Precautions and Warnings With Divalproex
There are a number of divalproex precautions and warnings that you should be aware of before starting the medication. For example, you should let your healthcare provider know if you have a blood disorder, liver disease, or a urea cycle disorder (among other conditions) prior to taking divalproex. It is also important to know that divalproex may cause liver failure, pancreatitis, or low platelets in the blood in some people.
You should talk with your healthcare provider prior to taking divalproex sodium (Depakote®) 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:
- Pregnant or thinking of becoming pregnant
You should also make sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Some precautions and warnings to be aware of prior to taking divalproex include:
- There have been cases of liver failure caused by divalproex. Children less than two years of age are at particularly high risk, especially children with mental retardation, brain damage or disease, or certain other health problems. Divalproex is not approved for children less than 10 years of age, and should rarely be used in young children, due to the risk of liver damage.
- You should not take divalproex if you have liver disease. Also, you should not take divalproex if you have a urea cycle disorder (a problem with the enzymes that clear ammonia from the body, leading to high ammonia levels in the blood), as the drug may worsen this condition. You should be evaluated for a urea cycle disorder if you have a history of:
- A brain disease or a problem associated with pregnancy
- Unexplained brain disease or problems
- Unexplained mental retardation
- High ammonia levels in your blood
- Vomiting and lethargy that come and go regularly.
- Divalproex can cause pancreatitis (inflammation of the pancreas), which may be very dangerous. Let your healthcare provider know immediately if you have any signs of pancreatitis, including:
- Severe abdominal pain (or stomach pain)
- Nausea and vomiting
- Loss of appetite.
- Elderly people may be more sensitive to the side effects of divalproex, such as drowsiness. If you are elderly and take divalproex, your healthcare provider should monitor you more closely.
- Divalproex can cause low platelets in the blood (thrombocytopenia). Tell your healthcare provider if you have any unusual bruises or bleeding during treatment with divalproex.
- As with all seizure medications, divalproex should not be stopped suddenly (see Depakote Withdrawal).
- Let your healthcare provider know right away if you have a rash along with a fever or any other symptoms, as this may be a sign of a dangerous allergic reaction.
- Divalproex can cause hypothermia (a body temperature below 95 degrees F), which can be dangerous. Let your healthcare provider know if you develop hypothermia.
- Divalproex can potentially interact with certain other medications (see Drug Interactions With Divalproex).
- Divalproex is considered a pregnancy Category D medication when used to treat epilepsy or bipolar disorder. This means that it is probably not safe for pregnant women to take in these situations. Divalproex is in pregnancy Category X when used to prevent migraine headaches. This means that the risks of taking the medication outweigh the benefits in this situation.
Talk with your healthcare provider about the risks and benefits of taking the drug during pregnancy (see Depakote and Pregnancy). Divalproex may increase the risk of birth defects and "cognitive impairment" problems (such as lower intelligence).
- Divalproex passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to taking the drug (see Depakote and Breastfeeding).