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SODIUM VALPROATE SYRUP
Active substance(s): SODIUM VALPROATE
Is this leaflet hard to see or read? Phone 0845 372 7101 for help.
▼This medicine is subject to additional monitoring. This will allow quick identification of
new safety information. You can help by reporting any side effects you may get. See the end
of section 4 for how to report side effects.
Valproate can cause birth defects and problems with early development of the child if it is taken
during pregnancy. If you are a female of childbearing age you should use an effective method of
contraception throughout your treatment.
Your doctor will discuss this with you but you should also follow the advice in section 2 of this
leaflet. Tell your doctor at once if you become pregnant or think you might be pregnant.
Read all of this leaflet carefully before you start taking this medicine because it contains important
information for you.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, please ask your doctor or pharmacist.
• This medicine has been prescribed for you. Do not pass it on to others. It may harm them even
if their symptoms are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side
effects not listed in this leaflet. See section 4.
What is in this leaflet
1. What Epilim Syrup is and what it is used for
2. What you need to know before you take Epilim Syrup
3. How to take Epilim Syrup
4. Possible side effects
5. How to store Epilim Syrup
6. Contents of the pack and other information
What Epilim Syrup is and what it is used for
What Epilim Syrup is
The name of your medicine is Epilim Syrup.
What Epilim Syrup contains
Epilim Syrup contains a medicine called sodium valproate. This belongs to a group of medicines
called anti-convulsants or anti-epileptic agents. It works by helping to calm the brain down.
What Epilim Syrup is used for
Epilim Syrup is used to treat epilepsy (fits) in adults and children.
What you need to know before you take Epilim Syrup
Do not take Epilim Syrup and tell your doctor if:
X You are allergic (hypersensitive) to sodium valproate or any of the other ingredients of Epilim
Syrup (see Section 6: Contents of the pack and other information).
Signs of an allergic reaction include: a rash, swallowing or breathing problems, swelling of your
lips, face, throat or tongue.
X You have liver problems or you or your family have a history of liver problems.
X You have a known metabolic disorder, i.e a urea cycle disorder.
X You have a rare illness called porphyria.
X If you have a genetic problem caused by a mitochondrial disorder (e.g. Alpers-Huttenlocher
Do not take this medicine if any of the above apply to you. If you are not sure, talk to your doctor or
pharmacist before taking Epilim Syrup.
Warnings and precautions
A small number of people being treated with anti-epileptics such as sodium valproate have had
thoughts of harming or killing themselves. If at any time you have these thoughts, immediately
contact your doctor.
As with other anti-epileptic drugs, convulsions may become worse or happen more frequently whilst
taking this medicine. If this happens contact your doctor immediately.
Talk to your doctor or pharmacist before taking Epilim Syrup:
• You have diabetes. This medicine may aff ect the results of urine tests.
• You have a carnitine palmitoyltransferase type II deficiency.
• You have kidney problems. Your doctor may give you a lower dose.
• You have fits (epilepsy), brain disease or a metabolic condition aff ecting your brain.
• You have a ‘urea cycle disorder’ where too much ammonia builds up in the body.
• You have an illness called ‘systemic lupus erythematosus (SLE)’ – a disease of the immune
system which aff ects skin, bones, joints and internal organs.
• You know that there is a genetic problem caused by a mitochondrial disorder in your family.
• If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before
taking Epilim Syrup.
Taking Epilim Syrup may make you put on weight. Talk to your doctor about how this will affect you.
Your doctor may wish to do blood tests before you start taking Epilim Syrup and during your
Other medicines and Epilim Syrup
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines.
This includes medicines you buy without a prescription, including herbal medicines. This is because
Epilim Syrup can affect the way some other medicines work. Also some medicines can affect the way
Epilim Syrup works.
The following medicines can increase the chance of you getting side effects, when taken with
• Some medicines used for pain and inflammation (salicylates) such as aspirin.
Some other medicines used to treat fits (epilepsy). This includes medicines such as
phenobarbital, primidone, phenytoin, carbamazepine, rufinamide, topiramate, acetazolamide,
lamotrigine and felbamate.
Epilim Syrup may increase the effect of the following medicines:
• Medicines used for thinning the blood (such as warfarin).
