Divalproex Sodium Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Epilepsy

For both delayed-release and extended-release tablets:

Complex partial seizures:
Initial Therapy: 10 to 15 mg/kg/day.
Titration: Increase by 5 to 10 mg/kg/week to achieve optimal clinical response.
Maintenance: Usually below 60 mg/kg/day. No recommendation regarding safety at doses above 60 mg/kg/day can be made.

Simple and Complex Absence Seizures:
Initial Therapy: 15 mg/kg/day.
Titration: Increase at one week intervals by 5 to 10 mg/kg/day until seizures are controlled or side effects preclude further increases.
Maximum Recommended Dose: 60 mg/kg/day.

Note: Extended-release tablets are intended for once a day oral administration. When using delayed-release tablets, total daily doses in excess of 250 mg should be given in divided doses.

Usual Adult Dose for Mania

Delayed-release tablets:
Initial dose: 250 mg daily in divided doses.
Maintenance dose: The dose should be rapidly titrated to achieve the lowest therapeutic dose which produces the desired clinical effect.

Extended-release tablets:
Initial dose: 25 mg/kg once a day.
Titration: Increase as rapidly as possible to achieve the lowest therapeutic dose which produces the desired clinical effect or the desired range of plasma concentrations.
Maximum dose: 60 mg/kg/day

Usual Adult Dose for Migraine Prophylaxis

Delayed-release tablets:
Initial dose: 250 mg orally twice a day.
Maintenance dose: Some patients may benefit from doses up to 1000 mg per day.

Extended-release tablets:
Initial dose: 500 mg orally once a day for 1 week
Maintenance dose: May increase to 1000 mg once daily.

Usual Pediatric Dose for Epilepsy

>=10 years old:
For both delayed-release and extended-release tablets:

Complex partial seizures:
Initial Therapy: 10 to 15 mg/kg/day.
Titration: Increase by 5 to 10 mg/kg/week to achieve optimal clinical response.
Maintenance: Usually below 60 mg/kg/day. No recommendation regarding safety at doses above 60 mg/kg/day can be made.

Simple and Complex Absence Seizures:
Initial Therapy: 15 mg/kg/day.
Titration: Increase at one week intervals by 5 to 10 mg/kg/day until seizures are controlled or side effects preclude further increases.
Maximum Recommended Dose: 60 mg/kg/day.

Note: Extended-release tablets are intended for once a day oral administration. When using delayed-release tablets, total daily doses in excess of 250 mg should be given in divided doses.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Divalproex sodium should not be used in patients with hepatic disease or significant dysfunction.

Dose Adjustments

In geriatric patients, the initial dose should be reduced. Dosing should also be increased more slowly. The ultimate therapeutic dose should be achieved on the basis of clinical response.

Dialysis

Divalproex sodium is not removed by hemodialysis or peritoneal dialysis.

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