Depakote Sprinkles

Generic Name: divalproex sodium (dye val PRO ex)
Brand Name: Depakote, Depakote ER, Depakote Sprinkles

What is Depakote Sprinkles (divalproex sodium)?

Divalproex sodium affects chemicals in the body that may be involved in causing seizures.

Divalproex sodium is used to treat various types of seizure disorders. Divalproex sodium is sometimes used together with other seizure medications.

Divalproex sodium is also used to treat manic episodes related to bipolar disorder (manic depression), and to prevent migraine headaches.

Divalproex sodium may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Depakote Sprinkles (divalproex sodium)?

If you take divalproex sodium for seizures or manic episodes: Do not start or stop taking the medicine during pregnancy without your doctor's advice. Divalproex sodium may cause harm to an unborn baby, but having a seizure during pregnancy could harm both the mother and the baby.

Do not use divalproex sodium to prevent migraine headaches if you are pregnant.

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Divalproex sodium can cause liver failure that may be fatal, especially in children under age 2. This risk may be greater in children taking more than one seizure medication, or those who have a metabolic disorder or brain disease causing mental impairment.

Call your doctor at once if the person taking this medicine has early signs of liver damage, such as: a general ill feeling, weakness, lack of energy, swelling in the face, loss of appetite, and vomiting.

Divalproex sodium can also cause serious harm to the pancreas, which may get worse quickly. Call your doctor at once if you have symptoms such as: nausea, vomiting, loss of appetite, and severe pain in your upper stomach spreading to your back.

What should I discuss with my healthcare provider before taking Depakote Sprinkles (divalproex sodium)?

Divalproex sodium can cause liver failure that may be fatal, especially in children under age 2. This risk may be greater in children taking more than one seizure medication, or those who have a metabolic disorder or brain disease causing mental impairment.

You should not use divalproex sodium if you are allergic to it, or if you have:

• liver disease; or

• a urea cycle disorder.

To make sure divalproex sodium is safe for you, tell your doctor if you have:

• a pancreas disorder;

• a bleeding or blood clotting disorder;

• a history of head injury, brain disorder, or coma;

• a family history of a urea cycle disorder or infant deaths with unknown cause; or

• HIV or CMV (cytomegalovirus) infection.

Some young people have thoughts about suicide when first taking divalproex sodium. Your doctor will need to check your progress at regular visits while you are using this medicine. Your family or other caregivers should also be alert to changes in your mood or symptoms.

If you take divalproex sodium for seizures or manic episodes: FDA pregnancy category D. Do not start or stop taking the medicine during pregnancy without your doctor's advice. Divalproex sodium can harm an unborn baby or cause birth defects, and may affect cognitive ability (reasoning, intelligence, problem-solving) later in the child's life. However, having a seizure during pregnancy could harm both the mother and the baby.

Seizure control is very important during pregnancy. The benefit of preventing seizures may outweigh any risks posed by taking divalproex sodium. There may be other seizure medications that can be more safely used during pregnancy. Follow your doctor's instructions about taking divalproex sodium while you are pregnant.

If you take divalproex sodium to prevent migraine headaches: FDA pregnancy category X. Do not use divalproex sodium to prevent migraine headaches if you are pregnant.

Use effective birth control while using divalproex sodium, and tell your doctor right away if you become pregnant.

Divalproex sodium can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I take Depakote Sprinkles (divalproex sodium)?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Drink plenty of water while you are taking this medication. Your dose may need to be changed if you do not get enough fluids each day.

You may open the divalproex sodium sprinkle capsule and sprinkle the medicine into a spoonful of pudding or applesauce to make swallowing easier. Swallow this mixture right away.

Do not crush, chew, break, or open a delayed-release or extended-release tablet or capsule. Swallow it whole.

While using divalproex sodium, you may need frequent blood tests.

Do not stop using divalproex sodium suddenly, even if you feel fine. Stopping suddenly may cause a serious, life-threatening type of seizure. If you need to stop taking divalproex sodium, follow your doctor's instructions about tapering your dose.

Wear a medical alert tag or carry an ID card stating that you take divalproex sodium. Any doctor, dentist, or emergency medical care provider who treats you should know that you are taking a seizure medication.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Depakote Sprinkles (divalproex sodium)?

Drinking alcohol can increase certain side effects of divalproex sodium.

Divalproex sodium may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Avoid exposure to sunlight or tanning beds. Divalproex sodium can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Depakote Sprinkles (divalproex sodium) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; fever, swollen glands, difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if the person taking this medicine has early signs of liver damage, such as: a general ill feeling, weakness, lack of energy, swelling in the face, loss of appetite, and vomiting. Later symptoms may include upper stomach pain, itching, dark urine, clay-colored stools, or yellowing of the skin or the whites of the eyes.

Call your doctor at once if you have symptoms of pancreatitis, which can get worse quickly: nausea, vomiting, loss of appetite, and severe pain in your upper stomach spreading to your back.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have any of these other side effects:

• worsening seizures;

• swelling in your hands or feet;

• bronchospasm (wheezing, chest tightness, trouble breathing);

• fever, chills, body aches, sore throat, flu symptoms;

• easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

• double vision, back-and-forth movements of the eyes, seeing flashes of light or "floaters" in your vision;

• extreme drowsiness, lack of coordination, confusion, hallucinations, tremors, jerking muscle movements; or

• severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

• indigestion, stomach pain, diarrhea, constipation;

• headache, dizziness, nervousness, problems with thinking or memory;

• mild drowsiness, feeling unsteady, feeling cold;

• back pain;

• thinning hair;

• runny nose;

• blurred vision, ringing in your ears; or

• increased appetite, weight changes, sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Depakote Sprinkles side effects (in more detail)

What other drugs will affect Depakote Sprinkles (divalproex sodium)?

Taking divalproex sodium with other drugs that make you sleepy or slow your breathing can worsen these effects. Ask your doctor before taking this medicine with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety or depression.

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with divalproex sodium, especially:

• aspirin;

• tolbutamide;

• topiramate;

• warfarin;

• zidovudine;

• an antibiotic--imipenem/cilastatin, meropenem, rifampin;

• an antidepressant--amitriptyline, nortriptyline;

• a sedative--clonazepam, diazepam, Valium; or

• other seizure medications--carbamazepine, ethosuximide, felbamate, lamotrigine, phenobarbital, phenytoin, primidone.

This list is not complete. Other drugs may interact with divalproex sodium, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

• Your pharmacist can provide more information about divalproex sodium.