Retrieved Oct 23, 2015. If you have any questions about divalproex sprinkle capsules, please talk with your doctor, pharmacist, or other health care provider. Anderson Gail D. Chapter 42: Pharmacokinetics and Drug Interactions. In: Wyllie's Treatment of Epilepsy: Principles and Practice, 5th Ed. 2011. order eldepryl 400 mg online
Liver problems may occur while you are using divalproex sodium, and some may be serious. Check with your doctor right away if you are having more than one of these symptoms: abdominal or stomach pain or tenderness, clay-colored stools, dark urine, decreased appetite, fever, headache, itching, loss of appetite, nausea and vomiting, skin rash, swelling of the feet or lower legs, unusual tiredness or weakness, or yellow eyes or skin. Cases of life-threatening pancreatitis have been reported in both children and adults receiving valproate. Some of the cases have been described as hemorrhagic with rapid progression from initial symptoms to death. Some cases have occurred shortly after initial use as well as after several years of use. The rate based upon the reported cases exceeds that expected in the general population and there have been cases in which pancreatitis recurred after rechallenge with valproate.
Respiratory System: Dyspnea, rhinitis. Concomitant administration of topiramate with valproate has also been associated with hypothermia in patients who have tolerated either drug alone. Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Food and Drug Administration. WebMD does not endorse any specific product, service or treatment. If your doctor changes your brand, strength, or type of gabapentin, your dosage needs may change. Ask your pharmacist if you have any questions about the new kind of gabapentin you receive at the pharmacy. Moderate. These medicines may cause some risk when taken together. Thanacoody RH 2009. "Extracorporeal elimination in acute valproic acid poisoning". Clin Toxicol Phila. Hepatic failure resulting in fatalities has occurred in patients taking this drug. Children younger than 2 years are at a considerably increased risk of developing fatal hepatotoxicity, especially those on multiple anticonvulsants, those with congenital metabolic disorders, those with severe seizure disorders accompanied by mental retardation, and those with organic brain disease. This drug should be used with extreme caution and only as monotherapy. Fatal hepatotoxicity decreases considerably in older patients. This usually occurs during the first 6 months of treatment and may be preceded by nonspecific symptoms such as malaise, weakness, lethargy, facial edema, anorexia, and vomiting. In patients with epilepsy, a loss of seizure control may occur. Liver function tests should be performed prior to therapy and at frequent intervals thereafter, especially during the first 6 months.
Divalproex sprinkle capsules may interfere with certain lab tests, including thyroid function. Be sure your doctor and lab personnel know you are taking divalproex sprinkle capsules. Hardy JR, Rees EA, Gwilliam B, Ling J, Broadley K, A'Hern R 2001. PDF. J Pain Symptom Manage. If pancreatitis is diagnosed, valproate should ordinarily be discontinued. Liver failure and death from liver failure has occurred in patients taking divalproex sprinkle capsules. This has usually occurred within the first 6 months of treatment. Tell your doctor right away if you notice symptoms of liver problems eg, a general feeling of discomfort, sluggishness, unusual tiredness or weakness, swelling of the face, loss of appetite, vomiting, stomach pain, dark urine, pale stools, or yellowing of the skin or eyes. In patients who have seizures, loss of seizure control may occur. You should have lab tests done before and during treatment to check for liver problems. Be sure to keep all doctor and lab appointments. Some MEDICINES MAY INTERACT with divalproex delayed-release tablets. CBZ-E increased by 45% upon coadministration of valproate and CBZ to epileptic patients. Call your healthcare provider between visits as needed, especially if you are worried about symptoms. Read the Guide and, if available, the Patient Information Leaflet provided by your before you start taking and each time you get a refill. If you have any questions, ask your doctor or pharmacist. Divalprox ER. I lost 140 pounds in 6 months and got all my hair back. I take Cymbals, Valium, Ritalin, and Gabapentin as well.
