Revalp Tablet

Divalproex Sodium 250mg tablets deliver valproic acid, a broad-spectrum anticonvulsant and mood stabilizer that enhances GABA neurotransmission, inhibits voltage-gated sodium channels, and modulates T-type calcium channels to suppress neuronal hyperexcitability. This multifaceted mechanism provides efficacy across generalized and partial seizures, manic episodes in bipolar disorder, and migraine prophylaxis. The enteric coating minimizes GI upset while achieving therapeutic valproate levels (50-100 mcg/mL) for seizure control and mood stabilization, with hepatic metabolism requiring regular monitoring.

Key Benefits:

• Broad-spectrum seizure control including absence, tonic-clonic, and partial seizures
• Effective acute and maintenance treatment of bipolar mania
• FDA-approved migraine prevention reducing attack frequency
• Dual utility in epilepsy and psychiatric disorders
• Once/twice-daily dosing improves adherence

How to Use

• Administration: Take orally with food to reduce GI irritation; swallow whole—do not crush/chew enteric coating.
• Timing: Once or twice daily; maintain consistent intervals for steady-state levels.
• Dosage: Individualized by indication/weight:
  • Epilepsy: 10-60mg/kg/day divided doses (500-2500mg/day)
  • Bipolar: 500-2500mg/day
  • Migraine: 500-1000mg/day
• Therapeutic Monitoring: Titrate slowly; target valproate levels 50-100mcg/mL.
• Duration: Long-term for chronic conditions; taper gradually to avoid withdrawal seizures.

Expert Tips from CureCart Direct:

• Take with food/milk to minimize stomach upset.
• Use pill organizer for divided doses; set reminders.
• Women of childbearing age: Discuss contraception—teratogenic risk.
• Avoid alcohol; potentiates sedation and hepatotoxicity.
• Regular bloodwork essential for safety monitoring.

Missed Dose: Take ASAP unless near next—skip and resume. Do not double; risk of toxicity.

Overdose: Life-threatening; symptoms include coma, respiratory depression, hyperammonemia. Emergency care: gastric lavage, activated charcoal, hemodialysis; monitor ammonia/valproate levels.

Primary Uses

• Epilepsy treatment across seizure types.
• Bipolar disorder management (acute mania, maintenance).
• Migraine headache prophylaxis.
• Adjunctive therapy in refractory seizures.

Indications

• Epilepsy: Monotherapy/adjunctive for complex partial, absence, myoclonic, tonic-clonic seizures (adults/children ≥10 years).
• Bipolar Disorder: Acute manic/mixed episodes; maintenance prevention.
• Migraine: Prophylaxis in adults (250-500mg BID). Contraindicated in hepatic disease, urea cycle disorders, mitochondrial disease.

Side Effects

Common:

• GI: Nausea, vomiting, abdominal pain, diarrhea
• Neurological: Tremor, dizziness, headache
• Dermatologic: Hair loss, rash
• Metabolic: Weight gain

Serious:

• Hepatotoxicity (especially children <2 years)
• Pancreatitis
• Thrombocytopenia, bleeding
• Hyperammonemia
• Teratogenicity (neural tube defects)

Monitor LFTs, platelets, ammonia regularly.

Warnings and Precautions

• Pregnancy: Category D—high teratogenic risk (spina bifida 1-2%); use contraception, folic acid.
• Lactation: Passes into milk; monitor infant for sedation.
• Driving: May impair coordination—avoid until effects known.
• Hepatic Impairment: Contraindicated; fatal hepatotoxicity risk.
• Renal Impairment: Dose adjust; monitor levels.
• Other: Screen for urea cycle disorders; pancreatitis risk; osteoporosis with long-term use.

Contraindications

Do not use in:

• Known hypersensitivity to valproate.
• Hepatic dysfunction or family history of severe liver disease.
• Urea cycle disorders.
• Mitochondrial disease (POLG mutations).
• Active bleeding disorders.
• Pregnancy planning (unless no alternatives).

Drug Interactions

• Highly Protein Bound Drugs (e.g., warfarin, phenytoin): Displacement increases free levels.
• Aspirin: Enhanced bleeding risk.
• Carbapenem Antibiotics: Rapid valproate clearance.
• Enzyme Inducers (e.g., phenytoin, carbamazepine): Reduce valproate levels.
• Lamotrigine: Valproate increases lamotrigine levels—adjust doses.

Laboratory Screening

Essential monitoring includes:

• Baseline and periodic: LFTs (ALT/AST), CBC (platelets), ammonia, renal function
• Therapeutic drug monitoring: Valproate levels 50-100mcg/mL
• Pregnancy testing for women of childbearing potential
• Bone density assessment for long-term users

Storage/Disposal

Store at controlled room temperature (15-30°C), protected from light/moisture. Keep in original container, tightly closed. Avoid bathroom storage. Dispose via pharmacy take-back; do not flush. Child-resistant packaging essential.

Doctor Review

Dr. Bilal Hassan, MBBS, FCPS – Consultant Neurologist & Psychiatrist “Divalproex Sodium 250mg harnesses valproate’s GABAergic enhancement and sodium channel blockade for broad-spectrum efficacy across epilepsies and bipolar spectrum disorders, achieving therapeutic levels (50-100mcg/mL) with 90% hepatic metabolism via glucuronidation and beta-oxidation. Complex partial seizure control reaches 50-70% response rates in adjunctive therapy, while bipolar mania remission occurs in 45-65% within 3 weeks per RCTs. Enteric coating mitigates GI AEs, though hepatotoxicity risk (1/500 children <2 years) mandates LFT surveillance, particularly during first 6 months. Teratogenicity concerns elevate it to first-line avoidance in women of childbearing potential unless alternatives fail, with folate supplementation insufficient to eliminate neural tube defect risk.”

FAQs

Multiple indications? Yes: Epilepsy, bipolar mania, migraine prophylaxis.

Blood monitoring needed? Essential: LFTs, platelets, valproate levels, ammonia.

Pregnancy safe? No—high fetal risk; requires contraception counseling.

Weight gain common? Yes; monitor BMI, encourage lifestyle measures.

Abrupt stop dangerous? Yes—risk status epilepticus; always taper.

Related Tests: Valproate levels, LFTs, CBC, pregnancy test.

Quick Tips:

• Take with food.
• Consistent timing.
• Monthly bloodwork initially.
• Contraception essential.

Disclaimer: This information is for educational purposes only and not a substitute for professional medical advice. Always consult a qualified physician before use. CureCart Direct ensures accurate details but cannot cover all interactions or precautions. Prices and availability subject to change.