Divalproex

Divalproex is commonly prescribed for migraine prevention and the treatment of epilepsy and manic episodes associated with bipolar disorder. The drug works by affecting sodium channels in the brain and increasing the amount of a certain brain chemical (GABA). Various divalproex products are available, including delayed-release tablets and sprinkle capsules. Possible side effects include headaches, shakiness, and drowsiness.

 

What Is Divalproex?

Divalproex sodium (Depakote®) is a prescription medication used to treat the following conditions:
 
Several different divalproex products are available. This article refers to regular divalproex delayed-release tablets and sprinkle capsules (Depakote® Sprinkle capsules). For information on the long-acting form, see Divalproex ER.
 
(Click What Is Divalproex Used For? for more information on specific uses, including possible off-label uses.)
 

Who Makes It?

Divalproex is made by Abbott Pharmaceuticals.
 

How Does Divalproex Work?

Epilepsy is a brain disorder that occurs when there are recurring, brief changes in how the brain's electrical system works. These changes in brain activity can lead to a seizure (see Epilepsy Symptoms).
 
Divalproex works by increasing the amount of gamma-aminobutyric acid (GABA) in the brain. GABA is a natural brain chemical that stops or slows down other brain signals. Increasing GABA helps prevent the abnormal brain signals that lead to a seizure. It is also thought that divalproex may prevent seizures by affecting sodium channels in the brain.
 
Divalproex tablets are "delayed-release," which means they have a special coating that prevents the drug from dissolving too early in the digestive tract, which can be irritating. The beads inside the sprinkle capsules also have this special coating. It is similar to an older medication, Depakene® (valproic acid). Divalproex is changed into valproic acid in the digestive tract. This (along with the special coating) helps reduce some of the side effects, compared to the older product (Depakene).
 

Effects of Divalproex

Several studies have evaluated the safety and effectiveness of divalproex in the treatment of certain conditions.
 
Mania
In one study, divalproex was compared to lithium (Lithobid®, Eskalith®) or a "sugar pill" (placebo) to treat people who were hospitalized with an episode of mania. After three weeks, those taking divalproex had at least as much improvement in bipolar symptoms as those taking lithium (and more improvement compared to those taking a "sugar pill").
 
Migraines
Another study looked at using divalproex for migraine prevention. Those not taking the medication experienced an average of almost six migraines in four weeks, while people taking it had only three to four migraines, on average.
 
Epilepsy
In one study, divalproex was added to other seizure medications in people with complex partial seizures that were not adequately controlled. Those who added it to their seizure medications decreased their seizure frequency, compared to those who did not take the drug.
 
Other studies have shown that using divalproex alone is also effective for complex partial seizures.
 

When and How to Take Divalproex

Some general considerations for when and how to take this medication include the following:
 
  • Divalproex comes in delayed-release tablets and "sprinkle capsules."
     
  • The medication can be taken with or without food. If divalproex upsets your stomach, try taking it with food.
     
  • Do not crush, break, or chew the tablets, as this will destroy the protective coating.
     
  • The sprinkle capsules can be swallowed whole or can be opened and the contents sprinkled on a spoonful of soft food (such as pudding or applesauce). Do not chew the contents, as each tiny bead is delayed-release, with a special protective coating.
     
  • Divalproex should be taken at the same times each day to maintain an even level in your blood.
     
  • For the medication to work properly, it must be taken as prescribed. Divalproex will not work if you stop taking it.
     
  • Do not stop taking the medication without first discussing it with your healthcare provider (see Depakote Withdrawal).
     

Dosing Information

The dose of divalproex your healthcare provider recommends will vary, depending on a number of factors, including:
 
  • The medical condition being treated
  • Your weight
  • Other medications you may be taking
  • Other medical conditions you may have.
     
As always, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
 
(Click Divalproex Dosing for more information.)
 

Divalproex Side Effects

As with any medicine, side effects are possible with divalproex. However, not everyone who takes the drug will experience side effects. In fact, most people tolerate it quite well. If side effects do occur, in most cases, they are minor and either require no treatment or can easily be treated by you or your healthcare provider. Serious side effects are less common.
 
Common side effects include but are not limited to:
 
  • Shakiness (tremors)
  • Nausea or vomiting
  • Headaches
  • Weakness
  • Drowsiness.
     
(Click Side Effects of Divalproex to learn more, including potentially serious side effects you should report immediately to your healthcare provider.)
 
For information about specific side effects, read the following eMedTV articles:
 

Drug Interactions

Divalproex can potentially interact with many other medicines (see Drug Interactions With Divalproex).
 

What Should I Tell My Healthcare Provider Before Taking Divalproex?

You should talk with your healthcare provider prior to taking the drug if you have:
 
  • Liver disease, such as liver failure or cirrhosis
  • A urea cycle disorder
  • Mental retardation
  • A blood disorder
  • Any allergies, including allergies to food, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
Make sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 
(Click Precautions and Warnings With Divalproex to learn more, including information on who should not take the drug.)
 

What If I Take an Overdose?

People who take too much divalproex may have overdose symptoms that could include:
 
  • Drowsiness
  • Heart block (a problem with the electrical system of the heart)
  • Coma
  • Loss of life.
     
If you happen to take an overdose, seek immediate medical attention.
 
(Click Depakote Overdose for more information.)
 

How Should Divalproex Be Stored?

Divalproex should be stored at room temperature, away from moisture and heat. You should store the tablets and capsules in an airtight container.
 
Keep this and all other medications out of the reach of children.
 

What Should I Do If I Miss a Dose?

If you do not take your divalproex as scheduled, take your missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose. Be sure to tell your healthcare provider if you miss any of your doses, as this information may be helpful in adjusting your current dosage.
 

Available Strengths

Divalproex delayed-release tablets are available in three strengths:
 
  • Divalproex 125 mg
  • Divalproex 250 mg
  • Divalproex 500 mg.
     
Delayed-release divalproex capsules are available in one strength -- Depakote Sprinkle 125 mg capsules.
 

Is There a Generic Version of Divalproex?

Currently, divalproex is not available in generic form (see Generic Depakote).
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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;