Contact your doctor or health care provider right away if any of these apply to you. Taking divalproex sodium delayed-release tablets with certain other medicines can cause side effects or affect how well they work. Do not start or stop other medicines without talking to your healthcare provider. Call your doctor at once if the person taking this medicine has signs of liver or pancreas problems, such as: loss of appetite, upper stomach pain that may spread to your back ongoing nausea or vomiting, dark urine, swelling in the face, or jaundice yellowing of the skin or eyes. Baselt, Disposition of Toxic Drugs and Chemicals in Man, 8th edition, Biomedical Publications, Foster City, CA, 2008, pp. 1622-1626. Swallow divalproex sprinkle capsules whole. Do not break, crush, or chew before swallowing. If you cannot swallow the capsule whole, you may open it and sprinkle the contents over a spoonful of soft food eg, applesauce, pudding. Mix the medicine with the food and swallow the mixture right away, followed by a glass of water. Do not crush or chew the medicine before swallowing. Do not store the mixture for future use. For the best effect, use this antibiotic at evenly spaced times. To help you remember, use this medication at the same times every day. Based on two placebo-controlled clinical trials and their long term extension, valproate was generally well tolerated with most adverse reactions rated as mild to moderate in severity. Of the 202 patients exposed to valproate in the placebo-controlled trials, 17% discontinued for intolerance. This is compared to a rate of 5% for the 81 placebo patients. PREGNANCY and BREAST-FEEDING: Divalproex sprinkle capsules has been shown to cause harm to the fetus. If you think you may be pregnant, contact your doctor right away. You will need to discuss the benefits and risks of using divalproex sprinkle capsules while you are pregnant. You and your doctor will need to decide if you will continue to take divalproex sprinkle capsules while you are pregnant. Divalproex sprinkle capsules are found in breast milk. Do not breast-feed while you are taking divalproex sprinkle capsules. Topamax when I learned I was pregnant. Burtis C, Ashwood E, Bruns D, Eds. 2006. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Elsevier Saunders, St. Louis, Missouri. Pp 1253-1254. Table 5 includes those adverse reactions reported for patients in the placebo-controlled trials where the incidence rate in the divalproex sodium-treated group was greater than 5% and was greater than that for placebo patients. In geriatric patients, the initial dose should be reduced. Dosing should also be increased more slowly. The ultimate therapeutic dose should be achieved on the basis of clinical response. It is very important to follow your doctor's dosing instructions exactly. The dose must be increased slowly. It may take several weeks or months to reach the best dose for you and to get the full benefit from this medication. Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same times each day. maxalt
Haddad PM, Das A, Ashfaq M, Wieck A 2009. "A review of valproate in psychiatric practice". Expert Opin Drug Metab Toxicol. Like other antiepileptic drugs, divalproex sodium delayed-release tablets may cause suicidal thoughts or actions in a very small number of people, about 1 in 500. Get emergency medical help if you have any of these signs of an allergic reaction: hives; fever, swollen glands, mouth sores, difficulty breathing; swelling of your face, lips, tongue, or throat. When these two medicines are taken together, the way your body processes each medicine may change. Stopping divalproex sodium delayed-release tablets suddenly can cause serious problems. Valproate has been found to be a weak inhibitor of some P450 isozymes, epoxide hydrase, and glucuronosyltransferases. cost of vistaril in nz vistaril
Aptiom eslicarbazepine US prescribing information. Sunovian Pharmaceuticals Inc. November, 2013. Rare but serious side effects include and problems producing enough bone marrow. Gidal BE, Zupanc ML. Potential pharmacokinetic interaction between felbamate and phenobarbital. Haidukewych D, Rodin EA, Zielinski JJ. Derivation and evaluation of an equation for prediction of free phenytoin concentration in patients co-medicated with valproic acid. Divalproex Sodium-Treated Patients During Placebo-Controlled Trials of Acute Mania The following adverse reactions occurred at an equal or greater incidence for placebo than for divalproex sodium: back pain, headache, constipation, diarrhea, tremor, and pharyngitis. Divalproex