• Zidovudine used to treat HIV infection.
• Temozolomide used to treat cancer.
• Medicines for depression.
• Monoamine oxidase inhibitors (MAOI) such as moclobemide, selegiline, linezolid.
• Medicines used to calm emotional and mental conditions health problems (including
schizophrenia, bipolar disorder and depression) such as quetiapine, diazepam and olanzapine.
• Propofol – used for anaesthesia.
The following medicines can aff ect the way Epilim Syrup works:
• Some medicines used for the prevention and treatment of malaria such as mefl oquine and
• Cimetidine used for stomach ulcers.
• Protease inhibitors such as lopinavir and ritonavir – used for HIV infection and AIDS.
• Carbapenem agents (antibiotics used to treat bacterial infections) such as imipenem,
meropenem, rifampicin and erythromycin. The combination of Epilim Syrup and carapenems
should be avoided because it may decrease the eff ect of your medicine.
• Cholestyramine used to lower blood fat (cholesterol) levels.
Taking Epilim Syrup with food and drink
Alcohol intake is not recommended during treatment.
Pregnancy, breast-feeding and fertility
Important advice for women
• Valproate can be harmful to unborn children when taken by a woman during pregnancy.
• Valproate carries a risk if taken during pregnancy. The higher the dose, the higher the risks but
all doses carry a risk.
• It can cause serious birth defects and can aff ect the way in which the child develops as it grows.
Birth defects which have been reported include spina bifida (where the bones of the spine are
not properly developed); facial and skull malformations; heart, kidney, urinary tract and sexual
organ malformations; limb defects.
• If you take valproate during pregnancy you have a higher risk than other women of having a
child with birth defects that require medical treatment. Because valproate has been used for
many years we know that in women who take valproate around 10 babies in every 100 will have
birth defects. This compares to 2-3 babies in every 100 born to women who don’t have
• It is estimated that up to 30-40% of preschool children whose mothers took valproate during
pregnancy may have problems with early childhood development. Children affected can be slow
to walk and talk , intellectually less able than other children, and have difficulty with language
• Autistic spectrum disorders are more often diagnosed in children exposed to valproate and
there is some evidence children may be more likely to develop symptoms of Attention Deficit
Hyperactivity Disorder (ADHD).
If you are a woman capable of becoming pregnant your doctor should only prescribe valproate
for you if nothing else works for you.
Before prescribing this medicine to you, your doctor will have explained what might happen to
your baby if you become pregnant whilst taking valproate. If you decide later you want to have
a child you should not stop taking your medicine until you have discussed this with your doctor
and agreed a plan for switching you onto another product if this is possible.
Ask your doctor about taking folic acid when trying for a baby. Folic acid can lower the general
risk of spina bifida and early miscarriage that exists with all pregnancies. However, it is unlikely
that it will reduce the risk of birth defects associated with valproate use.
If this is the first time you have been prescribed valproate your doctor will have explained the risks
to an unborn child if you become pregnant. Once you are of childbearing age, you will need to make
sure you use an effective method of contraception throughout your treatment. Talk to your doctor
or family planning clinic if you need advice on contraception.
• Make sure you are using an effective method of contraception.
• Tell your doctor at once if you are pregnant or think you might be pregnant.
CONTINUING TREATMENT AND NOT TRYING FOR A BABY
If you are continuing treatment with valproate but you don’t plan to have a baby make sure you are
using an effective method of contraception. Talk to your doctor or family planning clinic if you need
advice on contraception.
• Make sure you are using an effective method of contraception.
• Tell your doctor at once if you are pregnant or think you might be pregnant.
CONTINUING TREATMENT AND CONSIDERING TRYING FOR A BABY
If you are continuing treatment with valproate and you are now thinking of trying for a baby you
must not stop taking either your valproate or your contraceptive medicine until you have discussed
this with your prescriber. You should talk to your doctor well before you become pregnant so that
you can put several actions in place so that your pregnancy goes as smoothly as possible and any
risks to you and your unborn child are reduced as much as possible.
Your doctor may decide to change the dose of valproate or switch you to another medicine before
you start trying for a baby.
