Sodium Valproate + Valproic acid Pharmacology
Sodium Valproate + Valproic acid
Sodium Valproate
Valproic acid enhances the release and synthesis of inhibitory neurotransmitter GABA and inhibits its degradation. This will result in an increased concentration of GABA and is used as antiepileptic agent. Valproate is also used to treat the acute manic phase of bipolar disorder and for the prophylaxis of migraine.
2. Ataxia
3. Tremor
4. Headache
5. Dizziness
6. Nausea
7. Vomiting
8. Abdominal cramps
9. Diarrhoea
10. Anorexia
11. Pancreatitis
12. Elevated hepatic enzyme level
2. Sodium Valproate injection is contraindicated in hepatic dysfunction
2. Renal impairment
3. Acute Porphyria
4. Congenital heart defects
5. Slowly withdraw the drug with caution
6. Use with caution in patient receiving other anticonvulsants
7. Use caution when driving vehicle operating machine or performing other hazardous activities.
Below 2 years : contraindicated
NEONATES: contraindicated
2. Mania
3. Prophylaxis of migraine
Chlorpromazine, Cimetidine : Decreased clearance and increased half-life of sodium valporate.
Salicylates: Serum levels of sodium valproate elevated leading to toxicity.
Alcohol & other CNS depressants: CNS depressant effect potentiated.
Phenobarbital, Primidone: May result in increased phenobarbital level and an increase in CNS effects.
Carbamazepine, Clonazepam, Ethosuximide, Phenytoin: Variable changes in the effects of these agents and on sodium valproate.
Lab Tests: False interpretation of urine ketone test. Altered thyroid function tests may occur.
Anticonvulsant: 300 mg 2 times daily. Dose can be increased by 200 mg very 3 days until sufficient response is obtained. Maintenance dose: 1 - 2g / day
Maximum dose: 2.5 mg / day
Mania: 750 mg / day in divided doses
Prophylaxis of migraine: 500mg / day in 2 divided doses if needed dose can be increased up to 1 g.
Children :
Children up to 20 kg: 20 mg / kg body weight/ day in divided doses if needed dose can be increased up to 40mg/kg body weight/day.
Children over 20 kg: 200mg 2 times daily if needed dose can be gradually increased until control are achieved.
Maximum dose: 40 mg / kg body weight/ day
Valproic Acid
Valproic acid enhances the release and synthesis of inhibitory neurotransmitter GABA and inhibits its degradation. This will result in an increased concentration of GABA and is used as antiepileptic agent. Valproate is also used to treat the acute manic phase of bipolar disorder and for the prophylaxis of migraine.
Distribution: It is very widely distributed in the body in protein bound form.
Metabolism: It is extensively metabolised in the liver.
Excretion: It is excreted mainly in urine and small amount in faeces, exhaled air and breast milk.
2. Ataxia
3. Tremor
4. Headache
5. Dizziness
6. Nausea
7. Vomiting
8. Abdominal cramps
9. Diarrhoea
10. Anorexia
11. Pancreatitis
12. Elevated hepatic enzyme level
2. Valproic acid injection is contraindicated in hepatic dysfunction
2. Renal impairment
3. Acute Porphyria
4. Congenital heart defects
5. Slowly withdraw the drug with caution
6. Use with caution in patient receiving other anticonvulsants
7. Use caution when driving vehicle operating machine or performing other hazardous activities.
Below 2 years : contraindicated
NEONATES: contraindicated
2. Mania
3. Prophylaxis of migraine
Chlorpromazine, Cimetidine : Decreased clearance and increased half-life of sodium valporate.
Salicylates: Serum levels of sodium valproate elevated leading to toxicity.
Alcohol & other CNS depressants: CNS depressant effect potentiated.
Phenobarbital, Primidone: May result in increased phenobarbital level and an increase in CNS effects.
Carbamazepine, Clonazepam, Ethosuximide, Phenytoin: Variable changes in the effects of these agents and on sodium valproate.
Lab Tests: False interpretation of urine ketone test. Altered thyroid function tests may occur.
Anticonvulsant: 300 mg 2 times daily. Dose can be increased by 200 mg very 3 days until sufficient response is obtained. Maintenance dose: 1 - 2g / day
Maximum dose: 2.5 mg / day
Mania: 750 mg / day in divided doses
Prophylaxis of migraine: 500mg / day in 2 divided doses if needed dose can be increased up to 1 g.
Children :
Children up to 20 kg: 20 mg / kg body weight/ day in divided doses if needed dose can be increased up to 40mg/kg body weight/day.
Children over 20 kg: 200mg 2 times daily if needed dose can be gradually increased until control are achieved.
Maximum dose: 40 mg / kg body weight/ day
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