sodium delayed-release tablets USP are for oral administration. Divalproex sodium delayed-release tablets USP are supplied in three dosage strengths containing divalproex sodium, USP equivalent to 125 mg, 250 mg, or 500 mg of valproic acid. Tell your doctor if your condition lasts or gets worse. Hyperammonemia has been reported in association with valproate therapy and may be present despite normal liver function tests. In patients who develop unexplained lethargy and vomiting or changes in mental status, hyperammonemic encephalopathy should be considered and an ammonia level should be measured. DHEA. But, because DHEA affects hormone levels in the body, experts say more studies are necessary before recommending DHEA for use by the public. This medication is used to treat seizure disorders, certain psychiatric conditions manic phase of bipolar disorder and to prevent migraine headaches. It works by restoring the balance of certain natural substances neurotransmitters in the brain. Narayanaswamy, Sudha November 2010. National Collaborating Centre for Mental Health 2006. Bipolar Disorder: The Management of Bipolar Disorder in Adults, Children and Adolescents, in Primary and Secondary Care Clinical Guideline No. 38. London: National Institute for Health and Clinical Excellence. Take this medication with or without food, usually 1 to 2 times daily or as directed by your doctor. buy hytrin england
Hemic and Lymphatic System: Petechia. Doctors use a long, very thin needle to draw some of the fluid out of the spinal column to test for certain proteins. One of the most common mistakes people make when using alternative treatments is to stop the conventional medical treatment altogether. In most cases, supplements are not a proven alternative to medication for treating bipolar disorder, but sometimes may help in addition to your medicine. In six patients who were seropositive for HIV, the clearance of zidovudine 100 mg q8h was decreased by 38% after administration of valproate 250 or 500 mg q8h; the half-life of zidovudine was unaffected. Smith SM 2005. PDF. Retrovirology. This may decrease the effectiveness of hormonal products such as pills, patch, ring. Use with caution. May make these conditions worse. What is a dietary supplement? Some MEDICINES MAY INTERACT with divalproex sprinkle capsules. Inflammation of the pancreas is a potentially life-threatening illness associated with divalproex sprinkle capsules. Symptoms include stomach pain, vomiting, or loss of appetite. Contact your doctor at once if any of these symptoms occur. buy generic baclofen payment uk baclofen
The primary findings were an increase in the incidence of subcutaneous fibrosarcomas in high dose male rats receiving valproate and a dose-related trend for benign pulmonary adenomas in male mice receiving valproate. The significance of these findings for humans is unknown. Divalproex sodium delayed-release tablets are a valproate and are indicated for the treatment of the manic episodes associated with bipolar disorder. A manic episode is a distinct period of abnormally and persistently elevated, expansive, or irritable mood. Typical symptoms of mania include pressure of speech, motor hyperactivity, reduced need for sleep, flight of ideas, grandiosity, poor judgment, aggressiveness, and possible hostility. Higher than expected free fractions occur in the elderly, in hyperlipidemic patients, and in patients with hepatic and renal diseases. Swallow divalproex delayed-release tablets whole. Do not break, crush, or chew before swallowing. Praag, HM, van den Burg, W, Bos, ER, et al. 5-Hydroxytryptophan in Combination With Clomipramine in Therapy-Resistant Depression. Common side effects include nausea, vomiting, sleepiness, and a dry mouth. Serious side effects can include liver problems and regular monitoring of is therefore recommended. Other serious risks include and an increased risk. Children under the age of two years are at a considerably increased risk of developing fatal hepatotoxicity, especially those on multiple anticonvulsants, those with congenital metabolic disorders, those with severe seizure disorders accompanied by mental retardation, and those with organic brain disease. When divalproex sodium delayed-release tablets are used in this patient group, it should be used with extreme caution and as a sole agent. The benefits of therapy should be weighed against the risks. The incidence of fatal hepatotoxicity decreases considerably in progressively older patient groups. Maintenance dose: Some patients may benefit from doses up to 1000 mg per day.
