Valpex CR

Description

Valpex CR Tablet: Uses, Dosage, and Key Information

Valpex CR Tablet is a medication primarily used to treat various types of epilepsy and bipolar disorder. It can also be used for migraine prevention.

What Valpex CR Tablet is Used For:

• Epilepsy:
  • Partial seizures (complex, simple)
  • Absence seizures (petit mal)
  • Generalized tonic-clonic seizures (grand mal)
  • Myoclonic seizures
  • Atonic seizures
  • Mixed seizures (including those with absence seizures)
• Migraine: For the prevention of migraine headaches (it’s not for acute treatment).
• Bipolar Disorder: To treat manic episodes associated with bipolar disorder.

Please note: While listed in the original text, there is no strong evidence for the use of Valpex CR for anxiety disorder, post-traumatic stress disorder, febrile convulsion, anorexia nervosa, or panic attacks.

Dosage Information

The dosage of Valpex CR Tablet varies depending on the condition being treated, as well as the patient’s age and response. Always follow your doctor’s instructions carefully.

Adult Dosing

• Complex Partial Seizures (Monotherapy or Adjunctive Therapy):
  • Initial: 10-15 mg/kg per day orally.
  • Increase: By 5-10 mg/kg per day at weekly intervals, as directed by your doctor.
  • Maximum: Up to 60 mg/kg per day.
• Simple & Complex Absence Seizures (Monotherapy or Adjunctive Therapy):
  • Initial: 15 mg/kg per day orally, divided into 2 doses (every 6-12 hours).
  • Increase: By 5-10 mg/kg per day at weekly intervals, as directed by your doctor.
  • Maximum: Up to 60 mg/kg per day.
• Migraine Prophylaxis:
  • Initial: 250 mg orally twice daily (every 12 hours).
  • Adjustment: Your doctor will adjust the dose based on your clinical response.
  • Maximum: 1000 mg per day.
• Bipolar Mania:
  • Initial: 750 mg per day orally, in divided doses.
  • Adjustment: Your doctor will adjust the dose as rapidly as possible to achieve the desired therapeutic effect.
  • Maximum: Not to exceed 60 mg/kg per day.

Child Dosing

• Children under 10 years: The safety and effectiveness of Valpex CR Tablet have not been established.
• Complex Partial Seizures (>10 years): Same as adult dosage (10-15 mg/kg per day initially, increasing up to 60 mg/kg per day).
• Simple & Complex Absence Seizures (>10 years): 250 mg orally twice daily (every 12 hours); your doctor will adjust the dose based on clinical response up to 1000 mg per day.

Special Populations

• Hepatic Impairment (Liver Problems): Lower doses are administered. Valpex CR is contraindicated in severe hepatic impairment.
• Renal Impairment (Kidney Problems): No dosage adjustment is typically necessary.

Important Considerations & Precautions

How to Take

You can take Valpex CR Tablet with meals to help reduce gastrointestinal side effects. Starting with a low dose and using enteric-coated formulations can also help.

When Not to Take (Contraindications)

Do not take Valpex CR Tablet if you have:

• A pre-existing or family history of hepatic dysfunction (liver problems).
• Active liver disease.
• Porphyria.
• Mitochondrial or urea cycle disorders.
• Severe hepatic impairment.
• Are pregnant.

Warnings & Precautions

• Liver Toxicity: There’s an increased risk of liver toxicity, especially in children under 2 years old, or those with congenital metabolic disorders, organic brain disease, or severe seizure disorders.
• Monitoring: Regular monitoring of liver function tests (especially during the first 6 months), blood cell counts (including platelets), bleeding time, and coagulation tests is crucial.
• Symptoms to Watch For: Seek immediate medical advice if you experience signs of pancreatitis (e.g., abdominal pain, nausea, vomiting, anorexia) or signs of blood or liver toxicity.
• Behavioral Changes: Monitor for unusual behavior, including suicidal thoughts or actions, during and after treatment.
• Hyperammonemia: If unexplained lethargy, vomiting, or changes in mental status occur, suspect hyperammonemic encephalopathy and measure ammonia levels.
• Bone Health: If you are immobilized or have insufficient sun exposure or calcium intake, consider vitamin supplementation.
• Withdrawal: Do not stop taking Valpex CR abruptly. Withdrawal should be gradual and supervised by a doctor.
• Pregnancy & Breastfeeding: Valpex CR is contraindicated in pregnancy. Discuss the risks and benefits with your doctor if you are breastfeeding.

