7 Important Facts About Divalproex

1. Divalproex is Approved to Treat Three Different Conditions

Divalproex is an anti-seizure medication that has been approved by the FDA to treat various medical conditions. This includes treatment for seizures in two specific patient populations.

The approved indications for divalproex include:

• Treatment of bipolar disorder, specifically for acute manic episodes.
• Prevention of migraine headaches when an individual does not respond to therapies that typically resolve a migraine when it occurs.
• Use as an additional medication for patients who experience multiple types of seizures that include absence seizures.
• Use as an individual or additional medication for management of simple or complex absence seizures as well as complex partial seizures.
  • Absence seizures are seizures that present as period where an individual is no longer aware of their surroundings or responsive to external stimuli.
  • Primary generalized seizures with tonic-clonic manifestations present more obviously with both tonic (a “stiffening” of the body) and clonic (a twitching of jerking of muscles) activity.

Learn more about Types of Seizures

2. Divalproex Works By Balancing The Brain’s Electrical Activity

Seizures are caused by a dysregulation of electrical activity in the brain. Therefore, seizure treatment should be tailored toward preventing this dysregulation and/or stopping it once it has begun. Most antiepileptic medications work to counteract this uncontrolled activity in the brain.

Divalproex works to stabilize the brain against uncontrolled electrical activity. Though the exact mechanism is unknown, it is thought to be due to the medication causing an increase in a chemical that causes a reduction in excitation and therefore a reduction in this electrical activity.

Epilepsy is a condition in which you have had two or more unprovoked seizures. With this condition, people are typically on anti-seizure medications, such as divalproex, for the rest of their life. This is because seizures can be dangerous, and preventing this uncontrollable electrical activity is necessary when you don’t know when they will be provoked.

3. There Are 7 Common Side Effects of Divalproex

There are a number of possible side effects that can be experienced when taking divalproex. While not everyone experiences any or all of the possible side effects, some of them are relatively common. It is important for you to be aware of the possible changes to your body that may occur when you start a new medication. The most common side effects experienced when taking divalproex include:

• Nausea
• Vomiting
• Thrombocytopenia—a lowering of the platelets in your blood. Platelets are required for blood clotting when you bleed, and therefore it can be serious when your platelets are too low.
• Drowsiness
• Dizziness
• Tremor
• Weakness

It is important to speak with your healthcare provider if you experience any side effects when taking divalproex.

4. Use of Divalproex Comes With Serious Risks

Sometimes topiramate can cause changes or damage to the brain. This is sometimes called “encephalopathy” which refers to any change to the function or physical structure to the brain. Symptoms of encephalopathy include:

Liver failure

• Serious liver failure, sometimes resulting in death, has occurred in some patients receiving divalproex. Individuals with previous liver disease, those who are on multiple anti-seizure medications, children, and those with mitochondrial disease are at highest risk. This most typically occurs within the first 6 months of medication administration, so this is the timeframe in which there should be the most monitoring.
• Mitochondrial disease—Individuals who know they have mitochondrial disease should not take divalproex. This is because these people are at greater risk of liver failure as well as death.
• It is therefore important to have your blood levels checked throughout the first 6 months of divalproex therapy to ensure your liver is functioning properly.

Pancreatitis (inflammation of your pancreas)

• Life-threatening inflammation of the pancreas has occurred in some individuals receiving divalproex. This condition can occur at any point of medication therapy, and therefore should always be monitored for. The symptoms of pancreatitis typically include new abdominal pain, nausea, and vomiting.

Read about Risk of Seizures vs Risk of Seizure Medications

5. You Can Not Take Divalproex if You Are Pregnant or Planning to Become Pregnant

Many anti-seizure medications should not be taken during pregnancy due to the possible risk of adverse effects to the fetus. However, with divalproex this risk is so severe that is not usually considered a treatment option at all in women of childbearing potential, in order to eliminate the risk of pregnancy completely. This is because divalproex is very similar to another medication, valproic acid, which can be very toxic to the growing fetus. There is therefore a very high risk of both physical and neurological defects occurring in the fetus when divalproex is taken by a mother during pregnancy.

If there is no safe and effective alternative for epilepsy treatment, divalproex can be considered in women as long as she consents to the conditions of the pregnancy prevention program (PPP). This program includes but is not limited to, ensuring that the patient:

• is educated on and understands the severe risks to the fetus if pregnancy were to occur
• undergoes a pregnancy test before divalproex is started and throughout pregnancy when required (ie: following a missed period)
• is counselled on and agrees to comply with appropriate contraception/pregnancy prevention
• agrees to urgently consult their physician if they become pregnant or suspect pregnancy
• agrees to speak with their healthcare provider about alternative treatment options if they decide they would like to become pregnant in the near future.

When divalproex is prescribed to female children, it also must be ensured that the child immediately tell their parent/caregiver when they experience their first menstrual period. Their medication management must then immediately be reassessed with their healthcare provider.

6. Certain Medications Should Not be Taken at the Same Time as Divalproex

Due to the specific way in which divalproex is metabolized in the body, it must be used cautiously with certain medications that are metabolized in similar ways. If both medications use the same metabolism processes, it can sometimes lead to the body favouring one medication over the other. This then results in an increase or decrease in one or both of the medications in the blood, leading to ineffective or toxic effects. Medications that have this effect when combined with divalproex include aspirin, ritonavir, carbamazepine, warfarin, amitriptyline, and certain antibiotics. It is therefore important to check medication levels when starting divalproex or certain other new medications to ensure they stay at therapeutic levels.

There are also certain medications that can lead to dangerous side effects when used in combination with divalproex. These combinations should therefore be avoided. These include:

Phenobarbital

Some reports of coma have been reported following coadministration of divalproex and phenobarbital.

Lamotrigine

There have been serious skin reactions reported following coadministration of lamotrigine and divalproex. These include Stevens-Johnson syndrome and Toxic Epidermal Necrolysis. Both conditions are serious and can be life threatening. It is therefore essential to monitor yourself for fever and/or rash during coadministration of these medications.

Topiramate

Coadministration of divalproex with topiramate increases the risks of a number of adverse effects. For example, combination of the medications has been associated with higher risk of developing brain damage as well as increased risk of hypothermia (decreased body temperature).

7. At Marley Drug, You Can Get Your Divalproex Prescription For Less Than $6 Per Month

At Marley Drug, you can save money by buying your divalproex prescription in a longer supply. A 6-month supply of the medication would cost you $37, or a full 12-month supply only $70. This adds up to less than $6 per month!

Since divalproex is typically taken long-term, it is both convenient and cost-effective to buy your medication in longer supply. You are not only able to reduce the frequency of trips to the pharmacy, but you also avoid paying multiple pharmacy dispensing fees from multiple prescription pickups throughout the year.

We are able to price our prescriptions this way because we buy our medications from accredited wholesalers rather than insurance companies. This way, we are able to bypass the step that is usually responsible for hiking up drug costs for consumers. You are therefore able to get your medications from Marley Drug at prices competitive with even the best insurance plans.

Prices mentioned in this article are based on average retail price at major box chain pharmacy in the U.S. as of January 21, 2023.

References:

1. Divalproex (generic Depakote) – Access data FDA-Approved Drugs [Internet]. [Authorized 10/2011; accessed 01/2023].