If you do become pregnant you will be monitored very closely both for the management of your
underlying condition and to check how your unborn child is developing.
Ask your doctor about taking folic acid when trying for a baby. Folic acid can lower the general risk
of spina bifida and early miscarriage that exists with all pregnancies. However, it is unlikely that it
will reduce the risk of birth defects associated with valproate use.
• Do not stop using your contraception before you have talked to your doctor and worked
together on a plan to ensure your epilepsy is controlled and the risks to your baby are reduced.
• Tell your doctor at once when you know or think you might be pregnant.
UNPLANNED PREGNANCY WHILST CONTINUING TREATMENT
Babies born to mothers who have been on valproate are at serious risk of birth defects and problems
with development which can be seriously debilitating. If you are taking valproate and you think you
are pregnant or might be pregnant contact your doctor at once. Do not stop taking your medicine
until your doctor tells you to.
Ask your doctor about taking folic acid. Folic acid can lower the general risk of spina bifida and early
miscarriage that exists with all pregnancies. However, it is unlikely that it will reduce the risk of birth
defects associated with valproate use.
• Tell your doctor at once if you know you are pregnant or think you might be pregnant.
• Do not stop taking valproate unless your doctor tells you to.
Make sure you read the patient booklet and sign the Acknowledgement of Risk form which should
be given to you and discussed with you by your doctor or pharmacist.
Very little Epilim Syrup gets into the breast milk. However, talk to your doctor about whether you
should breast-feed your baby.
Ask your doctor or pharmacist for advice before taking any medicine.
Driving and using machines
You may feel sleepy when taking Epilim Syrup. If this happens to you, do not drive or use any tools or
machines. Taking other medicines used to treat fits or calm emotional and mental health problems
may increase sleepiness.
Important information about some of the ingredients of Epilim Syrup
This medicine contains:
• A colour called ‘ponceau 4R aluminium lake (E124)’: This may cause allergic reactions including
asthma in some people. You are more likely to have an allergy if you are also allergic to aspirin.
• Sucrose (3.6g in 5ml): People with diabetes need to take this into account.
• Sodium methyl hydroxybenzoate and sodium propyl hydroxybenzoate: This may cause allergic
reactions (may not happen straight away).
• Sorbitol: This is a type of sugar. If you have been told by your doctor that you cannot tolerate
some sugars, talk to your doctor before taking the syrup.
How to take Epilim Syrup
Always take Epilim Syrup exactly as your doctor has told you. You should check with your doctor or
pharmacist if you are not sure.
Epilim Syrup treatment must be started and supervised by a doctor specialised in the treatment of
Taking this medicine
• Your doctor will decide how much Epilim Syrup to give you or your child depending on you or
your child’s body weight.
• Take this medicine by mouth.
• Take Epilim Syrup with or after food. This will help to stop the feelings of sickness that may
happen after taking Epilim Syrup.
• Only dilute the syrup if your doctor or pharmacist tells you to.
• If you feel the eff ect of your medicine is too weak or too strong, do not change the dose
yourself but ask your doctor.
Take this in 2 separate doses – half in the morning and half in the evening.
You will be able to measure the dose in the marked measuring cup supplied with the syrup.
The marks of the cup show you how to measure between 5ml (200mg) and 15ml (600mg).
If the dose is less than 5ml (200mg), talk to your doctor or pharmacist about how to measure
How much to take
Adults (including the elderly)
• The starting dose is 600mg daily. Your doctor should gradually increase this dose by 200mg
every 3 days depending on your condition.
• The usual dose is between 1000mg and 2000mg (20-30mg per kilogram of body weight)
• This may be increased to 2500mg each day depending on your illness.
Children over 20 kilograms
• The starting dose should be 400mg daily. Your doctor should increase this dose depending
on your child’s illness.
• The usual dose is then between 20 mg and 30mg for each kilogram of body weight each
• This may be further increased to 35mg for each kilogram of body weight each day
depending on your child’s illness.
Children under 20 kilograms
• The usual dose is 20mg for each kilogram of body weight each day.
• Depending on the child’s condition your child’s doctor may decide to increase this dose.
Patients with kidney problems
• Your doctor may decide to adjust your or your child’s dose.
