"The Mechanisms of Action and Clinical Efficacy of Anticonvulsant Drugs in the Treatment of Epilepsy."

"The Mechanisms of Action and Clinical Efficacy of Anticonvulsant Drugs in the Treatment of Epilepsy."

DIVALPROEX SODIUM

CATEGORY

MEDICINES

SUB CATEGORY

EPILEPSY/CONVULSION

DRUG CLASS

Anti-convulsant

SCHEDULE

Schedule H

DOSAGE FORMS

Capsule, Tablet

COMPOSITION

Divalproex Sodium

PRESCRIPTION MANDATE

YES

DESCRIPTION

Dicorate ER 125 Tablet (Divalproex Sodium), which is an anti-convulsant drug used to treat various types of seizures/epilepsy (a condition in which nerve cell activity in the brain is disturbed).

HOW IT WORKS

Dicorate ER 125 Tablet contains a drug Divalproex Sodium is an anti-convulsant drug that acts by elevating brain concentrations of a neurotransmitter called GABA, which decreases nervous system excitability. This helps in the treatment of seizures and manic episodes, as well as the prevention of migraine headaches.

HOW TO USE

Dicorate ER 125 Tablet should be taken as directed by your doctor. Swallow it as a whole. It should not be chewed, crushed or broken. It can be taken with or without food.

STORAGE

Store below 30 ° C in a dry, dark place and keep out of reach of children.

SIDE EFFECTS

Most of the side effects are mild and can subside as the body adjusts to the drug. If it still persists, consult your physician.

Some of the common side effects include:

• Nausea

• Headache

• Tremor

• Dizziness

• Asthenia

• Vomiting

PRODUCT FORM

Tablet

PRODUCT USE

PRIMARY USE

• Treatment of seizure/epilepsy

OTHER USE

• Migraine Prophylaxis

• Treatment of bipolar disorder

PEDIATRIC USE

Dicorate ER 125 Tablet is not recommended in paediatric patients of less than 2 years of age since it may cause fatal hepatotoxicity. However, this medicine can be used in paediatrics above 2 years of age only if the possible benefit outweighs the potential harm. Please consult your physician.

GERIATRIC USE

Dicorate ER 125 Tablet should be used with caution in geriatric patients above 65 years of age. Your physician may start the therapy at lower doses and may increase gradually. Please consult your physician.

MEDICINE INTERACTION

Most drug interactions may not be the same for all individuals. So, it is necessary to inform your doctor about your current and previous medication history.

• Using hepatic enzyme-inducing drugs such as phenytoin, primidone, rifampin, carbamazepine, and phenobarbital may increase the Divalproex sodium clearance, whereas, enzyme inhibitors such as felbamate may decrease the Divalproex sodium clearance. Therefore, when enzyme-inducing or inhibitory medications are added or removed, additional monitoring of valproate and concomitant drug concentrations, as well as dosage modification, is recommended. Do not stop using these medications without consulting your doctor.

• Using carbapenem antibiotics such as doripenem, ertapenem, meropenem may decrease the blood levels of divalproex sodium. Therefore, monitor divalproex sodium. To use the medication safely, you may need to adjust the dose, monitor it frequently, or switch to a different medication.Do not stop using these medications without consulting your doctor.

ALCOHOL INTERACTION

Avoid alcohol consumption while taking Dicorate ER 125 Tablet, as this medicine may cause dizziness. Please consult your physician.

KIDNEY INTERACTION

In patients with kidney disease, use Dicorate ER 125 Tablet with caution. Dose adjustment is not needed for renally impaired patients. Please consult your physician.

LIVER INTERACTION

Dicorate ER 125 Tablet is not recommended for use in patients with liver disease. Please consult your physician.

DISEASE INTERACTION

Most disease interactions may not be the same for all individuals. So, it is necessary to inform your doctor about your current and previous medical history.

