Sodium Valproate
Pronunciation: pronunciation varies by local usage.
- Generic name
- sodium valproate
- Brand names
- Depacon, Epilim
- Drug class
- Anti-seizure (anti-epileptic) medicine
- Form
- Oral tablets (UK, Epilim) and intravenous injection (US, valproate sodium injection) were the two forms reviewed for this page. An oral syrup formulation is marketed in some countries but was not separately reviewed in this research pass.
- Route
- Oral (UK tablets reviewed) and intravenous (US injection reviewed)
- Legal status
- US and UK legal/dispensing classification was not specifically extracted from the sources reviewed for this page; this is an evidence gap.
Availability and supply rules vary by country
Trade names by country: United States · Canada
Australia: · Full directory
What sodium valproate is and how it works
Sodium valproate is an anti-epileptic medicine used to treat various types of seizures. This page reviews a UK oral tablet product (Epilim) and a US intravenous injection product used when oral administration is temporarily not possible; an oral syrup formulation is marketed in some countries but was not separately reviewed for this page. (1) (2)
The specific indication, formulation, dosing, and monitoring depend on the country and product. In some countries, valproate is also used for bipolar disorder and migraine prophylaxis, but those uses were not reviewed in this information source. Use in women and girls of childbearing potential is highly restricted due to significant fetal risks.
Mechanism of action: how sodium valproate works
No specific pharmacological information was extracted in this research. (1) (2)
What sodium valproate is used for
Epilepsy
Sodium valproate is used to treat various seizure types, including complex partial seizures, simple and complex absence seizures, and as adjunctive therapy for multiple seizure types including absence seizures. The intravenous injection is an alternative when oral valproate products cannot temporarily be used. (1) (2)
Before taking sodium valproate
Do not take / not appropriate for
- Tell your prescriber if you have significant liver disease or a history of hepatic dysfunction before starting sodium valproate. If you are already taking it and this applies to you, seek prompt medical advice — do not stop on your own, since the treating clinician needs to weigh the risks of continuing against the risks of stopping. (US injectable and UK oral-tablet products reviewed for this page (not verified for every valproate product worldwide)) (1) (2)
- Tell your prescriber if you have a known POLG mitochondrial disorder, or if you are the parent of a child under 2 years with suspected POLG-related disorder, before starting sodium valproate. If already taking it and this applies, seek prompt medical advice rather than stopping on your own. (US injectable and UK oral-tablet products reviewed for this page (not verified for every valproate product worldwide)) (1) (2)
- Tell your prescriber if you have a urea cycle disorder before starting sodium valproate. If already taking it and this applies, seek prompt medical advice rather than stopping on your own. (US injectable and UK oral-tablet products reviewed for this page (not verified for every valproate product worldwide)) (1) (2)
- Tell your prescriber if you have known hypersensitivity to valproate before starting. If already taking it and this applies, seek prompt medical advice rather than stopping on your own. (US injectable-label source (this contraindication was not separately extracted from the UK SmPC in this pass)) (1)
- Pregnancy and childbearing-potential restrictions differ by country and indication in the sources reviewed for this page. In the US injectable-label source, pregnancy and childbearing-potential contraindication is specific to migraine-prophylaxis use. In the UK oral-tablet source, valproate is contraindicated in pregnancy unless a specialist determines no other effective treatment is appropriate, and women/girls under 55 require the UK Pregnancy Prevention Programme (two independent specialists' approval, a negative pregnancy test, effective contraception, and annual review) before starting. If you are pregnant, could become pregnant, or are under this programme, this is a decision for your specialist team, not a self-directed choice. (varies by country and indication — see text) (1) (2)
Tell your clinician about
- All current medical conditions, especially liver problems, mitochondrial disorders, pancreatitis, or bleeding problems.
- All medicines you take, including other seizure medicines, antibiotics (especially carbapenems), aspirin, oral contraceptives, topiramate, lamotrigine, phenytoin, or phenobarbital.
- If you are pregnant, planning pregnancy, or breastfeeding.
- Any new or unusual symptom, especially anything that could suggest liver trouble, severe abdominal pain, suicidal thoughts, or unusual bleeding/bruising.
- If you have a history of allergic reaction to valproate.
- If you are under 2 years of age (heightened liver-risk evaluation applies) or elderly (closer monitoring of somnolence and fluid/nutritional intake applies).
How to take sodium valproate
- Sodium valproate is taken by mouth as tablets, or given by intravenous infusion, depending on the product and the clinical situation. Whether IV administration is always given in a hospital setting was not specifically established in the sources reviewed for this page.
- Oral tablets must be swallowed whole; do not crush or chew.
- Intravenous infusions are administered over 60 minutes at a rate not exceeding 20 mg/min.
