Experiences with
Sodium valproateSodium valproate is not suitable for some people. For example, check with your doctor if you're trying for a baby or have liver problems.
Sodium valproate comes as capsules, tablets, liquid or granules that you take 1 or 2 times a day. Follow the instructions that come with the medicine.
Common side effects of sodium valproate include stomach pain, feeling or being sick and diarrhoea. More serious side effects can happen in rare cases.
Sodium valproate is not recommended in pregnancy as it can harm your baby. Check with a doctor.
It can cause problems to take sodium valproate with some other medicines, such as other medicines for epilepsy, or medicines for blood clots.
Who can take sodium valproate
Most adults can take sodium valproate to treat epilepsy or bipolar disorder or help prevent migraine.
Most children can take sodium valproate to treat epilepsy.
Who may not be able to take sodium valproate
Girls and women who need to take sodium valproate must be enrolled on Prevent, the valproate pregnancy prevention programme. Speak to your doctor about this.
Sodium valproate may affect fertility in men. There may also be a small chance of learning or behavioural problems in the baby if you are taking sodium valproate and your partner becomes pregnant. For these reasons, doctors may recommend different treatments for men who could possibly have children, or in those planning to try for a baby.
To make sure sodium valproate is safe for you, tell your doctor if you:
- have ever had an allergic reaction to sodium valproate or any other medicine
- have liver problems
- have a rare metabolic or genetic condition such as porphyria, urea cycle disorder, mitochondrial disorder or primary carnitine deficiency
Dosage and how to take sodium valproate
The usual dose of sodium valproate for treating epilepsy in adults and children aged 12 years and over is 600mg to 2,000mg a day, as 1 dose or split into 2 doses. Some people take a higher dose of 2,500mg a day.
For younger children aged 1 month to 11 years, the doctor will use your child's weight to work out the right dose for them.
The usual dose for treating bipolar disorder in adults is 750mg to 2,000mg a day, as 1 dose or split into 2 doses.
The usual dose for preventing migraine in adults is 400mg to 1,500mg, split into 2 doses.
If your doctor tells you to take sodium valproate twice a day, you'll usually take half the dose in the morning and half in the evening (to make up your full daily dose).
If you're taking sodium valproate and have kidney problems, your doctor may prescribe a lower dose.
Changes to your dose
To reduce the chance of side effects, your doctor will start you off on a low dose of sodium valproate. They will increase it gradually over a few days or weeks.
Once you find a dose that suits you, it will usually stay the same, unless your condition changes, or your doctor starts you on a new medicine that may affect sodium valproate.
How to take it
Sodium valproate comes as gastro-resistant tablets, crushable tablets, and as a liquid. It also comes as slow release (also called prolonged or sustained release) tablets, capsules and granules.
Slow release medicine passes into your body gradually.
Gastro-resistant tablets release the medicine as soon as it passes through your stomach. This means the sodium valproate is less likely to upset your stomach.
You can take sodium valproate with or without food, but it's best to stick to the same way each time. Try not to take it with food some days and without food on other days.
Common side effects of sodium valproate
These common side effects of sodium valproate may happen in more than 1 in 100 people. They're usually mild and go away by themselves. There are things you can do to help cope with them:
Take sodium valproate with or after a meal or snack. It may also help if you avoid rich or spicy food. Take small, frequent sips of water if you're being sick to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee.
Talk to a doctor or pharmacist if these side effects get worse or do not go away.
If you take the combined contraceptive pill or progestogen-only pill and you're being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.
Drink plenty of fluids such as water or squash to avoid dehydration. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.
If you take the combined contraceptive pill or progestogen-only pill and you have severe diarrhoea for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.
For a dry mouth try sugar-free gum or sweets, or try sipping cold drinks. If this does not help, or you have mouth ulcers, talk to your pharmacist or doctor.
If you're bothered by swollen gums or this symptom does not go away, talk to your doctor or dentist.
As your body gets used to sodium valproate, these side effects should wear off.
If these symptoms do not get better within a week or 2, your doctor may either reduce your dose or increase it more slowly. If that does not work, talk to your doctor as they may want to switch you to a different medicine.
Make sure you rest and drink plenty of fluids. Try not to drink too much alcohol. Ask your pharmacist to recommend a painkiller. Talk to your doctor if your headaches are severe or do not go away.
