Generic Depakote (Divalproex)
Depakote
Depakote is used to heal seizure disorders, convulsions, to prevent migraine and treat acute manic episodes associated with bipolar disorder.
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Product Description

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Common use

Depakote contains Divalproex sodium, the substance which interacts with certain substances in the brain and increases the concentration of gamma-aminobutyric acid (GABA), which is a neurtransmitter. The drug is used to treat seizure disorders, the manic phase of bipolar disorders, to prevent migraine headaches.



Dosage and direction

The recommended initial dose for treatment of acute mania due to bipolar disorder is 750 mg daily taken in divided doses. For prevention of migraines take 250 mg twice daily. To treat seizures take initial dose calculated as 10-15 mg/kg/day, the dose should be increased gradually by 5-10 mg/kg/day every week to achieve the desired effect. Do not exceed the recommended dose and follow all recommendations of your health care advisor. Drink plenty of water during treatment. Liver function should be controlled on a regular basis to avoid harmful effects. Swallow the pill whole, do not crush or chew it. Inform your doctor immediately if you suppose that the medication does not work properly to prevent seizures. Do not stop taking the medicine without your doctor's permission even if you feel better.



Precautions

Life-threating hepatic failure may develop, this is most likely to occur in children under two years of age especially if they if they have a metabolic disorder or a brain disease causing mental impairment (multiple sclerosis, Huntington disease, Creutzfeldt-Jacob disease, a brain injury or infection). Liver failure symptoms include malaise, lethargy, weakness, facial edema, vomiting, anorexia. Depakote also may cause rare cases of pancreatitis resulting in fatalities, which may suddenly appear even after several years of treatment with Depakote. Dose adjustment is needed in the patients with a bleeding or blood clotting disorder, a history of brain disorder, head injury, or coma, a family history of a urea cycle disorder, a family history of infant deaths with unknown cause, HIV or CMV (cytomegalovirus) infection. Suicide thoughts are also possible during treatment with the drug.



Contraindications

The medication cannot be administered to the patients with hepatic diseases, significant hepatic dysfunction known urea cycle disorders.



Possible side effect

The most common reported side effects are: nausea, somnolence, dizziness, vomiting, asthenia, abdominal pain, dyspepsia, rash, diarrhea, weight loss, tremors, low fever, dark urine, clay-colored stools. In some cases alopecia (loss of hair), itching and sensitivity to sunlight occur. More rare but serious adverse reactions include pancreatitis, liver injury, and abnormal bleeding. Liver is more likely to occur in children. The risk increases when a patient is taking two more more anti-seizure drugs. Symptoms of damaged liver are malaise, weakness, jaundice, swelling in the face, vomiting, loss of appetite.



Drug interaction

The following drugs may interact with Depakote: topiramate (Topamax), tolbutamide (Orinase), a blood thinner such as warfarin (Coumadin), aspirin or acetaminophen (Tylenol), clozapine (Clozaril, FazaClo), diazepam (Valium), zidovudine (Retrovir), meropenem (Merrem), rifampin (Rifadin, Rimactane, Rifater), ethosuximide (Zarontin), indomethacin (Indocin), nabumetone (Relafen), ibuprofen (Motrin, Advil), naproxen (Naprosyn, Aleve), diclofenac (Voltaren, Cataflam, Arthrotec), ketorolac (Toradol) and aspirin. Such medicines as warfarin or heparin if used concomitantly with Depakote may affect blood clotting and lead to abnormal bleeding. Aspirin and felbamate (Felbatol) reduce catabolism of Depakote and hereby increase its blood concentrations. On the contrary phenytoin (Dilantin), Rifampin (Rifadin; Rimactane), carbamazepine (Tegretol) reduce its blood concentrations. Absorptin of Depakote is reduced by Cholestyramine (Questran), therefore intake of Depakote should be separated by at least two hours before or six hours after doses of cholestyramine.

