Experiences with
Valproic acidValproic acid is not suitable for some people. For example, check with your doctor if you're trying for a baby or have liver problems.
Valproic acid comes as tablets and capsules that you take 2 to 4 times a day. Follow the instructions that come with your medicine.
Common side effects of valproic acid include stomach pain, feeling or being sick and diarrhoea. More serious side effects can happen in their cases.
Valproic acid is not recommended in pregnancy as it can harm your baby. Check with a doctor.
It can cause problems to take valproic acid with some other medicines, such as aspirin, other medicines for epilepsy, or medicines for blood clots.
Who can take valproic acid
Most adults can take valproic acid to treat bipolar disorder or epilepsy or help prevent migraine.
Most children aged 1 month or older can take valproic acid to treat epilepsy.
Who may not be able to take valproic acid
Girls and women who need to take valproic acid must be enrolled on Prevent, the valproate pregnancy prevention programme.
Valproic acid may affect fertility in men. There may also be a small chance of learning or behavioural problems in the baby if you are taking valproic acid 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 valproic acid is safe for you, tell your doctor if you:
- have ever had an allergic reaction to valproic acid 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 valproic acid
The usual dose of valproic acid for treating bipolar disorder in adults is 750mg to 2,000mg a day, split into 2 or 3 doses.
The usual dose for preventing migraine in adults is 500mg to 1,000mg a day, split into 2 or 3 doses.
The usual dose for treating epilepsy in adults and children aged 12 years and over is 600mg to 2,000mg a day, split into 2 to 4 doses. Some people take a higher dose of 2,500mg a day.
For younger children who weigh more than 20kg, the doctor will use your child’s weight to work out the right dose.
If you need to take your medicine more than once a day, you'll take equal doses that add up to your daily total. Ask your doctor or a pharmacist if you're unsure how much to take each time.
If you're taking valproic acid 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 valproic acid. 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 valproic acid.
How to take it
Valproic acid comes as gastro resistant tablets and capsules. These release the valproic acid into your body as soon as they pass through your stomach.
Swallow the tablets or capsules whole with a drink of water or squash. Do not chew them.
You can take valproic acid with or without food, but it's best to do the same each time.
If you're taking valproic acid twice a day, try to leave a gap of 10 to 12 hours between doses. For example, you could take your first dose in the morning (between 7am and 8am) and your second dose in the evening (between 7pm and 8pm).
If you take it 3 to 4 times a day, try to space your doses evenly throughout the day. If you need to take 3 doses, for example, you could take a dose first thing in the morning, early afternoon and bedtime.
Common side effects of valproic acid
These common side effects of valproic acid 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:
This is most likely when you start treatment.
It usually helps if you take valproic acid 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.
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, watery diarrhoea, or any diarrhoea that lasts 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 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 valproic acid, 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. Do not drink too much alcohol.
Ask your pharmacist to recommend a painkiller. Talk to your doctor if your headaches do not go away or are severe.
If you find you're putting on weight after taking valproic acid, 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 valproic acid, a late period is a sign that you could be pregnant, and valproic acid 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 valproic acid. 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.
Valproic acid and pregnancy
Valproic acid 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 while taking valproic acid, contact your doctor or nurse urgently.
If you're taking valproic acid 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.
For pregnant women with epilepsy or bipolar disorder your doctor may continue to prescribe valproic acid, but only if there's no other suitable treatments.
For pregnant women with recurrent migraine your doctor should offer you an alternative treatment to valproic acid.
For men who could possibly have children, it's important to discuss valproic acid with your doctor. You and your partner should use contraception while you're taking valproic acid 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 valproic acid 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.
Valproic acid and breastfeeding
If your baby is healthy, you may be able to take valproic acid while breastfeeding. Other treatments might be more suitable, but your doctor may still recommend valproic acid if it’s the only medicine that works for you.
Valproic acid 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 also 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 you notice that 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.
It's important not to share a bed with your baby while you're taking valproic acid.
Cautions with other medicines
There are some medicines that may affect how valproic acid works. Valproic acid can also affect the way other medicines work.
Tell your doctor if you're taking:
- 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
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