Patients taking other medicines for fits (epilepsy)
• You or your child may be taking other medicines for epilepsy at the same time as Epilim
Syrup. If so, your doctor should gradually initiate treatment depending on you or your
• Your doctor may increase the dose of Epilim Syrup by 5 to 10mg for each kilogram of body
weight each day depending on which other medicines you are taking.
If you take more Epilim Syrup than you should
If you take more Epilim Syrup than you should, tell a doctor or go to a hospital casualty department
straight away. Take the medicine pack with you. This is so the doctor knows what you have taken.
The following effects may happen: feeling sick or being sick, pupils of the eye become smaller,
dizziness, loss of consciousness, weak muscles and poor reflexes, breathing problems, headaches,
fits (seizures), confusion, memory loss and unusual or inappropriate behaviour.
If you forget to take Epilim Syrup
If you forget to take a dose, take it as soon as you remember. However, if it is nearly time for the
next dose, skip the missed dose. Do not take a double dose to make up for a forgotten dose.
If you stop taking Epilim Syrup
Keep taking until your doctor tells you to stop. Do not stop taking Epilim Syrup just because you feel
better. If you stop your fits may come back.
Make sure you or your child keep your regular appointments for a check up. They are very important
as your or your child’s dose may need to be changed. Epilim Syrup can change the levels of liver
enzymes shown up in blood tests. This can mean that your or your child’s liver is not working
properly. If you or your child go into hospital or visit another doctor or a dentist, tell them you are
taking Epilim Syrup.
If you have any further questions on the use of this product, ask your doctor or pharmacist.
4. Possible side effects
Like all medicines, Epilim Syrup can cause side effects, although not everybody gets them.
Tell your doctor straight away if you notice any of the following serious side effects - you may
need urgent medical treatment:
• You have an allergic reaction. The signs may include: a rash, joint pain, fever (systemic lupus
erythematosus), swallowing or breathing problems, swelling of your lips, face, throat or
tongue. Hands, feet or genitals may also be affected. More severe allergic reactions can lead to
lymph node enlargement and possible impairment of other organs.
• Liver problems and problems of the pancreas may show as a sudden illness which may happen
in the first six months of treatment. This happens in a very small number of people taking
Epilim Syrup. It includes feeling and being sick many times, being very tired, sleepy and weak,
stomach pain including very bad upper stomach pain, jaundice (yellowing of the skin or whites
of the eyes), loss of appetite, swelling (especially of the legs and feet but may include other
parts of the body), worsening of your fits or a general feeling of being unwell. Your doctor may
tell you to stop taking Epilim Syrup immediately if you have these symptoms.
• You have a skin rash or skin lesions with a pink/ red ring and a pale centre which may be itchy,
scaly or filled with fluid. The rash may appear especially on the palms or soles of your feet.
These could be signs of a serious allergy to the medicine called ‘erythema multiforme’.
• Blistering or bleeding of the skin around the lips, eyes, mouth, nose and genitals. Also flu-like
symptoms and fever. This may be something called ‘Stevens-Johnson syndrome’.
• Severe blistering rash where layers of the skin may peel off to leave large areas of raw exposed
skin over the body. Also a feeling of being generally unwell, fever, chills and aching muscles.
This may be something called ‘Toxic epidermal necrolysis’.
• Bruising more easily and getting more infections than usual. This could be a blood problem
called ‘thrombocytopenia’. It can also be due to a fall in the number of white blood cells, bone
marrow depression or another condition that aff ects red blood cells, white blood cells and
platelets (pancytopenia) or how the blood clots.
• Blood clotting problems (bleeding for longer than normal), bruising or bleeding for no reason.
• Changes in mood, loss of memory, lack of concentration and deep loss of consciousness (coma).
• Underactive thyroid gland, which may cause tiredness or weight gain (hypothyroidism).
• Breathing difficulty and pain due to inflammation of the lungs (pleural effusion).
• An increase in the number and severity of convulsions.
Tell your doctor as soon as possible if you have any of the following side effects:
• Changes in behaviour including being very alert, and sometimes also aggressive, hyperactive
and unusual or inappropriate behaviour. This is more likely if other medicine to treat fits such as
phenobarbital are taken at the same time or if the Epilim Syrup starting dose is high or has been
Changes in the amount of ammonia in the blood. Symptoms of this condition are being sick,
problems with balance and co-ordination, feeling lethargic or less alert.
