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Medicines > classes: [[:Category:Mood_stabilizers|Mood stabilizer]] & routes: rectal (off-label use of injection)

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generic:
Valproate (valproic acid, divalproex sodium, sodium valproate) (1)
brand:
Depakote, Depakote ER, Depakene, Depacon (IV) (1)
classes: (Click arrow to add another value)
mechanism:
'"`UNIQ--vote-00000975-QINU`"' Hyperammonemic encephalopathy (consider in any unexplained CNS depression), thrombocytopenia, and polycystic ovary syndrome are characteristic chronic-use adverse effects beyond hepatic and pancreatic risks'"`UNIQ--ref-00000976-QINU`"'. (1)
uses:
'"`UNIQ--vote-00000977-QINU`"', '"`UNIQ--vote-00000978-QINU`"', '"`UNIQ--vote-00000979-QINU`"', '"`UNIQ--vote-0000097A-QINU`"', '"`UNIQ--vote-0000097B-QINU`"' (1)
starting dose:
Seizures: 10-15 mg/kg/d divided BID-TID, titrate to therapeutic level (50-100 mcg/mL); bipolar mania: 750 mg/d divided, titrate (1)
preparations:
125, 250, 500 mg delayed-release tablets (Depakote); 250, 500 mg ER tablets (Depakote ER); 125, 250 mg sprinkle capsules; 250 mg/5 mL syrup; 500 mg IV (Depacon) (1)
fda max:
60 mg/kg/d (typically up to 3000 mg/d) (1)
routes: (Click arrow to add another value)
onset:
Anticonvulsant effect within days; mood-stabilizing effect 1-3 weeks (1)
duration:
12 hours (IR); 24 hours (ER) (1)
halflife:
9-16 hours'"`UNIQ--ref-0000097C-QINU`"' (1)
bioavailability:
~100% (oral); highly (~90%) protein-bound, with non-linear binding above therapeutic levels (free fraction matters clinically in hypoalbuminemia)'"`UNIQ--ref-0000097D-QINU`"' (1)
pregnancy:
'''Contraindicated for migraine prophylaxis in pregnancy; high teratogenic risk''' (neural tube defects, craniofacial anomalies, cardiac defects, cognitive/IQ impairment); avoid in women of childbearing potential without reliable contraception when alternatives exist'"`UNIQ--ref-0000097E-QINU`"' (1)
legal:
[[USLegal:Prescription only|Rx-only]] in US. Carries '''Boxed Warnings''' for hepatotoxicity (especially children <2 with metabolic disorders), teratogenicity, and pancreatitis'"`UNIQ--ref-0000097F-QINU`"' (1)

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