of aspirin in your body. This can cause more side effects.

Seizures drugs

Taking these drugs with valproic acid can increase levels of these seizure drugs in your body. This can cause more side effects. Examples of these drugs include:

  • ethosuximide
  • lamotrigine
  • phenobarbital
  • primidone
  • phenytoin

Topiramate

Taking topiramate with valproic acid can increase your blood levels of ammonium and cause low body temperature.

Tuberculosis drugs

Taking rifampin with valproic acid can lower the levels of valproic acid in your body. This means that it won’t work as well to treat your seizures.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
urea cycle disorder
People with urea cycle disorder

You shouldn’t take this drug if you have urea cycle disorder. This drug can cause higher levels of ammonia in your brain leading to neurological problems (hyperammonemic encephalopathy).  Tell your doctor if you have a family history of urea cycle disorder.

liver
People with liver disease

If you have a history of liver disease, you may have a higher risk of liver failure within the first 6 months of treatment with this drug. Your doctor will watch you closely for signs of liver damage. Also, people with liver disease may not be able to clear this drug from their bodies as well as they should. This increases your risk of toxicity and side effects. Your doctor may give you a lower dose of this drug.

depression
People with depression

This drug can increase suicidal thoughts and behaviors. Tell your doctor right away if you have any new or worsening symptoms of depression, suicidal thoughts, and changes in mood or behavior.

mitochondrial disease
People with mitochondrial disease

If you or anyone in your family has a history of a mitochondrial disorder, such as Alpers disease, you may have a higher risk of liver failure when taking this drug.

pregnant women
Pregnant women

This drug is a category D pregnancy drug. That means two things:

  1. Research in humans has shown adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases where it's needed to treat a dangerous condition in the mother.

This drug may harm your fetus. Taking this drug during pregnancy puts your baby at risk for serious birth defects that affect the brain, spinal cord, heart, head, arms, legs, and the opening where urine comes out (urethra). These defects can start before you know that you’re pregnant. Taking this drug during pregnancy may also cause your child to have a lower IQ. 

If you’re a woman of childbearing age and must take this drug, you should use effective forms of birth control.

Talk to your doctor if you’re pregnant or planning to become pregnant. Ask your doctor to tell you about the specific harm that may be done to the fetus. This drug should be only used if the potential risk to the fetus is acceptable given the drug’s potential benefit.

If you become pregnant while taking this drug, talk to your healthcare provider about registering with the North American Antiepileptic Drug Pregnancy Registry. The purpose of this registry is to collect information about the safety of drugs that treat seizures during pregnancy.

breastfeeding
Women who are breast-feeding

This drug may pass into breast milk and may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your child. You may need to decide whether to stop breast-feeding or stop taking this medication.

for seniors
For seniors

If you’re a senior with dementia, you’re at a greater risk for feeling sedated after taking this drug. Your risk may be higher if you’re not drinking enough fluids.

If you’re eating or drinking less than you normally do and feel extremely sleepy, your doctor may reduce your dose.

for children
For children

The safety and effectiveness of this drug hasn’t been established in people younger than 10 years who have complex partial seizures. This drug can be used in children of all ages with simple and complex absence seizures.

Children younger than 2 years have a higher risk of liver damage while taking this drug. Their risk may be higher if they take more than one drug to treat their seizures. If it’s necessary for your child to take this drug, the benefits of treatment should be weighed against the risks.   

allergies
Allergies

This drug can cause a severe allergic reaction. Symptoms can include:

  • fever
  • skin rash
  • hives
  • sores in your mouth
  • blistering and peeling of your skin
  • swelling of your lymph nodes
  • swelling of your face, eyes, lips, tongue, and throat
  • trouble swallowing or breathing

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take valproic-acid (Dosage)

Oral capsule

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

Blood levels of valproic acid should be between 50 micrograms/mL and 100 micrograms/mL.

What are you taking this medication for?

