It works by binding to the receptors in the brain and inhibits the excitation of brain cells.
Side effects
Major & minor side effects for Epival Injection IV 500 mg 1 Ampx5 mL

Diarrhea severe

Confusion severe

Headache severe

Muscle pain severe

Unusual tiredness and weakness severe

Sleepiness severe

Anxiety severe

Blurred vision severe

Yellow colored eyes or skin severe

Weight gain

Acid or sour stomach

Skin rash

Forgetfulness

Irregular menstrual periods

Ear pain

Uses of Epival Injection IV 500 mg 1 Ampx5 mL
What is it prescribed for?

Epilepsy
Epival Injection IV 500 mg 1 Ampx5 mL is used in the treatment of Epilepsy which is a brain disorder that causes repeated seizures. Uncontrolled jerking movements and loss of consciousness are some of the symptoms of Epilepsy.

Mania
Epival Injection IV 500 mg 1 Ampx5 mL is used in the treatment of mania which is a mental disorder characterized by hyperactivity and racing thoughts.

Migraine Prophylaxis
Epival Injection IV 500 mg 1 Ampx5 mL is used as prophylaxis in migraine headaches characterized by severe headache, eye pain, nausea and vomiting.

Concerns

Frequently asked questions

Onset of action
The peak effect of this medicine can be observed in 2 hours for a delayed release tablet.

Duration of Effect
The effect of this medicine lasts for an average of 1 to 2 days.

Safe with Alchohol?
Consumption of alcohol with this medicine is not recommended as it increases the risk of side effects like dizziness, difficulty in concentration. Do not perform activities that require mental alertness like driving or operating machinery.

Is it habit forming?
No habit forming tendency has been reported

Usage in pregnancy?
This medicine is not recommended for pregnant women.

Usage while breast-feeding?
This medicine is recommended only if clearly needed when no safer alternative is available. Monitoring of undesired effects like discoloration of eyes and skin is necessary.

When not to use?

Allergy
Do not take this medicine if you have a known allergy to Epival Injection IV 500 mg 1 Ampx5 mL .

Liver disease
Do not take if you have any liver injury or a family history of liver injury.

Urea cycle disorders
Do not use in patients with urea cycle disorder (high ammonium levels in the blood) or family history of urea cycle disorder.

Mitochondrial disorders
Do not use in patients and in children who are suspected to have the mitochondrial disorder (POLG e.g Alpers-Huttenlocher Syndrome).

Warnings

Warnings for special population

Pregnancy
This medicine is not recommended for pregnant women.

Breast-feeding
This medicine is recommended only if clearly needed when no safer alternative is available. Monitoring of undesired effects like discoloration of eyes and skin is necessary.

General Warnings

Pancreatitis
Epival Injection IV 500 mg 1 Ampx5 mL may cause Pancreatitis which is a serious life-threatening reaction. Discontinue the medicine if Pancreatitis is detected and an alternate medicine should be considered.

Bleeding disorder
Use with caution in patients with the bleeding disorder as it may cause Thrombocytopenia. Make necessary dosage adjustments or discontinue the medicine if this condition is identified.

Suicidal behavior
Epival Injection IV 500 mg 1 Ampx5 mL may increase the risk of suicidal thoughts. It should be used with caution and prescription size should be limited in patients with depression or suicidal tendencies.

Pediatric use
Epival Injection IV 500 mg 1 Ampx5 mL is not recommended in children less than 2 years of age due to the increased risk of liver injury.

Geriatric use
Use with caution in the elderly population as it may lead to dizziness. The safety and efficacy of this medicine in the prophylaxis of migraines is not established.

Impaired liver function
This medicine is not recommended in patients with liver injury or a family history of liver injury.

Impaired kidney function
Use with caution in the patients with the kidney injury. Suitable dose adjustments are to be made based on the clinical condition.

Dosage

Missed Dose
If you miss a dose of Epival Injection IV 500 mg 1 Ampx5 mL , take the missed dose as soon as you remember. If it?s almost time for your next dose, skip the missed dose. Do not double your dose to make up for the missed dose.

Overdose
Seek emergency medical treatment or contact the doctor in case of an overdose.

Interactions
Interaction with Medicines

Lamotrigine severe

Metoclopramide moderate

Warfarin moderate

Ethinyl Estradiol moderate

Imipenem severe

Disease interactions

severe
Epival Injection IV 500 mg 1 Ampx5 mL should be given with caution in the patients with depression and suicidal thoughts. Frequent monitoring of depression symptoms is necessary. Dose adjustments are to be made based on the outcomes in the patient.

severe
Epival Injection IV 500 mg 1 Ampx5 mL is not recommended in patients with liver injury or a family history of liver injury. This risk is more in children less than 2 years of age. Liver function tests are to be performed before starting the treatment. Discontinue the medicine if any abnormality is identified.

Lab interactions

General Instructions

Take Epival Injection IV 500 mg 1 Ampx5 mL with or without food. Do not take in larger amounts than advised. Consult the doctor if you experience any undesirable effects. Do not stop taking the medicine without consulting your doctor as it may cause seizures.

Other details

Food timings: Information not available

Administration time: Information not available

Sleep inducing: Information not available

References

practo.com –
Divalproex [Internet].
Available from: https://www.practo.com/medicine-info/divalproex-87-api
[cited 20 september 2019].
20 Mar 2017

dailymed.nlm.nih.gov –
Divalproex [Internet].
Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f911748c-fb3a-fe1a-ab2a-4b40455e05ef
[cited 20 september 2019].
March 25, 2019

medlineplus.gov –
Divalproex [Internet].
Available from: https://medlineplus.gov/druginfo/meds/a682412.html
[cited 20 september 2019].
11 September 2019