- Dosing is individualised based on weight, age, seizure type, and response. Contact your prescriber before changing the dose or stopping the medicine — let them advise on how any change should be made.
- Ask your prescriber about the blood-test monitoring schedule that applies to you — the sources reviewed describe baseline and periodic liver function, blood count, and valproate-level checks as part of clinician-directed monitoring, not a fixed universal schedule.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2)
Missed dose
No specific missed-dose protocol was established in the sources reviewed for this page. Contact your prescriber for individual instructions if you miss a dose.
Overdose
If too much valproate may have been taken, seek emergency medical attention immediately. Specific overdose-management protocol details were not established in the sources reviewed for this page beyond the general boxed-warning risk information; this is an evidence gap. (1) (2)
Side effects
Adverse effects vary. Common effects include gastrointestinal, neurological, and metabolic complaints. Serious risks include liver damage, pancreatitis, and fetal harm.
Nausea and vomiting
What to notice: Feeling sick or being sick, which may be common especially at the start of treatment.
What to do: Inform your prescriber if severe or persistent. (1) (2)
Tremor and somnolence
What to notice: Shakiness, drowsiness, or feeling of sleepiness.
What to do: Report if troublesome. A specific driving/machinery-operation caution was not established in the sources reviewed for this page. (1) (2)
Dizziness and ataxia
What to notice: Feeling unsteady or having coordination problems.
What to do: Inform your prescriber if this interferes with daily activities. (1) (2)
Weight gain
What to notice: Increase in body weight, which may be marked and progressive.
What to do: Monitor weight regularly. Discuss dietary and lifestyle measures with your prescriber. (1) (2)
Hair loss (alopecia)
What to notice: Thinning of hair or hair loss, often reversible.
What to do: Inform your prescriber; it is usually not permanent. (1) (2)
Headache
What to notice: General head pain.
What to do: Consult your prescriber if severe or persistent. (1)
Abdominal pain
What to notice: Stomach discomfort.
What to do: Report to prescriber, especially if severe or accompanied by nausea/vomiting. (1)
Diplopia (double vision)
What to notice: Seeing two images of one object.
What to do: Inform your prescriber. (1)
Emotional lability
What to notice: Rapid mood changes or emotional instability.
What to do: Discuss with prescriber if distressing. (1)
Thrombocytopenia (low platelets)
What to notice: Unexplained bruising or bleeding.
What to do: Report immediately to your prescriber. Whether further blood testing is needed is a decision for the prescriber. (1)
Injection-site reactions (IV form)
What to notice: Pain, redness, or inflammation at the injection site.
What to do: Inform healthcare provider if bothersome. (1)
Signs of liver damage
What to notice: A detailed symptom checklist was not established in the sources reviewed for this page.
What to do: Seek immediate medical assessment for any new or unusual symptom; liver damage can be fatal if not caught early. (1) (2)
Signs of pancreatitis
What to notice: Abdominal pain or vomiting are the specific symptoms the sources reviewed for this page link to evaluation for pancreatitis; a complete symptom checklist was not established.
What to do: Seek urgent medical evaluation. Pancreatitis can be life-threatening and may occur at any time during treatment. (1) (2)
Suicidal thoughts or behaviour
What to notice: Suicidal ideation and behaviour. A more detailed symptom catalogue was not established in the sources reviewed for this page.
What to do: Contact your prescriber immediately or seek emergency help if you have suicidal thoughts or behaviour. (2)
Hyperammonemia
What to notice: Confusion, lethargy, vomiting, or changes in mental status, especially with topiramate co-administration.
What to do: Report to prescriber promptly; ammonia levels may need to be checked. (1)
Serious warnings
Hepatotoxicity — emergency
Symptoms: A detailed symptom checklist was not established in the sources reviewed for this page.
Action: Seek immediate medical attention for any new or unusual symptom. Liver damage can be fatal; the US source identifies children under 2 years and the UK source identifies children under 3 years as at particularly elevated risk. The US source identifies particular risk during the first 6 months of treatment; the UK source recommends liver monitoring during that period. (1) (2)
Pancreatitis — emergency
Symptoms: Abdominal pain or vomiting are the specific symptoms the sources reviewed for this page link to evaluation for pancreatitis; a complete symptom checklist was not established.
Action: Seek immediate medical attention if these symptoms occur. Pancreatitis can be life-threatening and may occur at any time during treatment. (1) (2)
Fetal harm — high
Symptoms: Valproate can cause severe birth defects and developmental problems in babies exposed during pregnancy. It is not an emergency for the patient, but pregnancy must be avoided.
Action: If you are pregnant or planning pregnancy, seek medical attention promptly and discuss urgently with your specialist. Let the clinician you see advise on whether to continue or stop the medicine. (1) (2)
Suicidal thoughts and behaviour — high
Symptoms: Suicidal ideation and behaviour. A more detailed symptom catalogue was not established in the sources reviewed for this page.
