- Body system
- Neurology
- Brand names
- Depakote, Depakote ER, Depakene
- Therapeutic level
- Commonly 50 to 100 mcg/mL for epilepsy (higher in some protocols for mania).
What is Valproic acid used for?
- Many seizure types, including absence seizures
- Bipolar mania
- Migraine prevention
How Valproic acid works
Increases GABA availability and blocks sodium and calcium channels.
Common side effects
- Nausea and vomiting
- Tremor
- Weight gain
- Hair loss
- Thrombocytopenia
Report right away
- Yellow skin, dark urine, unusual tiredness or vomiting (liver injury)
- Severe abdominal pain with vomiting (pancreatitis)
- Confusion or lethargy (high ammonia)
- Easy bruising or bleeding
Nursing considerations for Valproic acid
- Monitor liver function, platelets and drug levels (commonly 50 to 100 mcg/mL for epilepsy); check ammonia if mental status changes.
- Avoided in pregnancy and in women who could become pregnant unless no other drug works: it causes neural tube defects and lower IQ in the child.
- Swallow delayed-release and extended-release tablets whole.
Patient teaching
- Use effective contraception if you could become pregnant, and discuss folic acid.
- Report abdominal pain, vomiting or yellowing right away.
- Do not stop it suddenly.
This card does not list doses. Use the prescriber's order, the product label and a current drug reference for dosing, and follow your facility's policies.
Anticonvulsants (antiepileptic drugs) practice questions
NCLEX-style questions on the class Valproic acid belongs to.
3 questions. Choose an answer to see the rationale.
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Which IV solution is compatible with phenytoin?
Show answer
Answer B: 0.9% sodium chloride Phenytoin precipitates in dextrose solutions; it is mixed and flushed with normal saline only.
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A patient taking phenytoin has nystagmus, unsteady gait and slurred speech. What does the nurse suspect?
Show answer
Answer D: Phenytoin toxicity Nystagmus and ataxia are classic signs of high phenytoin levels. Check the level and notify the provider.
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What teaching point applies to every antiepileptic drug?
Show answer
Answer C: Do not stop it suddenly Abrupt withdrawal can trigger seizures, including status epilepticus.
Frequently asked questions
What is Valproic acid used for?
Many seizure types, including absence seizures; Bipolar mania; Migraine prevention.
What drug class is Valproic acid?
Valproic acid (divalproex) belongs to the class anticonvulsants (antiepileptic drugs). Increases GABA availability and blocks sodium and calcium channels.
What are the nursing considerations for Valproic acid?
Monitor liver function, platelets and drug levels (commonly 50 to 100 mcg/mL for epilepsy); check ammonia if mental status changes. Avoided in pregnancy and in women who could become pregnant unless no other drug works: it causes neural tube defects and lower IQ in the child.
What should patients report while taking Valproic acid?
yellow skin, dark urine, unusual tiredness or vomiting (liver injury); severe abdominal pain with vomiting (pancreatitis); confusion or lethargy (high ammonia); easy bruising or bleeding.