Depakote Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Depakote Tablet contains divalproex sodium, a fatty acid derivative anticonvulsant (antiepileptic) medicine. It is used to treat manic episodes in bipolar disorder, certain types of seizures, and to help prevent migraine headaches. Depakote works by raising levels of a calming brain chemical called GABA, which may reduce abnormal electrical activity in the brain. It carries important warnings related to liver function, pancreas problems, and use during pregnancy.

What is Depakote Tablet

Depakote is a prescription tablet that contains divalproex sodium, a type of anti-seizure (antiepileptic) medicine. It is also used to treat certain mood episodes in bipolar disorder and to help prevent migraine headaches.

Depakote Tablet uses

• Treating manic episodes associated with bipolar disorder
• Treating complex partial seizures in adults and children 10 years and older, alone or with other seizure medicines
• Treating simple and complex absence seizures, alone or with other seizure medicines
• Preventing migraine headaches in adults (not for treating a migraine once it has started)

Benefits of Depakote Tablet

• Can reduce the number of seizures in people with certain types of epilepsy
• Can help control manic episodes in bipolar disorder
• Can lower how often migraine headaches happen when taken regularly

How Depakote Tablet works

Depakote is thought to work by raising the level of a calming brain chemical called GABA, which may help reduce the abnormal electrical activity in the brain that causes seizures.

Depakote Tablet dosage

Take Depakote exactly as your doctor prescribes and follow your prescription label. Swallow tablets whole; do not crush, chew, break, or open them. Drink plenty of water each day while taking this medicine. Do not stop taking this medicine suddenly without talking to your doctor, since stopping abruptly can cause severe, life-threatening seizures. If you have stomach upset, taking the medicine with food may help.

In elderly patients, doctors usually start with a lower dose and increase it more slowly, watching closely for excess sleepiness and fluid or nutrition problems. Tell your surgeon ahead of time if you are taking this medicine before any surgery. Consider wearing or carrying medical identification stating that you take this medicine.

Available forms and strengths

• Delayed-release tablets (125 mg, 250 mg, 500 mg)

Side effects of Depakote Tablet

Common

• Nausea, vomiting, stomach pain, diarrhea, constipation
• Headache, back pain
• Dizziness, drowsiness, weakness, tremors
• Memory problems, mood changes, trouble sleeping
• Bruising or bleeding
• Runny nose, sore throat, cough, wheezing, trouble breathing
• Fever, flu symptoms
• Problems with walking or coordination
• Swelling in hands or feet
• Blurred vision, double vision, unusual eye movements
• Ringing in the ears
• Rash, hair loss
• Changes in weight or appetite

Serious

• Signs of liver problems: loss of appetite, upper stomach pain that may spread to the back, ongoing nausea or vomiting, dark urine, swelling in the face, or yellowing of skin or eyes
• Signs of pancreas problems: severe stomach pain (that may spread to the back), nausea, vomiting, loss of appetite
• Serious allergic reaction: hives, difficulty breathing, swelling of face or throat
• Severe skin reaction: fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling
• Multi-organ hypersensitivity reaction: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of skin or eyes
• Signs of low platelets or bleeding problems: easy bruising, unusual bleeding from nose, mouth, or gums, purple or red pinpoint spots under the skin
• High ammonia levels: confusion, tiredness, cold feeling, vomiting, change in mental state
• Severe drowsiness
• Worsening seizures
• New or worsening mood or behavior changes, depression, anxiety, panic attacks, trouble sleeping, feeling impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive, or thoughts of suicide or self-harm
• Low body temperature (hypothermia) with symptoms like confusion or coma
• Medicine residue in the stool

Warnings and precautions

• This medicine can cause liver failure that may be fatal, especially in children under age 2 and people with certain genetic liver disorders.
• This medicine can cause severe, sometimes fatal, inflammation of the pancreas.
• Do not stop taking this medicine suddenly, as this can trigger a dangerous, ongoing seizure that will not stop.
• This medicine may increase the risk of suicidal thoughts or actions in a small number of people.
• This medicine should not be used to prevent migraines in women who are pregnant or who could become pregnant without using effective birth control.
• Serious skin reactions, including toxic epidermal necrolysis and Stevens-Johnson syndrome, have occurred with this medicine.
• This medicine can cause swelling of the face, mouth, or throat (angioedema), which can be dangerous.
• Depakote can seriously harm an unborn baby, including causing birth defects such as spina bifida and problems with a child's later thinking ability. 
• It should generally not be used during pregnancy for epilepsy or bipolar disorder unless other medicines have not worked or cannot be used, and it should not be used at all to prevent migraines in women who are or could become pregnant. 
• Do not start or stop this medicine during pregnancy without your doctor's advice.
• Depakote passes into breast milk. Talk with your doctor about the safest way to feed your baby if you are taking this medicine, and watch the baby for signs of liver problems like yellowing skin or unusual bruising.
• Discuss kidney problems with your doctor before starting this medicine, since drug clearance can change.
• This medicine should not be used if you have liver disease, since it can cause serious and sometimes fatal liver damage, especially within the first six months of treatment and in young children.
• Do not drink alcohol while taking this medicine, as it can increase sleepiness and dizziness.
• Avoid driving or doing anything dangerous until you know how this medicine affects you, since it can slow your thinking and reactions.

Storage

• Store tablets below 86°F (30°C)
• Keep this and all other medicines out of the reach of children

When to see a doctor

• Get emergency help right away for signs of a severe allergic reaction such as hives, trouble breathing, or swelling of the face or throat.
• Call your doctor right away if you notice signs of liver or pancreas problems, such as loss of appetite, upper stomach pain, ongoing nausea or vomiting, dark urine, facial swelling, or yellowing of the skin or eyes.
• Call your doctor right away if you notice easy bruising, unusual bleeding, fever, swollen glands, mouth sores, confusion, extreme tiredness, or worsening seizures.
• Report any new or worsening mood or behavior changes, including thoughts of suicide or self-harm, to your doctor right away.
• Seek emergency medical attention if you think you or someone else has taken too much of this medicine.

Alternatives

• Lamotrigine
• Topiramate
• Oxcarbazepine