Valance OD Tablet

Divalproex Sodium
750mg
Abbott India Ltd.
Pack size 1
Dispensing mode
Source
Agent
Retail Price 15.62 NPR

Indications

Valance OD 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

Valance OD 750mg Tablet manufactured by Abbott India Ltd.. Its generic name is Divalproex Sodium. Valance OD is availble in Nepal. Farmaco Nepal drug index information on Valance OD Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.

Some other brands of Divalproex Sodium :