Some products that may interact with this drug include: certain antidepressants (such as amitriptyline, nortriptyline, phenelzine), certain antibiotics (carbapenems such as imipenem), mefloquine, orlistat, other medications for seizure (such as ethosuximide, lamotrigine, rufinamide, topiramate), warfarin, vorinostat, ...
DRUG INTERACTIONS: Tell your doctor of any over-the-counter or prescription medication you may take including: any medication for depression or seizures, narcotic pain relievers, sedatives. Avoid the use of alcohol while taking this medication. Do not start or stop any medicine without doctor or pharmacist approval.
Depakote is contraindicated in patients with known urea cycle disorders (UCD). Hyperammonemic encephalopathy, sometimes fatal, has been reported following initiation of valproate therapy in patients with urea cycle disorders, a group of uncommon genetic abnormalities, particularly ornithine transcarbamylase deficiency.
There are currently no reports of Depakote or Depakote ER interacting with food. But caffeine, which is found in certain foods and drinks such as coffee, chocolate, and tea, may worsen some side effects of Depakote or Depakote ER. These side effects can include: nervousness.
The following serious side effects are associated with taking Depakote products: Serious liver damage that can cause death, especially in children younger than 2 years old. Risk of serious liver damage is more likely to occur within the first 6 months of treatment, and may continue despite discontinued use of the drug.
You should avoid or limit the use of alcohol while being treated with valproic acid. Do not use more than the recommended dose of valproic acid, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you.
A synergistic interaction between caffeine and valproic acid was observed for 143B and MG63 cells (Figure 1). The CI values were significantly <1 and indicated synergy at all tested concentrations in the MG63 cell line (Table II). In the 143B cell line, synergy was observed at caffeine concentration of 1 mM or higher.
Comment: If stabilized on calcium/magnesium/potassium/sodium oxybates, decrease nightly dose by at least 20% when starting valproic acid; if already taking valproic acid, use a lower starting calcium/magnesium/potassium/sodium oxybates dose; monitor dose and adjust dose accordingly.
Valerian root could function as a low potency alternative for more traditional medications like Depakote or GABA (a neuropeptide in your central nervous system that has depressant effects). Omega-3 fatty acids, as well as N-acetyl cysteine (NAC), are other substances that have purported mood-stabilizing properties.
The starting dose of Depakote tablets for preventing migraine episodes is 250 mg twice daily. Your doctor can increase this to a maximum daily dose of 1,000 mg. Similarly, the starting dose for Depakote ER tablets is 500 mg daily for 1 week. Then your dose may increase to a maximum of 1,000 mg.
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