Bilo, Leonilda; Meo, Roberta October 2008. Use of this medication for prolonged or repeated periods may result in oral thrush or a new yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms. In a steady-state study involving 10 healthy volunteers, the elimination half-life of lamotrigine increased from 26 to 70 hours with valproate coadministration a 165% increase. The dose of lamotrigine should be reduced when coadministered with valproate. Serious skin reactions such as Stevens-Johnson syndrome and toxic epidermal necrolysis have been reported with concomitant lamotrigine and valproate administration. See lamotrigine package insert for details on lamotrigine dosing with concomitant valproate administration. Depakote divalproex sodium US prescribing information. AbbVie Inc. Reidenberg P, Glue P, Banfield CR, Colucci RD, Meehan JW, Radwanski E, Mojavarian P, Lin CC, Nezamis J, Guillaume M, et al. Effects of felbamate on the pharmacokinetics of phenobarbital. In patients with epilepsy, there have been reports of breakthrough seizures occurring with the combination of valproate and phenytoin. The dosage of phenytoin should be adjusted as required by the clinical situation. Patients should be especially careful when brushing and flossing teeth. This drug may make you dizzy or drowsy or cause blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcoholic beverages. Retrieved 18 January 2014. Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, pancreatitis, certain metabolic disorders such as urea cycle disorders, Alpers-Huttenlocher syndrome alcohol abuse, bleeding problems, brain disease dementia kidney disease, low body water dehydration poor nutrition. dnif.info plavix
It is very important that your doctor check your progress closely while you are using divalproex sodium to see if it is working properly and to allow for a change in the dose. Blood tests may be needed to check for any unwanted effects. It is hard to predict whether you will have more seizures. Antiepileptic medicines are not usually prescribed unless you have risk factors for having another seizure, such as injury, abnormal test results, or a seizure that occurred at night. Body as a Whole: Back pain, chest pain, malaise. Mood stabilizers have been well studied in adults, but there are currently few studies in children. Digestive System: Anorexia, constipation, dry mouth, flatulence, gastrointestinal disorder unspecified and stomatitis. Serious liver damage that can cause death, especially in children younger than 2 years old. If you break a Neurontin tablet and take only half of it, take the other half at your next dose. Any tablet that has been broken should be used as soon as possible or within a few days. Christensen J, Grønborg TK, Sørensen MJ, Schendel D, Parner ET, Pedersen LH, Vestergaard M 2013. Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same times each day. Get emergency medical help if you have signs of an allergic reaction to Neurontin: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Additionally, TRUVEN HEALTH MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Truven Health does not assume any responsibility or risk for your use of the Truven Health products. One randomised double-blind placebo-controlled trial. Tell your doctor if you have ever had any unusual or allergic reaction to divalproex sodium or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. PREGNANCY and BREAST-FEEDING: Divalproex delayed-release tablets has been shown to cause harm to the fetus. If you think you may be pregnant, contact your doctor right away. You will need to discuss the benefits and risks of using divalproex delayed-release tablets while you are pregnant. You and your doctor will need to decide if you will continue to take divalproex delayed-release tablets while you are pregnant. Divalproex delayed-release tablets are found in breast milk. Do not breast-feed while you are taking divalproex delayed-release tablets. Wyllie's Treatment of Epilepsy: Principles and Practice, 5th Ed. 2011. buy epivir online usa