Depakote can significantly increase concentrations in blood of lamotrigine (Lamictal), zidovudine (AZT), ethosuximide (Zarontin), diazepam (Valium) and phenobarbital, thereby increasing their concentrations in blood.



Missed dose

Never take a double dose of this medication. If it is almost time of the next dose just skip the missed portion and continue to take the medicine according to the schedule.



Overdose

Depakote overdose symptoms include weak pulse, drowsiness, shallow breathing, somnolence, heart block, loss of consciousness, and deep coma. In case of the suspected overdose contact your doctor immediately and seek for immediate medical attention.



Storage

Store at room temperature 15-30 C (59-86 F) away from moisture and heat.



Disclaimer

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

How does Lasix work and what pharmaceutical group does it belong to?

Lasix is a diuretic agent. Lasix causes a short term diuresis. Lasix action mechanism is associated with the reabsorbtion block of chloride and sodium ions in the Henle's loop.Lasix works by increasing excretion of K+, Ca2+, Mg2+ out of the organism. Hypotensive effect of the medication is associated with increased elimination of sodium and water.

Which conditions are treated with Lasix?

Lasix is used for the treatment of the following conditions:

  • Edema syndrome in chronic cardiac failure(II - III stage)
  • Cirrhosis
  • Kidney diseases
  • Cerebral edema
  • Hypertensive crisis
  • Hypertension
  • High calcium blood level

What should a patient know before using Lasix?

The Lasix should not be used in cases of:

  • Hypersensitivity
  • Severe renal failure
  • Acute liver failure
  • Ankylurethria
  • Acute glomerulonephritis
  • Hyperglycemic coma
  • Hyperuricemia
  • Arthragra
  • Decompensated mitral or aortal stenosis
  • Hypotension
  • Acute myocardial infarction
  • Pancreatitis
  • Digitalis intoxication

The drug should be used with caution in the following conditions:

  • Prostatic Hyperplasia
  • Systemic lupus erythematosus
  • Diabetes
  • Pregnancy
  • Breastfeeding

Which adverse effects may manifest when using the medication?

The side effects of Lasix include:

  • Cardiovascular system: hypotension, postural hypotension, collapse, tachycardia, arrhythmia, volume of blood circulation decrease.
  • Central nervous system: dizziness, headache, myasthenia, cramp in leg, paresthesia, apathy, adynamia, weakness, drowsiness,
  • Sense organs: vision and hearing disorders.
  • Gastrointestinal tract: appetite reduce, xerostomia, nausea, vomiting, constipations and diarrhea, pancreatitis.
  • Urinary system: oliguria, acute retention of urine, interstitial nephritis, erythrocyturia, decrease of sexual potency.
  • Allergic reactions: purpura, urticaria fever, exfoliative dermatitis, vasculitis, skin rash, shakes, fever.
  • Hematopoietic system: leukopenia, thrombocytopenia, agranulocytosis, anemotrophy.
  • Water-electrolyte balance: hypovolemia, anhydration, hypokalemia, hyponatremia, hypomagnesemia, metabolic alkalosis.

It is not necessary that the side effects will manifest in an individual but the possibility still exist. For more information please consult your health care provider.

Which groups of drugs or specific preparations may interact with Lasix?

The drug is affected by the following:

  • Immunodepresants
  • Aminoglycosides
  • Antimicrobial agents
  • Diuretics
  • Antineoplastics
  • Antimycotics
  • Antiulcer agents
  • Bronchodilating agents
  • Hypotensive preparations
  • Glucocorticosteroids
  • Cardiac glycosides
  • NSAID

Tell your doctor about all the herbal preparations as well as prescription drugs that you are currently taking even if they are not on the list.

Important information for the patient:

Lasix is supplied for individual use. Do not use it to treat other conditions not listed in the leaflet. Keep the product out of children reach. Do not reuse any disposable materials if supplied with the preparation.