Action: Contact your prescriber immediately or seek emergency help if you have suicidal thoughts or behaviour. (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Enzyme-inducing antiepileptics (phenytoin, carbamazepine, phenobarbital, rifampin) | These medicines increase valproate clearance, potentially lowering its levels and reducing seizure control. | Tell your prescriber about all of these medicines you take. Valproate-level monitoring and any dose adjustment are decisions for the prescriber, not for you to make on your own. (1) |
| Felbamate | Felbamate increases valproate concentrations by 35-50%. | Tell your prescriber if felbamate is being considered or used. Any valproate dose change is a decision for the prescriber. (1) |
| Aspirin | Aspirin decreases valproate's protein binding, increasing the free (unbound) valproate fraction up to fourfold. | Tell your prescriber before using aspirin so they can review whether closer monitoring or a different approach is needed. (1) |
| Carbapenem antibiotics | These antibiotics can reduce serum valproate concentrations, sometimes to subtherapeutic levels. | Tell your prescriber if a carbapenem antibiotic is being considered so they can review valproate monitoring and treatment options. (1) |
| Estrogen-containing contraceptives | These may decrease valproate levels. | Tell your prescriber if you use or plan to use estrogen-containing contraceptives, so they can monitor seizure control and decide whether any dose adjustment is needed. (1) |
| Topiramate | Co-administration is associated with hyperammonemia, encephalopathy, and hypothermia. | Seek prompt medical assessment for any symptom of confusion, lethargy, vomiting, or mental-status change if you take both medicines. Whether ammonia-level testing is needed is a decision for the assessing clinician. (1) |
| Lamotrigine | Valproate increases lamotrigine's half-life by approximately 165%, raising lamotrigine levels. | Tell your prescriber if you take lamotrigine. Any lamotrigine dose change is a decision for the prescriber, based on this interaction. (1) |
| Phenytoin | Valproate increases phenytoin's free fraction by approximately 60%. | Tell your prescriber if you take phenytoin. Phenytoin-level monitoring and any dose change are decisions for the prescriber. (1) |
| Phenobarbital | Valproate increases phenobarbital's half-life by approximately 50%. | Tell your prescriber if you take phenobarbital and seek prompt medical attention for excess drowsiness. Any phenobarbital dose change is a decision for the prescriber. (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Children and adolescents
The US source identifies children under 2 years, and the UK source identifies children under 3 years, as at particularly elevated risk of severe liver damage. Children under 2 years with a suspected POLG-related disorder should not receive valproate. Dosing must be individually determined by the treating clinician. (1) (2)
Pregnancy and childbearing potential
Valproate is extremely teratogenic with a high risk of major malformations and neurodevelopmental disorders. Use in women of childbearing potential is restricted and requires specialist review and effective contraception. If pregnancy occurs, seek urgent medical advice promptly and let the specialist you see advise on whether to continue or stop valproate. (1) (2)
Elderly
The sources reviewed for this page support monitoring elderly patients for somnolence and fluid/nutritional intake; whether elderly patients require lower doses was not specifically established. (1)
Mitochondrial disorders
Valproate is contraindicated in patients with known POLG mutations, and in children under 2 years with a suspected POLG-related disorder. Whether general screening is needed before starting treatment in all children under 2 was not specifically established in the sources reviewed for this page. (1) (2)
Women and girls under 55 in the UK
In the UK, valproate is only used in this group when no other effective treatment is available, and requires compliance with the Pregnancy Prevention Programme, including two independent specialists' documented approval, a negative pregnancy test before starting, effective contraception throughout treatment, and annual specialist review. (2)
Breastfeeding
Breastfeeding is a separate question from pregnancy, and the sources do not treat the two the same way: nothing here reduces the pregnancy risks of valproate described above, which remain severe and are governed by the pregnancy-prevention requirements. On breastfeeding specifically, the US valproate sodium label states that valproate is excreted in human milk at concentrations of 0.4 to 3.9 mcg/mL, corresponding to 1% to 10% of maternal serum levels, that serum concentrations in breastfed infants aged 3 days to 12 weeks were 1% to 6% of maternal levels, and that a published study in children up to six years of age did not report adverse developmental or cognitive effects after exposure through breast milk; there are no data on effects on milk production. The label advises weighing the developmental and health benefits of breastfeeding against the mother's clinical need for valproate, and monitoring the breastfed infant for signs of liver damage including jaundice and unusual bruising or bleeding, noting that hepatic failure and clotting abnormalities have been reported in the offspring of women who used valproate during pregnancy. LactMed states that valproic acid levels in breast milk are low, that infant serum levels range from undetectable to low, that breastfeeding during valproate monotherapy does not appear to adversely affect infant growth or development, and that if valproate is required by the mother it is not a reason to discontinue breastfeeding, with the same monitoring for jaundice and unusual bruising or bleeding. Do not change or stop valproate on the basis of this page: the specialist who prescribes it decides. (1)
Monitoring
Before starting
- Baseline liver function tests, then frequently during the first 6 months of treatment.
