Divalproex
Brand names: DIVALPROEX SODIUM, DIVALPROEX SODIUM DELAYED-RELEASE, DIVALPROEX SODIUM EXTENDED-RELEASE, Depakote, Divalproex Sodium, Divalproex Sodium Delayed Release, Divalproex Sodium Extended Release, Divalproex Sodium Extended-Release, Divalproex SodiumDelayed-Release, Divalproex sodium, divalproex sodium
Warnings
BOXED WARNING describing three life-threatening risks. Hepatotoxicity: "hepatic failure resulting in fatalities has occurred... usually during the first six months of treatment," with children under two and patients with mitochondrial disorders at greatest risk. Fetal risk: "valproate can cause major congenital malformations, particularly neural tube defects" and "decreased IQ scores and neurodevelopmental disorders following in utero exposure," so it should not be used for migraine prophylaxis in pregnant women or those of childbearing potential unless no alternative is acceptable. Pancreatitis: "life-threatening pancreatitis... some described as hemorrhagic with rapid progression from initial symptoms to death." Contraindicated in hepatic disease, known urea cycle disorders, known POLG-related mitochondrial disorders, and in pregnancy for migraine prevention.
Uses
Divalproex sodium is indicated for: "treatment of the manic episodes associated with bipolar disorder," "monotherapy and adjunctive therapy of complex partial seizures" and simple and complex absence seizures, and "prophylaxis of migraine headaches."
Dosage forms & strengths
All identified pills
MYLAN 8008
PURPLE;WHITE CAPSULE · Divalproex
2 manufacturers
NR
ORANGE OVAL · Divalproex
NS
PURPLE OVAL · Divalproex
NT
PINK OVAL · Divalproex
R 533
WHITE ROUND · Divalproex
7 manufacturers
R 534
GRAY OVAL · Divalproex
9 manufacturers
R529
BROWN CAPSULE · Divalproex
R530
YELLOW CAPSULE · Divalproex
R531
PINK CAPSULE · Divalproex
THIS END
WHITE CAPSULE · Divalproex
4 manufacturers
THIS END
BLUE;WHITE CAPSULE · Divalproex
THIS END
WHITE;BLUE CAPSULE · Divalproex
2 manufacturers
U S
PINK OVAL · Divalproex
5 manufacturers
U S
PINK OVAL · Divalproex
10 manufacturers
U S
PINK OVAL · Divalproex
8 manufacturers
U S
PINK OVAL · Divalproex
UL 250
PINK OVAL · Divalproex
14 manufacturers
UL 500
PINK OVAL · Divalproex
14 manufacturers
UL 125
ORANGE OVAL · Divalproex
5 manufacturers
W 724
WHITE OVAL · Divalproex
5 manufacturers
W 725
GRAY OVAL · Divalproex
3 manufacturers
W725
GRAY OVAL · Divalproex
4 manufacturers
W974
WHITE OVAL · Divalproex
2 manufacturers
W975
WHITE OVAL · Divalproex
2 manufacturers
Watson 667
RED OVAL · Divalproex
ZA06
WHITE OVAL · Divalproex
4 manufacturers
ZA07
WHITE OVAL · Divalproex
4 manufacturers
ZA08
WHITE OVAL · Divalproex
3 manufacturers
ZA47
WHITE CAPSULE · Divalproex
4 manufacturers
ZA48
WHITE CAPSULE · Divalproex
5 manufacturers
ZA66 125mg
BLUE;WHITE CAPSULE · Divalproex
8 manufacturers
a NT
PINK OVAL · Divalproex
a NR
ORANGE OVAL · Divalproex
5 manufacturers
a HF
WHITE OVAL · Divalproex
5 manufacturers
a NS
PURPLE OVAL · Divalproex
4 manufacturers
a HC
GRAY OVAL · Divalproex
7 manufacturers
dsp 125
BLUE CAPSULE · Divalproex
WHITE CAPSULE · Divalproex
WHITE OVAL · Divalproex
BLUE OVAL · Divalproex
BROWN OVAL · Divalproex
Side effects
Most common adverse reactions, reported in 15% or more of patients in at least one indication, include "abdominal pain, alopecia, asthenia, diarrhea, diplopia, dizziness, headache, infection, insomnia, nausea, somnolence, thrombocytopenia, tremor, vomiting." Other notable risks include hyperammonemia and, as with other antiepileptic drugs, increased risk of suicidal thoughts or behavior.