Complex partial seizures

Generic: valproic acid

Form: Oral capsule
Strengths: 250 mg
Form: Oral syrup
Strengths: 250 mg/5 mL

Brand: Depakene

Form: Oral capsule
Strengths: 250 mg
Form: Oral syrup
Strengths: 250 mg/5 mL
Adult dosage (ages 18–64 years)
  • Starting dose: 10–15  mg/kg taken by mouth once per day
  • Dose increases: Your dose may be increased by 5–10  mg/kg once each week until your seizures are controlled.
  • Maximum dose: 60 mg/kg per day. If this amount is more than 250 mg, it should be given in two divided doses.
Child dosage (ages 10–17 years)
  • Starting dose: 10–15 mg/kg taken by mouth once per day
  • Dose increases: Your dose may be increased by 5–10 mg/kg once each week until your seizures are controlled.
  • Maximum dose: 60 mg/kg per day. If this amount is more than 250 mg, it should be given in two divided doses.
Child dosage (ages 0–9 years)

The safety and effectiveness of this drug to treat complex partial seizures hasn’t been established in children younger than 10 years.

Senior dosage (ages 65 years and older)

Your body processes this drug more slowly. Your doctor may start you on a lowered dose so that too much of this drug doesn’t build up in your body. Too much of the drug in your body can be toxic. If you’re not eating well, or drinking enough fluids, or if you feel extremely sleepy, your doctor may reduce the dose of valproic acid.

Special considerations

Liver disease: If you have liver disease, you may not be able to clear this drug from your body as well as you should Your doctor may decrease your dose to prevent this drug from building up in your body and causing side effects.

Warnings

As your dose increases, you may have a greater risk for side effects, such as higher liver enzymes and low platelet count. Your doctor will watch you during dose increases.

Simple and complex absence seizures

Generic: valproic acid

Form: Oral capsule
Strengths: 250 mg
Form: Oral syrup
Strengths: 250 mg/5 mL

Brand: Depakene

Form: Oral capsule
Strengths: 250 mg
Form: Oral syrup
Strengths: 250 mg/5 mL
Adult dosage (ages 18–64 years)
  • Starting dose: 10–15  mg/kg taken by mouth once per day
  • Dose increases: Your dose may be increased by 5–10  mg/kg once each week until your seizures are controlled.
  • Maximum dose: 60 mg/kg per day. If this amount is more than 250 mg, it should be given in two divided doses.
Child dosage (ages 0–17 years)
  • Starting dose: 15 mg/kg taken by mouth once per day
  • Dose increases: Your dose may be increased by 5–10 mg/kg once each week until your seizures are controlled.
  • Maximum dose: 60 mg/kg per day. If this amount is more than 250 mg, it should be given in two divided doses.
Senior dosage (ages 65 years and older)

Your body processes this drug more slowly. Your doctor may start you on a lowered dose so that too much of this drug doesn’t build up in your body. Too much of the drug in your body can be toxic. If you’re not eating well, or drinking enough fluids, or if you feel extremely sleepy, your doctor may reduce the dose of valproic acid.

Special considerations

Liver disease: If you have liver disease, you may not be able to clear this drug from your body as well as you should Your doctor may decrease your dose to prevent this drug from building up in your body and causing side effects.

Warnings

As your dose increases, you may have a greater risk for side effects, such as higher liver enzymes and low platelet count. Your doctor will watch you during dose increases.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug comes with serious risks if you don’t take it as prescribed.

If you stop taking It suddenly

Don’t stop taking this drug suddenly if you have epilepsy. It can increase the risk of having seizures that don’t stop (status epilepticus).

If you skip or miss doses or if you don’t take it at all

Your seizures won’t be controlled and your condition may get worse.

If you take too much

If you take too much you may feel very sleepy. Taking too much could cause you to develop heart block, fall into a deep coma, or have high sodium levels. It may even be fatal. Go to the emergency room right away if you take too much.

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

If this drug is working, your seizures will be under control.

This drug is used for long-term treatment.

You can take this drug with or without food

If this drug upsets your stomach, taking it with food may help.

Store this drug carefully

  • Store the capsules at room temperature between 59ºF and 77°F (15ºC and 25°C).
  • Store the oral solution at room temperature below 86°F (30°C).
  • Keep this drug and all medicines out of the reach of children.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Before starting and/or during treatment with this drug, your doctor may check the following:

  • valproic acid levels: Your doctor may check the level of valproic acid in your blood during dose adjustments and if you have side effects. 
  • liver function. Your doctor will check your liver function before starting this drug, often during the first 6 months of treatment, and regularly after that. They will also monitor you for signs of liver damage.
  • blood ammonia levels
  • body temperature
  • signs of pancreatitis
  • signs of suicidal thoughts
  • blood cell counts and blood clotting tests

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

What does the pill look like?

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SECTION 5 of 5

How Much Does valproic-acid Cost?

Oral capsule

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on September 30, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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