Divalproex

Key facts

• Divalproex releases valproic acid in the body once absorbed, a medicine that calms overactive nerve signaling. It is sold as delayed-release and extended-release tablets, often under the brand Depakote.
• It is usually taken once or twice daily with food to reduce stomach upset; doses are adjusted gradually based on response and blood levels.
• Valproate causes neural tube defects and other major birth defects when taken during pregnancy, along with lower IQ in children exposed in the womb. It is not used for migraine prevention in anyone who could become pregnant, and is avoided in epilepsy and bipolar disorder unless no other treatment works.
• Seek urgent care for yellowing skin or eyes, severe abdominal pain, or unusual bleeding or bruising.

What divalproex treats

Divalproex treats seizures in epilepsy, manic or mixed episodes of bipolar disorder, and it prevents migraine attacks. It does not stop a migraine that has already started.

How divalproex works

Divalproex is converted to valproic acid, which increases levels of GABA, a chemical that calms nerve cell firing in the brain. By enhancing this calming signal, it reduces the abnormal electrical activity that causes seizures, steadies mood in bipolar disorder, and lowers the frequency of migraine attacks.

Before you take it

• Do not take divalproex if you are pregnant or could become pregnant and have migraine, unless no other option controls your seizures or bipolar symptoms and you use effective contraception.
• Do not take it if you have a urea cycle disorder or significant liver disease.
• Tell your prescriber about a history of pancreatitis, bleeding disorders, or other seizure medicines, since these change monitoring or dosing.
• Combining divalproex with other sedating medicines or alcohol increases drowsiness; some antibiotics and blood thinners can also interact.

Side effects

Common effects include nausea, drowsiness, tremor, weight gain, and hair thinning.

Stop and seek urgent medical care for any of these:

• Yellowing of the skin or eyes, dark urine, or unusual fatigue, which can signal liver injury.
• Sudden, severe abdominal pain, which can signal pancreatitis.
• Unusual bruising or bleeding.
• Extreme drowsiness, confusion, or difficulty waking.

Safety essentials

• Valproate is teratogenic: it causes neural tube defects and other serious birth defects, and children exposed in the womb can have lower IQ. Anyone who could become pregnant needs reliable contraception and a discussion of the risks before starting.
• Divalproex can cause rare but fatal liver failure, most often in the first six months of treatment and especially in children under two; your prescriber checks liver function before you start and periodically afterward.
• Blood tests also monitor platelet counts and valproic acid levels, since both toxicity and effectiveness depend on staying in the right range.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.