Epilepsy, Mania, Chronic Headache
fatty acid with anticonvulsant properties
The active ingredient is Sodium Valproate which shows antiepileptic properties in various types of seizures. The exact mechanism of Sodium Valproate is not yet established. However it is suggested that its activity is related to increased brain levels of Gama Amino Butyric Acid (GABA).
Adults: Initial: 600mg/day in 2 divided doses, preferably after food. Dose may be increased by 200mg/day at 3 days interval to a maximum of 2.5g daily in divided doses until control of seizure is achieved. Maintenance dose: Usually 1-2g daily (20-30 mg/kg daily). Children (up to 20kg): Initial: 20mg/ kg daily in divided doses. Dose may be increased in severe cases with proper monitoring of plasma concentration. Children (over 20kg): Initial: 400mg/ day (irrespective of weight). Dose may be increased by 20-30 mg/kg if required to achieve control.
Sodium Valproate is a non specific inhibitor of drug metabolism. Phenobarbital, Phenytoin, Warfarin, Aspirin etc. interacts with Sodium Valproate
Sodium valproate is contra-indicated in patients with known hypersensitivity of sodium valproate, personal or family history of severe active liver disease hepatic dysfunction, porphyria & known urea cycle disorder.
Gastric irritation, nausea, ataxia & tremor; hyperammonaemia, increased appetite & weight gain; transient hair loss, oedema, thrombocytopenia, & inhibition of platelet aggregation, impaired hepatic function leading rarely to fetal hepatic failure; rashes; sedation; rarely lethargy & confusion & also increased alertness; rarely pancreatitis, leucopenia, pancytopenia, red cell hypoplasia, fibrinogen reduction; irregular periods, amenorrhoea, gynaecomastia, toxic epidermal necrolysis, hearing loss, Fancoli’s syndrome, dementia, Steven’s-Johnson syndrome, & vasculitis have also been reported.
Overdosage with valproate may result in somnolence, heart block, deep coma, and hypernatremia. Fatalities have been reported; however patients have recovered from valproate serum concentrations as high as 2120 mcg/mL. In overdose situations, the fraction of drug not bound to protein is high and hemodialysis or tandem hemodialysis plus hemoperfusion may result in significant removal of drug. General supportive measures should be applied with particular attention to the maintenance of adequate urinary output. Naloxone has been reported to reverse the CNS depressant effects of valproate overdosage. Because naloxone could theoretically also reverse the antiepileptic effects of valproate, it should be used with caution in patients with epilepsy.
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
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