Potential Drug Interactions

Valpex CR can interact with many other medications. It’s crucial to tell your doctor about all medicines you are taking, including over-the-counter drugs and herbal supplements.

Some key interactions include:

• Increased toxicity with: Bupropion.
• Increased risk of convulsions with: Mefloquine.
• Increased risk of carnitine deficiency with: Pivmecillinam and pivampicillin.
• Carbamazepine: Can lead to decreased valproic acid levels and increased carbamazepine toxicity. Concurrent use is not recommended.
• Decreased Valproic Acid levels with: Carbapenems (potentially fatal interaction, avoid concurrent use), rifampicin, phenytoin, phenobarbital (or primidone), and certain antineoplastic drugs.
• Increased Valproic Acid levels with: Felbamate and aspirin (avoid concurrent salicylates in children under 3 due to hepatotoxicity risk).
• Increased levels of other drugs with Valproate: Phenobarbital, nimodipine, nifedipine, lamotrigine, zidovudine, amitriptyline, nortriptyline, and benzodiazepines.
• Decreased levels of other drugs with Valproate: Tiagabine and clozapine.
• Increased risk of absence status with: Clonazepam.
• Increased risk of hyperammonemia with: Topiramate.
• Ethanol (alcohol): Avoid concurrent use as it may increase CNS depression.

Possible Side Effects

Like all medications, Valpex CR Tablet can cause side effects. Many are mild and resolve on their own, but some can be serious.

Very Common (more than 10% of users):

• Nausea
• Headache
• Increased bleeding time
• Thrombocytopenia (low platelet count)
• Tremor
• Alopecia (hair loss)
• Asthenia (weakness)
• Infection
• Somnolence (drowsiness)
• Amblyopia (lazy eye)
• Diarrhea
• Diplopia (double vision)
• Dizziness
• Dyspepsia (indigestion)
• Nystagmus (involuntary eye movements)
• Tinnitus (ringing in the ears)
• Vomiting

Common (1-10% of users):

• Ataxia (impaired coordination)
• Increased appetite
• Rash
• Abdominal pain
• Back pain
• Mood changes
• Anxiety
• Confusion
• Abnormal gait (walking)
• Paresthesia (numbness/tingling)
• Hallucinations
• Catatonia
• Dysarthria (difficulty speaking)
• Tardive dyskinesia (involuntary movements)
• Vertigo
• Irregular menstrual periods
• Weight gain

Frequency Not Defined (may occur, but exact frequency is unknown):

• Anorexia (loss of appetite)
• Acute pancreatitis (can be life-threatening)
• Hepatic toxicity (liver damage)
• Hyperammonemia (high ammonia levels)
• Weight loss
• Fractures
• Osteoporosis (bone thinning)
• Osteopenia (reduced bone density)
• Cerebral pseudoatrophy (apparent brain shrinkage)

How Valpex CR Works (Mechanism of Action)

Valproate, the active ingredient in Valpex CR, is a carboxylic acid anticonvulsant. While its exact mechanism isn’t fully understood, it’s believed to increase levels of gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter that helps calm nerve activity, which can reduce seizures.

General Information

• Valpex CR 200mg Tablet is manufactured by Alkem Laboratories Ltd.
• Its generic name is Sodium Valproate (valproic acid).
• Valpex CR is available in Nepal.

Disclaimer: This information is for general knowledge only and is not intended for diagnosis, medical advice, or treatment. It is not a substitute for professional medical judgment. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.