Implementation

• Do not confuse Depakote ER and regular dose forms. Depakote ER produces lower blood levels than Depakote dosing forms. If switching from Depakote to Depakote ER, increase dose by 8-20%

» Single daily doses are usually administered at bedtime because of sedation

• PO: Administer with or immediately after meals to minimize GI irritation. Extended-release and delayed-release tablets should be swallowed whole, do not break or chew; will cause mouth or throat irritation and destroy extended release mechanism. Do not administer tablets with milk or carbonated beverages (may cause premature dissolution). Delayed-release divalproex sodium may cause less GI irritation than valproic acid capsules

» Shake liquid preparations well before pouring. Use calibrated measuring device to ensure accurate dosage. Syrup may be mixed with food or other liquids to improve taste

» Sprinkle capsules may be swallowed whole or opened and entire capsule contents sprinkled on a teaspoonful of soft, cool food (applesauce, pudding). Do not chew mixture.Administer immediately; do not store for future use

» To convert from valproic acid to divalproex sodium, initiate divalproex sodium at same total daily dose and dosing schedule as valproic acid. Once patient is stabilized on divalproex sodium, attempt administration 2–3 times daily

• Rect: Dilute syrup 1:1 with water for use as a retention enema

• Intermittent Infusion:

Diluent: May be diluted in at least 50 ml of D5W, 0.9% NaCl, or LR. Solution is stable for 24 hr at room temperature
Concentration: 2 mg/ml.

• Rate:
Infuse over 60 min (<=20 mg/min). Rapid infusion may cause increased side effects. Has been given as a one-time infusion of 1000 mg over 5-10 min @ 3 mg/kg/min up to 15 mg/kg in patients with no detectable valproate levels

VALPROATES is a sample topic found in Davis's Drug Guide. All other sections of this record are viewable by clicking on the index in the left column, or by clicking on "Display all Sections" in the "Content Manager".

To find other Davis's Drug Guide topics, please login or purchase a subscription.