Depakote Sprinkles (divalproex sodium) Disease Interactions

There are 4 disease interactions with Depakote Sprinkles (divalproex sodium):

Valproate (Includes Depakote Sprinkles) ↔ Liver Disease

Severe Potential Hazard, High plausibility

Applies to: Liver Disease, Mental Retardation, Metabolic Disorder - Congenital, Brain Anomalies - Congenital

The use of valproate derivatives is contraindicated in patients with hepatic disease or significant hepatic dysfunction. Serious and potentially fatal hepatotoxicity has been reported in patients treated with these agents. The risk appears to be greatest in children less than 2 years of age--particularly those on multiple anticonvulsants and those with congenital metabolic disorders, severe seizure disorders accompanied by mental retardation, or organic brain disease--and decreases considerably in progressively older patient groups. Therapy with valproate products should be administered with extreme caution and as a sole agent in patients with risk factors for valproate-related hepatotoxicity. In reported cases, the onset has generally been within the first 6 months of treatment and may be preceded by nonspecific symptoms such as malaise, weakness, lethargy, facial edema, anorexia, nausea, vomiting, and a loss of seizure control. Patients should be monitored closely for appearance of these symptoms, and therapy withdrawn immediately if significant hepatic dysfunction occurs. Liver function tests should be performed prior to initiating therapy and at frequent intervals thereafter, especially during the first 6 months. However, clinicians should bear in mind that transient, dose-related, asymptomatic elevations in serum transaminase, amylase and ammonia levels may commonly occur and often return to normal with or without dosage adjustment.

Valproate (Includes Depakote Sprinkles) ↔ Thrombocytopenia

Moderate Potential Hazard, Moderate plausibility

Applies to: Thrombocytopenia, Coagulation Defect, Thrombocytopathy, Vitamin K Deficiency, Bleeding

The use of valproate derivatives may be associated with dose-related thrombocytopenia, the incidence of which is generally low but has been reported at up to 27% in one study using high dosages (approximately 50 mg/kg/day of valproic acid). In that study, platelet counts returned to normal in all patients, some despite continued treatment. Valproate may also inhibit the secondary phase of platelet aggregation, although this effect is unlikely to be of clinical significance except during the concomitant use of other drugs that affect coagulation. However, altered bleeding time, ecchymosis, petechiae, bruising, hematoma formation, epistaxis, and frank hemorrhage have been reported rarely. Hypofibrinogenemia has also been observed. Therapy with valproate products, particularly at high dosages, should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment. The manufacturers recommend platelet counts and coagulation tests prior to initiating therapy and at periodic intervals thereafter, as well as before planned surgery. The dosage should be reduced or the drug withdrawn if clinical evidence of hemorrhage, bruising, or a disorder of hemostasis or coagulation occurs.

Valproate (Includes Depakote Sprinkles) ↔ Thyroid Function Tests

Moderate Potential Hazard, Low plausibility

Applies to: Thyroid Disease

The manufacturers state that there have been reports of altered thyroid function tests associated with the use of valproate. However, no specific information is given. Clinicians should be cognizant of this potential effect when prescribing or administering valproate products to patients with thyroid disease.

Valproate (Includes Depakote Sprinkles) ↔ Urine Ketone Test

Moderate Potential Hazard, High plausibility

Applies to: Diabetes Mellitus

Valproate is partially eliminated in the urine as a ketone-containing metabolite, which may lead to a false interpretation of the urine ketone test. Clinicians should be cognizant of this interaction when prescribing or administering valproate products to patients with diabetes.

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Depakote Sprinkles (divalproex sodium) drug Interactions

There are 636 drug interactions with Depakote Sprinkles (divalproex sodium)

Depakote Sprinkles (divalproex sodium) alcohol/food Interactions

There is 1 alcohol/food interaction with Depakote Sprinkles (divalproex sodium)

See also...

• Depakote Sprinkles (divalproex sodium) Side Effects
• Depakote Sprinkles (divalproex sodium) Consumer Information

• Drug Interactions Checker

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