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Depakote ER

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

Medically reviewed on May 29, 2018

What is Depakote ER?

Depakote ER affects chemicals in the body that may be involved in causing seizures.

Depakote ER is used to treat various types of seizure disorders. This medicine is sometimes used together with other seizure medications.

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

Depakote ER may also be used for purposes not listed in this medication guide.

Important Information

Depakote ER can cause liver failure that may be fatal, especially in children under age 2 and in people with liver problems caused by certain genetic disorders.

You should not use Depakote ER if you have liver disease, a urea cycle disorder, or a genetic disorder such as Alpers' disease or Alpers-Huttenlocher syndrome.

Follow your doctor's instructions about taking Depakote ER if you are pregnant. Depakote ER may harm an unborn baby, but having a seizure during pregnancy could harm both mother and baby. The benefit of preventing seizures may outweigh any risks to the baby.

Do not use Depakote ER to prevent migraine headaches if you are pregnant.

Call your doctor at once if the person taking this medicine has signs of liver or pancreas problems, such as: loss of appetite, upper stomach pain (that may spread to your back), ongoing nausea or vomiting, dark urine, swelling in the face, or jaundice (yellowing of the skin or eyes).

Do not stop using Depakote ER without your doctor's advice. Stopping suddenly may cause a serious, life-threatening type of seizure.

Before taking this medicine

You should not use Depakote ER if you are allergic to it, or if you have:

  • liver disease;

  • a urea cycle disorder; or

  • a genetic mitochondrial (MYE-toe-KON-dree-al) disorder such as Alpers' disease or Alpers-Huttenlocher syndrome, especially in a child younger than 2 years old.

Depakote ER can cause liver failure that may be fatal, especially in children under age 2 and in people with liver problems caused by a genetic mitochondrial disorder.

Tell your doctor if you have ever had:

  • liver problems caused by a genetic mitochondrial disorder;

  • depression, mental illness, or suicidal thoughts or actions;

  • 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 Depakote ER. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Do not use Depakote ER to prevent migraine headaches if you are pregnant.

If you take Depakote ER for seizures or manic episodes: This medicine can harm an unborn baby, 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. Do not start or stop taking the medicine during pregnancy without your doctor's advice.

Use effective birth control while using Depakote ER, and tell your doctor right away if you become pregnant. Tell your doctor if you start or stop using hormonal contraception that contains estrogen (birth control pills, injections, implants, skin patches, and vaginal rings). Estrogen can interact with this medicine and make it less effective in preventing seizures.

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

It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.

How should I take Depakote ER?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

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.

If you cannot swallow a sprinkle capsule whole, open it and sprinkle the medicine into a spoonful of pudding or applesauce. Swallow the mixture right away. Do not save it for later use.

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

You may need frequent blood tests.

In case of emergency, wear or carry medical identification to let others know you use Depakote ER.

If you need surgery, tell the surgeon ahead of time that you are using Depakote ER.

Do not stop using Depakote ER suddenly, even if you feel fine. Stopping suddenly may cause a serious, life-threatening type of seizure. Follow your doctor's instructions about tapering your dose.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

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 ER?

Drinking alcohol may increase certain side effects of divalproex sodium.

Avoid driving or hazardous activity until you know how Depakote ER will affect you. Your reactions could be impaired.

Depakote ER could make you sunburn more easily. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Depakote ER side effects

Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Call your doctor at once if the person taking this medicine has signs of liver or pancreas problems, such as: loss of appetite, upper stomach pain (that may spread to your back), ongoing nausea or vomiting, dark urine, swelling in the face, or jaundice (yellowing of the skin or eyes).

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:

  • confusion, tiredness, cold feeling, vomiting, change in your mental state;

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

  • severe drowsiness;

  • worsening seizures; or

  • signs of inflammation in your body--swollen glands, flu symptoms, severe tingling or numbness, muscle weakness, chest pain, new or worsening cough with fever, trouble breathing.

Common side effects may include:

  • nausea, vomiting, mild stomach pain, diarrhea;

  • headache, mild dizziness, weakness, tremors;

  • problems with balance or walking;

  • blurred vision, double vision; or

  • changes in appetite, weight gain.

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: Side effects (in more detail)

What other drugs will affect Depakote ER?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Many drugs can affect Depakote ER. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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

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