Depression: Patients using Dicorate ER 125 Tablet for any reason may experience increased sadness and suicidal thoughts or actions. Patients should be watched for the onset or exacerbation of depression, suicidal thoughts, and unexpected mood or behaviour changes. Caretakers should monitor them closely if any signs and symptoms occur. Please consult your physician immediately.

Urea cycle disorder: Valproic acid and their derivative products are contraindicated in patients with known urea cycle disorders (UCD), as these individuals have been documented to develop hyperammonemic encephalopathy, which can be deadly, after starting treatment.

PREGNANCY INTERACTION

Dicorate ER 125 Tablet is not recommended for use in pregnant women since it may harm the unborn baby. These birth abnormalities can occur as early as the first month of pregnancy, even before you realise you're pregnant. Please consult your physician.

LACTATION INTERACTION

Dicorate ER 125 Tablet is excreted in breast milk. Either discontinue the drug or discontinue the nursing based on the severity of the condition. Please consult your physician.

LAB INTERACTION

Urine ketone test: The urine ketone test may be misinterpreted if you take this medication. Before having any laboratory testing, it is recommended that you notify your doctor and laboratory technicians about this medication.

Thyroid Function Tests: Thyroid function tests may be altered by this medication. Before having any laboratory testing, it is recommended that you notify your doctor and laboratory technicians about this medication.

DRIVING INTERACTION

Dicorate ER 125 Tablet may cause dizziness or drowsiness, so they should be used with caution while driving and operating heavy machinery. Please consult your physician.

MONITORING PARAMETERS

Your doctor may perform the following tests before beginning and throughout therapy with this drug:

• Drug plasma levels (if you're suffering adverse effects or if you require a dosage change, your doctor may test your medication plasma levels).

• Hepatic function

• Ammonia levels

• Your doctor may also regularly monitor for the indications of pancreatitis, as well as suicidal thoughts or behaviours.

GENERAL WARNINGS

Pancreatitis: Dicorate ER 125 Tablet medication has the potential to induce pancreatitis (severe inflammation in your pancreas). This disorder has the potential to be harmful. This might happen just after you start therapy or after you've been on the medication for a long time.

Liver damage: Patients with inherited neurometabolic disorders who have DNA mutations in the mitochondrial DNA polymerase-gamma (POLG) gene are more likely to develop valproate-induced acute liver failure, which results in death.

Birth defects: Dicorate ER 125 Tablet may cause major harm to the foetus. If you use this medication while pregnant, your baby may have significant birth abnormalities such as affecting the brain, spinal cord, heart, head, arms, legs, and the hole through which urine exits are among them. These birth abnormalities can occur as early as the first month of pregnancy, even before you realise, you're expecting. This medication may potentially cause your baby to have a lower IQ, as well as cognitive, learning, and emotional problems.

EXPERT ADVICE

• This medicine is not recommended for use if you have previously known an allergic reaction or any other ingredients present along with it.

• This drug might cause weight gain, so make note of your weight while using it.

• Regular blood tests may be performed by your doctor to check how the drug is affecting your body. If you detect yellowing of the eyes or skin, black urine, or stomach pain, consult your doctor.

• Do not discontinue this medicine immediately as it may cause withdrawal symptoms.

• Divalproex may cause you to burn more easily, so avoid too much sun or tanning beds. When you're outside, use sunscreen and wear protective clothes.

• Regular follow-up should be done for the betterment of the condition.

HABIT FORMING

No habit-forming tendencies have been reported.

MISSED DOSE

If you miss taking the medicine, take it as soon as possible when you remember. But do not take the dose if it’s already time for your next dose schedule.

OVERDOSE

Do not administer more than the prescribed dose, as it may tend to cause undesirable adverse effects such as somnolence, heart block, and deep coma. Consult your doctor immediately if you suspect an overdose.

REFERENCES

• https://www.healthline.com/health/drugs/divalproex-sodium-oral-tablet#about

• https://www.drugs.com/mtm/divalproex-sodium.html

• https://reference.medscape.com/drug/depakote-divalproex-sodium-999832#3