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EPILIM (SODIUM VALPROATE) - a patient's guide
Natalie Gauld - Pharmacy Educator
USE: Epilepsy, mania
Sodium valproate (val-pro-ate) is used for epilepsy, including
generalised and partial. Sodium valproate is also used for
mania (a condition in which a person is very excited, agitated,
talking quickly, sleeping little and with expansive ideas).
Sodium valproate has been used for prevention of migraine,
and pain conditions including trigeminal neuralgia. Usually
the medicine is started as a low dose and gradually increased
to get the best benefit.
Epilim comes in a cherry flavoured liquid or syrup, chewable
tablets or enteric-coated tablets. The syrup contains regular
sugar (sucrose) and artificial sweeteners, the liquid contains
artificial sweeteners.
Cautions:
Sodium valproate must not be used in people with:
Allergy to sodium valproate
Current liver problems
Family history of severe liver problems, especially from
medicines
Porphyria
A urine test for diabetes may show positive if using sodium
valproate even if the person tested is not actually diabetic.
Special care needs to be taken with children - especially
under 3 years of age, or those with brain disease, severe
seizure disorders with mental retardation, congenital disorders
(health problems since newborn), or on other epilepsy medicines.
A lower dose may be needed if kidneys are not working
properly.
Side effects:
Like all medicines, sodium valproate can have side effects.
Most people will not get these problems:
Most commonly stomach effects can occur, especially when
starting the medicine. The enteric-coated tablets are designed
to stay intact in the stomach and not dissolve until they
get to the intestine, so can reduce the stomach effects.
The liquid, syrup or chewable tablets can be taken with
meals.
Liver effects - watch for weakness, lethargy (lying around
not wanting to do anything), tiredness or drowsiness, generally
feeling unwell, vomiting, stomach pain, not wanting to eat,
jaundice (person looks yellow) - these symptoms would usually
happen suddenly.
Can prolong bleeding time - if bruising without a cause
or bleeding occurs talk immediately to your doctor.
Skin rash (talk to the doctor immediately).
Sedation - usually is only temporary as the body gets
used to the medicine. Some people will become more alert
instead.
Tremor or lack of coordination (occasionally with high
dose).
Increased appetite and increase in weight.
There are other less common side effects which are not
listed above. If the dose is too high to start with or is
increased too fast there can be a higher chance of side
effects. Talk to your doctor if you think you may have any
of these side effects or other symptoms.
Interactions:
Possible interactions include:
Neuroleptics (e.g. chlorpromazine), antidepressants and
benzodiazepines (e.g. diazepam, some sleeping tablets)
Other epilepsy medicines - phenobarbitone, phenytoin,
primidone, carbamazepine, lamotrigine
Zidovudine
Warfarin
Felbamate
Cimetidine (stomach medicine)
Erythromycin (antibiotic)
Mefloquine (malaria preventer)
Cholestyramine (for cholesterol)
Aspirin
Sodium valproate is not thought to interact with the oral
contraceptive pill.
Patient information:
Follow the instructions on the label of the medicine or
as directed by your doctor.
If the following symptoms occur, talk immediately to a
doctor: weakness, lethargy (lying around not wanting to
do anything), tiredness or drowsiness, vomiting, stomach
pain, not wanting to eat, jaundice (person looks yellow).
These symptoms could be from a liver problem caused by the
medicine.
Talk immediately to a doctor if you get a skin rash (and
mention that you are taking this medicine).
The tablets take on moisture from the air so it is important
that they are left sealed in the foil until taken.
The sodium valproate liquid should not be mixed with other
fluid.
If drowsy or less alert do not drive or operate machinery.
If being prescribed other medicines or buying medicines
from a pharmacy or supermarket check that they will not
interfere with sodium valproate.
Do not stop taking this medicine without your doctor's
advice.
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