Desval ER Tablet
Divalproex Sodium
500mg
Ranbaxy Laboratories Ltd.
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| Retail Price | 13.11 NPR |
Available as:
Indications
Desval ER Tablet is used for:
Mania, Epilepsy
Adult Dose
Mania
Indicated for treatment of manic episodes associated with bipolar disorder
ER Tablet initial dose: 25 mg/kg PO once daily Increase as rapidly as possible to achieve the lowest therapeutic dose that provides desired clinical effect or plasma concentration
Not to exceed 60 mg/kg/day
Epilepsy
10-15 mg/kg/day PO initially; may increase by 5-10 mg/kg/week to achieve optimal clinical response; not to exceed 60 mg/kg/day
If daily dose >250 mg, give as divided dose
Migraine Prophylaxis
ER initial dose: 500 mg PO qDay for 1 week
May increase dose up to 1000 mg/day if needed
Hepatic impairment
Administer lower doses
Contraindicated in severe impairment
Child Dose
Epilepsy
<10 years: Safety and efficacy not established
Child > 10 years: 10-15 mg/kg/day PO initially; may increase by 5-10 mg/kg/week to achieve optimal clinical response; not to exceed 60 mg/kg/day
Renal Dose
Renal impairment
No adjustment necessary; protein binding is reduced and may cause measurement of total valproate concentrations to be inaccurate
Administration
Contra Indications
Hypersensitivity. Liver disease, significant hepatic impairment. Urea cycle disorders. Migraine headache prevention in women who are pregnant or plan to become pregnant.
Precautions
Probability of thrombocytopenia increases significantly at total trough valproate plasma concentrations exceed 110 mcg/mL in females and 135 mcg/mL in males
Hepatotoxic (age <2 years, higher risk of fatal hepatotoxicity)
Discontinue if hyperammonemia/encephalopathy occurs; check ammonia level if emesis occurs or if the patient displays lethargy or abnormal behavior; evaluate patient for urea cycle disorder
Pancreatitis, including fatalities reported. Potential for thrombocytopenia, porphyria, and multiorgan hypersensitivity reaction.
May produce false-positive urine ketone test and alter TFTs
Reversible cerebral and cerebellar atrophy reported; monitor motor and cognitive function routinely and assess for signs and symptoms of brain atrophy
May cause CNS depression and impair physical or mental abilities
Somnolence in the elderly can occur; divalproex dosage should be increased slowly and with regular monitoring for fluid and nutritional intake
Not for administration to post-traumatic seizure prophylaxis in patients with acute head trauma (increased mortality reported when used)
Lactation: Excreted in breast milk; use caution (AAP and ACOG say compatible)
Pregnancy-Lactation
Pregnancy Category: D for seizures or manic episodes that are unresponsive to other treatments
Pregnancy category: X for migraine headache prevention
Interactions
Adverse Effects
Side effects of Divalproex Sodium :
>10%
Nausea (48%),Headache (31%),Asthenia (27%),Vomiting (27%),Somnolence (27%),Tremor (25%),Dizziness (25%),Abdominal pain (23%),Diplopia (16%),Diarrhea (13%),Anorexia (12%),Amblyopia/blurred vision (12%),Flu syndrome (12%),Infection (12%)
1-10%
Dyspepsia (8%),Ataxia (8%),Nystagmus (8%),Fever (6%),Emotional lability (6%),Thinking abnormal (6%),Alopecia (6%),Weight loss (6%),Constipation (5%),Amnesia (5%),Bronchitis (5%),Rhinitis (5%)
Frequency Not Defined
Cerebral pseudoatrophy
Mechanism of Action
May increase levels of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) in brain; may enhance or mimic action of GABA at postsynaptic receptor sites; may also inhibit sodium and calcium channels
Divalproex sodium is a stable co-ordination compound comprised of sodium valproate and valproic acid in a 1:1 molar relationship and formed during the partial neutralization of valproic acid with 0.5 equivalent of sodium hydroxide
Note
Desval ER 500mg Tablet manufactured by Ranbaxy Laboratories Ltd.. Its generic name is Divalproex Sodium. Desval ER is availble in Nepal.
Farmaco Nepal drug index information on Desval ER Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.