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Divalproex Sodium Dosage

Medically reviewed by Drugs.com. Last updated on Feb 23, 2024.

Applies to the following strengths: 250 mg; 125 mg; 500 mg

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Epilepsy

COMPLEX PARTIAL SEIZURES:
Initial Dose: 10 to 15 mg/kg/day orally (see below for frequency)

Maximum dose: 60 mg/kg/day

SIMPLE AND COMPLEX ABSENCE SEIZURES:
Initial Therapy: 15 mg/kg/day orally (see below for frequency)
Maximum Recommended Dose: 60 mg/kg/day

FREQUENCY:

CONVERSION to Monotherapy:

CONVERSION From Delayed-Release to Extended-Release: Patients should receive an extended-release dose that is 8% to 20% higher than the total daily dose of the delayed-release

Comments:

Uses: As monotherapy and adjunctive therapy in the treatment of patients with complex partial seizures; as monotherapy and adjunctive therapy for the treatment of simple and complex absence seizures; and adjunctively in patients with multiple seizure types that include absence seizures.

Usual Adult Dose for Mania

Delayed-release tablets:
Initial dose: 750 mg orally per day in divided doses

Maximum dose: 60 mg/kg/day

Extended-release tablets:
Initial dose: 25 mg/kg orally once a day
Maximum dose: 60 mg/kg/day

Comments:

Use: For the treatment of the manic episodes associated with bipolar disorder.

Usual Adult Dose for Migraine Prophylaxis

Delayed-release tablets:
Initial dose: 250 mg orally 2 times 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: 500 to 1000 mg orally once a day

Comments:

Use: For the prophylaxis of migraine headaches.

Usual Pediatric Dose for Epilepsy

10 years or older:
COMPLEX PARTIAL SEIZURES:
Initial Dose: 10 to 15 mg/kg/day orally (see below for frequency)

Maximum dose: 60 mg/kg/day

SIMPLE AND COMPLEX ABSENCE SEIZURES:
Initial Therapy: 15 mg/kg/day orally (see below for frequency)
Maximum Recommended Dose: 60 mg/kg/day

FREQUENCY:

CONVERSION to Monotherapy:

CONVERSION From Delayed-Release to Extended-Release: Patients should receive an extended-release dose that is 8% to 20% higher than the total daily dose of the delayed-release

Comments:

Uses: As monotherapy and adjunctive therapy in the treatment of patients with complex partial seizures; as monotherapy and adjunctive therapy for the treatment of simple and complex absence seizures; and adjunctively in patients with multiple seizure types that include absence seizures.

Renal Dose Adjustments

Use caution; no adjustment recommended, but higher than expected free fractions may be expected

Liver Dose Adjustments

Contraindicated in patients with hepatic disease or with significant hepatic dysfunction

Dose Adjustments

Elderly Patients:


Concomitant use of rufinamide:

Therapeutic drug monitoring:

Drug Withdrawal/Discontinuation:

Precautions

US BOXED WARNINGS: LIFE-THREATENING ADVERSE REACTIONS:
HEPATOTOXICITY:

FETAL RISK:
PANCREATITIS: Cases of life-threatening pancreatitis have been reported in children and adults receiving this drug; some cases were hemorrhagic with a rapid progression from initial symptoms to death. Cases have been reported shortly after initiating therapy as well as after several years of use. Patients and guardians should be warned that abdominal pain, nausea, vomiting, and/or anorexia can be symptoms of pancreatitis that require prompt medical evaluation. If pancreatitis is diagnosed, valproate should ordinarily be discontinued. Alternative treatment for the underlying medical condition should be initiated as clinically indicated.

CONTRAINDICATIONS:

Safety and efficacy have not been established in patients younger than 10 years for epilepsy or younger than 18 years for any other indication.

Consult WARNINGS section for additional precautions.

Dialysis

Hemodialysis reduces serum valproate concentrations by approximately 20%; however, no specific dose adjustment guidelines have been suggested

Other Comments

Administration advice:
Take orally; If a patient experiences gastrointestinal irritation, take with food; may start at lower dose and slowly increase dose when possible


Missed doses: If a dose is missed, take as soon as possible, unless it is almost time for the next dose. If a dose is skipped, do not double next dose

General:

Monitoring:

Patient advice:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.