- Blood counts and coagulation studies before therapy and periodically thereafter.
- Valproate plasma concentration monitoring (therapeutic range 50-100 mcg/mL) as needed.
- Clinical assessment for signs of pancreatitis, suicidal ideation, and hyperammonemia.
During treatment
- Continue periodic liver function tests, especially in the first 6 months.
- Monitor valproate levels and adjust dose under specialist guidance.
- Be alert for signs of pancreatitis, suicidal behaviour, or hyperammonemia, especially with co-administered topiramate.
- In pregnancy, prenatal diagnostic testing for neural tube defects and monitoring of clotting parameters if valproate use continues.
Storage
Specific storage conditions were not established in the sources reviewed for this page. Follow the applicable product package instructions.
Study the drug class: Antiepileptics · Mood stabilisers
Professional information
Clinician-facing context only. This draft does not replace the full prescribing information or country-specific clinical guidelines.
US (IV formulation)
Indication: Complex partial seizures (monotherapy or adjunctive, adults and children ≥10 years)
Dose summary: Initial 10-15 mg/kg/day; increase by 5-10 mg/kg/week; maximum 60 mg/kg/day. Administer as a 60-minute IV infusion at a rate not exceeding 20 mg/min.
Renal context: No renal dose adjustment data was extracted in this research. (1)
US (IV formulation)
Indication: Absence seizures
Dose summary: Initial 15 mg/kg/day; increase by 5-10 mg/kg/week; maximum 60 mg/kg/day. IV infusion as above.
Renal context: No data extracted. (1)
UK (oral tablets, Epilim)
Indication: Epilepsy (generalised, partial, or other)
Dose summary: Adults: initial 600 mg daily, increased by 200 mg every 3 days; usual range 1000-2000 mg/day, may increase to 2500 mg/day. Tablets must be swallowed whole.
Renal context: No data extracted. (2)
Hepatic guidance
No specific hepatic impairment dosing was extracted; use in hepatic disease is contraindicated.
Overdose note
No specific overdose-management protocol was established in the sources reviewed for this page beyond the general boxed-warning risk information; this is an evidence gap. (1) (2)
Frequently asked questions
Can I take sodium valproate if I am pregnant?
Valproate can cause serious birth defects and developmental problems in a pregnancy, and pregnancy-related restrictions differ by country and indication (see special populations above). If you are pregnant or planning pregnancy, seek medical attention promptly and discuss with your specialist immediately — let them advise on whether to continue or stop valproate. (1) (2)
What are the signs of liver problems?
A detailed symptom checklist was not established in the sources reviewed for this page. Contact your doctor immediately about any new or unusual symptom, since liver damage is a serious risk of this medicine, especially in the first 6 months of treatment. (1) (2)
Is it safe to use in children?
Valproate can be used in children with epilepsy, but the US source identifies children under 2 years, and the UK source identifies children under 3 years, as at particularly elevated risk of severe liver damage. Careful monitoring and specialist oversight are essential. (1) (2)
Can I take other medicines with valproate?
Many medicines interact with valproate, including other seizure medicines, antibiotics, aspirin, and oral contraceptives. Always tell your prescriber about all medicines you take. (1)
What is the mechanism of action of sodium valproate?
No specific pharmacological information was extracted in this research. (1) (2)
References
- Valproate Sodium Injection — prescribing informationU.S. Food and Drug Administration · United States · accessed 2026-08-05 · source 1
- Epilim 500 mg Gastro-resistant Tablets — Summary of Product Characteristicselectronic Medicines Compendium (UK) · United Kingdom · accessed 2026-08-05 · source 2
- VALPROATE SODIUM INJECTION, SOLUTION [SAGENT PHARMACEUTICALS] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 3
- Valproic Acid — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 4
- Valproate Sodium — FDA approval record (Drugs@FDA ANDA076539)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 5
- valproate — RxNorm normalized drug concept (RXCUI 40254)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 6
Brand names by country
Single-ingredient sodium valproate names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Divalproex Sodium500 [hp_C], 6 [hp_C], 200 [hp_C], 30 [hp_C], 1 [hp_M], 12 [hp_C], 100 [hp_C], 1 [hp_Q] · hahnemann laboratories, inc.
Canada
- DIVALPROEX
- EPIVAL
- DEPAKENE
- APO-DIVALPROEX
- TEVA-DIVALPROEX
- PMS-DIVALPROEX
- DOM-DIVALPROEX
- MYLAN-DIVALPROEX
- NOVO-VALPROIC
- RATIO-VALPROIC