Feeling shaky (tremor), sleepy or unsteady when walking or jerky muscle movements.
Feeling tired or confused with loss of consciousness sometimes accompanied by hallucinations
Blisters with the skin flaking away.
Rapid, uncontrollable movement of the eyes.
Tell your doctor or pharmacist if any of the following side effects get serious or lasts longer than a
few days, or if you notice any side effects not listed in this leaflet:
• Feeling sick (nausea), being sick (vomiting), stomach ache or diarrhoea, especially when starting
treatment. This may be helped by taking Epilim Syrup with food.
• Swelling of gums or sore mouth
• Hearing loss
• Nail and nail bed disorders
• Skin problems such as rashes. These happen rarely, but more often in people also taking
• Hair loss which is usually temporary. When it grows back it may be more curly than before.
• Hair disorders (changes in texture, colour or growth)
• Increased levels of some hormones (androgens), which may lead to increased hair growth on
the face, breasts or chest, acne or thinning hair.
• Skin rash caused by narrow or blocked blood vessels (vasculitis)
• Changes in women’s periods and increased hair growth in women
• Breast enlargement in men
• Swelling of the feet and legs (oedema)
• Weight gain – as your appetite may be increased
• Kidney disease
• Kidney problems, bedwetting or increased need to pass urine
• Blood in the urine
• Seeing or hearing things that are not there (hallucinations)
• Aggression, agitation, disturbance in attention, abnormal behaviour, restlessness/hyperactivity,
and learning disorder
• Tingling or numbness in the hands and feet
• Lowering of normal body temperature
• Abnormal blood clotting factors
• Muscle pain and weakness (rhabdomyolysis)
There have been reports of bone disorders including osteopenia and osteoporosis (thinning of the
bone) and fractures. Check with your doctor or pharmacist if you are on long-term anti-epileptic
medication, have a history of osteoporosis, or take steroids.
Epilim Syrup can change levels of liver enzymes, salts or sugars shown up on blood and urine tests.
Taking Epilim Syrup can be a contributing factor in male infertility.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side
effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme
at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App
By reporting side effects you can help provide more information on the safety of this medicine.
How to store Epilim Syrup
Keep out of the sight and reach of children.
Do not take this medicine after the expiry date shown on the label and carton after EXP. The expiry
date refers to the last day of that month.
Store this medicine below 25oC.
The diluted product has a 14-day shelf life.
Medicines should not be disposed of via household wastewater or household waste. Ask your
pharmacist how to dispose of medicines no longer required. These measures will help protect the
Contents of the pack and other information
What Epilim Syrup contains
• Each 5ml of the Syrup contains 200mg of the active substance, sodium valproate.
• The other ingredients are sucrose, sorbitol (E420), sodium methyl hydroxybenzoate (E219),
sodium propyl hydroxybenzoate (E217), saccharin sodium, water, Ponceau 4R (E124) and cherry
What Epilim Syrup looks like and contents of the pack
Epilim Syrup is a red, cherry flavoured syrup supplied in bottles of 300ml.
Marketing Authorisation Holder and Manufacturer
Marketing Authorisation Holder
One Onslow Street
Tel: 0845 372 7101
Unither Liquid Manufacturing,
1-3 allee de la Neste
This leaflet does not contain all the information about your medicine. If you have any questions or
are not sure about anything, ask your doctor or pharmacist.
This leafl et was last revised in March 2018
© Sanofi , 1976 – 2018
There are two organisations that will also be happy to try and answer any general questions on
They can be contacted at:
Epilepsy Action, New Anstey House, Gate Way Drive, Yeadon, Leeds, LS19 7XY
Telephone: 0808 800 5050. Website: www.epilepsy.org.uk
National Society for Epilepsy (NSE), Chesham Lane, Chalfont St Peter, Bucks, SL9 0RJ
Telephone: 01494 601400. Website: www.epilepsynse.org.uk
Source: Medicines and Healthcare Products Regulatory Agency
Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.