Sodium valproate

Drug brand names

Sodium valproate may be supplied to you under the following names:

Uses

Sodium valproate is used to reduce the frequency and severity of seizures in people who experience epilepsy. It can be used for many types of seizure. Sodium valproate is also used to treat certain types of pain, migraine and bipolar disorders.

Side effects

(The list of side effects is not exhaustive, please refer to the patient information leaflet provided with the medication for more information).

Dose-related side effects become more likely the higher the dose of medication and improve if the dose is reduced again. These side-effects sometimes occur temporarily when the medication is started or as the dose is increased. These tend to include: nausea; vomiting, stomach ache and diarrhoea. Taking sodium valproate after food may help reduce these effects. These side-effects often settle within a few weeks, and please report to your GP/specialist team.

Other side effects are:

• gingival hyperplasia (tender/inflamed or painful gums and/or a build-up of plaque on the teeth)
• sleepiness, dizziness and sometimes difficulty concentrating
• tremor/shaking or feeling unsteady when walking
• feeling lethargic and shortness of breath
• headache, being agitated, having difficulty concentrating or having difficulty sleeping
• sudden bruising or bleeding
• skin problems such as rashes, blisters or flaking skin
• unusual movements to the arm, leg, facial or neck muscles
• thinning of the hair (usually reversible on stopping the drug); hair regrowth normally begins within six months although may become more curly than previously
• unusual eye movements
• menstrual cycle irregularities
• difficulty passing urine or passing urine too frequently
• all antiepileptic medication can cause feelings of depression, or severe mood changes. If you experience any of these please contact your specialist.
• Some patients will notice an increase in weight. The best way of dealing with this is to weigh yourself regularly on the same set of scales and if your weight starts to increase, discuss the options with your doctor. Regular exercise and balanced healthy diet is encouraged.

Serious side effects

Medically serious side effects are very rare but may affect the blood or the liver. Blood tests will be performed where appropriate.

The following side effects should be reported to a medical professional as soon as possible:

• yellowing of the skin or eyes
• feeling generally unwell along with reduced appetite and drowsiness which may also occur with vomiting and abdominal pain or oedema (fluid build-up causing swelling in the body)
• increase in seizure frequency
• severe abdominal pain, nausea and repeated vomiting
• unusual or unexplained bruising, bleeding, or a sore throat

In the event of any of the above serious side-effects contact the Epilepsy Specialist Nurse (contact details are at the end of this page), or your GP.

Pregnancy and contraception

Women of childbearing potential who are taking valproate must use effective contraception without interruption during the entire duration of treatment with valproate to avoid an unplanned pregnancy.

Talk to your GP, specialist or gynaecologist/obstetrician or midwife/professional at the hospital/family planning/sexual health clinic for advice on the method of contraception.

Make an urgent appointment with your GP or specialist if you think you are pregnant. Do not stop taking valproate until you have discussed this with your specialist even if you have become pregnant.

Consult your doctor if you are thinking about having a baby and do not stop using contraception until you and your specialist agree on what to do with your treatment.

You will need to review your treatment with your specialist regularly (at least once a year). During the annual visit your specialist will ask you to read and sign an Annual Risk Acknowledgement Form to make sure you know and have understood all the risks related to the use of valproate during pregnancy and the need to avoid becoming pregnant while taking valproate.

More details on avoiding pregnancy whilst on valproate will be provided to you by your specialist. Information can also be found here: here. (opens in a new tab)

The risks to your baby from sodium valproate include spina bifida and skull/ facial defects such as cleft lip. Others include defects of the urinary system, heart and the limbs, delayed early developments and low intelligence quotient (IQ). The risk depends on the dosage and whether or not you are also taking other antiepileptic medication with sodium valproate. We recommend you take folic acid 5mg daily from at least twelve weeks prior to conception until the end of week 12 of pregnancy in order to reduce this risk.

Sodium valproate is excreted into breast milk in small amounts. Consult your specialist if you wish to breastfeed whilst taking sodium valproate, who will advise you about how best to monitor your baby.

Drug interactions

Please let your doctor and pharmacist know that you are taking sodium valproate before starting to take any new medication. This includes medication acquired over the counter from a pharmacy, supermarket or health food shop.

Sodium valproate can affect how some medications work and can itself be affected by certain medications, therefore it is important for health professionals to know you are taking sodium valproate.

Other useful information

Sodium valproate can be taken with or without food. Taking with food may help to reduce side effects.

• Do not stop taking your medication without first consulting your specialist.
• If you've missed a dose, what you do next depends on whether you usually take your medicine once or twice a day. Do not take two doses at once.
  • Once a day - take the forgotten dose as soon as you remember. If it's within a few hours of the next dose, skip the missed dose and take your next dose as normal.
  • Twice a day - take the forgotten dose as soon as you remember. If it is within 2 hours of the next dose, skip the missed dose and take your next dose as normal.
• Store your medication in the packaging it comes in below 30C. There are many types of sodium valproate; ensure you check storage conditions for each type on your patient information leaflet (in the box).
• Keep a record of your seizures when you start any new medication. This will help to determine future drug dosages.

Contact details

If you have any questions or concerns, please contact the epilepsy nurse specialist on 01223 217992.

The information on this leaflet is not exhaustive. Please refer to the patient information leaflet prepared by the manufacturer of you drug which can be found in the medicine packaging.