If you find you're putting on weight after taking sodium valproate, try to have a healthy balanced diet. Regular exercise will also help you keep your weight stable.
Your doctor will usually monitor your weight while you're taking this medicine. Speak to them if you have any concerns.
If these symptoms bother you, ask your doctor whether it's possible to lower your dose. Your hair may regrow after either reducing your dose or switching to a different medicine.
As well as being a side effect of sodium valproate, a late period is a sign that you could be pregnant, and sodium valproate can be harmful for an unborn baby. If you usually have regular periods, take a pregnancy test if your period is late, and speak to your doctor straight away if the result is positive.
Changes to your periods can also be a symptom of polycystic ovary syndrome (PCOS), a rare side effect of sodium valproate. Your doctor will be able to do some tests to check whether you have PCOS.
Keep taking the medicine but talk to your doctor or a pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.
Sodium valproate and pregnancy
Sodium valproate is not recommended in pregnancy, as it can cause birth defects and problems with your child's learning and behaviour.
If there's a chance you could become pregnant while taking this medicine, your doctor will enrol you on Prevent, the valproate pregnancy prevention programme.
If you think you might be pregnant and you're taking sodium valproate, contact your doctor or nurse urgently.
If you're taking sodium valproate for epilepsy or bipolar disorder and you become pregnant, do not stop taking your medicine without talking to your doctor first. This is because your symptoms may get worse.
Your doctor may continue to prescribe sodium valproate, but only if there's no other suitable treatment for your epilepsy or bipolar disorder.
For pregnant women with recurrent migraine your doctor should offer you an alternative treatment to sodium valproate.
For men who could possibly have children, it's important to discuss sodium valproate with your doctor. You and your partner should use contraception while you're taking sodium valproate and for at least 3 months after stopping.
For men who are planning to start a family within the next year, speak to a doctor about your treatment options. Do not stop taking sodium valproate without speaking to a doctor first.
You must have a review of your treatment every year. Contact your doctor or specialist now if you have not had one.
Sodium valproate and breastfeeding
If your baby is healthy, you may be able to take sodium valproate while breastfeeding. Other treatments might be more suitable, but your doctor may still recommend sodium valproate if it's the only medicine that works for you.
Sodium valproate passes into breast milk in very small amounts, and does not usually cause any side effects in breastfed babies.
If there's a chance you could become pregnant while taking this medicine, your doctor will put you on Prevent, the valproate pregnancy prevention programme.
It's important to keep taking your medicine to keep you well. Breastfeeding will also benefit both you and your baby.
It's very rare for breastfed babies to have side effects from medicines you're taking. But it's important to keep monitoring your baby if you're taking any medicine while breastfeeding.
Contact your healthcare professional or call 111 as soon as possible if your baby is:
- not feeding as well as usual, or not putting on weight and developing as you would expect
- unusually sleepy
- behaving differently, for example being irritable
- bruising more easily than usual
- being sick (vomiting), or they have diarrhoea
- showing signs of jaundice, including yellowing of the whites of the eyes and the skin (this may be less obvious on brown or black skin), dark pee and pale poo
If your baby has any symptoms that are not listed, or if you're worried about them, you can also call 111 or contact any healthcare professional.
Carry on taking the medicine, and keep breastfeeding as usual until you've got advice about your baby's symptoms.
It's important not to share a bed with your baby while you're taking sodium valproate.
Cautions with other medicines
There are some medicines that may affect how sodium valproate works. Sodium valproate can also affect the way other medicines work.
Tell your doctor if you're taking any other medicines, including:
- any other medicines for epilepsy such as carbamazepine
- medicines for preventing blood clots such as warfarin
- aspirin for pain relief or low-dose aspirin
- cimetidine, a medicine for stomach ulcers
- medicines to treat HIV and AIDS such as ritonavir
- antibiotics such as erythromycin
- medicines for depression or other mental health problems, such as venlafaxine, quetiapine or diazepam
- cholesterol-lowering medicines such as cholestyramine
- medicines to prevent malaria such as mefloquine or chloroquine
These are not all the medicines that may cause problems if you take them with sodium valproate. For a full list, see the leaflet inside your medicine packet.
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