If you are able to become pregnant, you must use an effective form of birth control while you take divalproex delayed-release tablets. Contact your doctor right away if you become pregnant or think you may be pregnant while taking divalproex delayed-release tablets. If any of these effects persist or worsen, tell your doctor or promptly. Epilim EC200 by Sanofi is a 200-mg sodium valproate tablet. Divalproex sprinkle capsules may cause an unusual drop in body temperature hypothermia. Symptoms may include confusion, lack of energy, loss of coordination, shivering, slow heartbeat, slow or shallow breathing, slurred speech, or unusual drowsiness. Contact your doctor right away if you have any of these symptoms. Retrieved 14 February 2014. Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment. You may rarely see partial tablets in your stool. This may occur if you have certain intestinal disorders such as ileostomy, colostomy. Tell your doctor right away if you see partial tablets in your stool. Pre-existing acute or chronic liver dysfunction or family history of severe hepatitis particularly medicine related. Riva R, Albani F, Contin M, Perucca E, Ambrosetto G, Gobbi G, Santucci M, Procaccianti G, Baruzzi A. Time-dependent interaction between phenytoin and valproic acid. These actions are likely to be involved in the reproductive endocrine disturbances seen with valproic acid treatment. Consult WARNINGS section for additional precautions. buy clozapine pills online pharmacy
Chemically it is designated as sodium hydrogen bis2-propylpentanoate. The increased risk of suicidal thoughts or behavior with AEDs was observed as early as one week after starting drug treatment with AEDs and persisted for the duration of treatment assessed. Because most trials included in the analysis did not extend beyond 24 weeks, the risk of suicidal thoughts or behavior beyond 24 weeks could not be assessed. The fraction of phenobarbital dose excreted unchanged increased by 50% in presence of valproate. Divalproex delayed-release tablets comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get divalproex delayed-release tablets refilled. Days 7, 14, and 21, respectively. Patients were assessed on the Young Mania Rating Scale YMRS; score ranges from 0 to 60 an augmented Brief Psychiatric Rating Scale BPRS-A and the Global Assessment Scale GAS. Dose is based on body weight and must be determined by your doctor. At first, the usual dose is 10 to 15 milligrams mg per kilogram kg of body weight per day. Your doctor may increase your dose gradually every week by 5 to 10 mg per kg of body weight if needed. However, the dose is usually not more than 60 mg per kg of body weight per day. If the total dose a day is greater than 250 mg, it is usually divided into smaller doses and taken two or more times during the day. Figure 3 presents the proportion of patients X axis whose percentage reduction from baseline in complex partial seizure rates was at least as great as that indicated on the Y axis in the monotherapy study. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports. Kuendgen A, Schmid M, Schlenk R, Knipp S, Hildebrandt B, Steidl C, Germing U, Haas R, Dohner H, Gattermann N 2006. PDF. Cancer. Some forms of this medication have sodium. Metabolic and Nutritional Disorders: Edema, peripheral edema. About FAERS: The FDA Adverse Event Reporting System FAERS is used by FDA for activities such as looking for new safety concerns that might be related to a marketed product, evaluating a manufacturer's compliance to reporting regulations and responding to outside requests for information. Reporting of adverse events is a voluntary process, and not every report is sent to FDA and entered into FAERS. Meador KJ, Baker GA, Finnell RH, Kalayjian LA, Liporace JD, Loring DW, Mawer G, Pennell PB, Smith JC, Wolff MC 2006. priligy
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Hicks CW, Pandya MM, Itin I, Fernandez HH 2011. "Valproate for the treatment of medication-induced impulse-control disorders in three patients with Parkinson's disease". Parkinsonism Relat. Disord. Candelaria M, Herrera A, Labardini J, González-Fierro A, Trejo-Becerril C, Taja-Chayeb L, Pérez-Cárdenas E, de la Cruz-Hernández E, Arias-Bofill D, Vidal S, Cervera E, Dueñas-Gonzalez A 2011. "Hydralazine and magnesium valproate as epigenetic treatment for myelodysplastic syndrome. Preliminary results of a phase-II trial". Ann. Hematol. Valproate can cause decreased IQ scores following in utero exposure. Published epidemiological studies have indicated that children exposed to valproate in utero have lower cognitive test scores than children exposed in utero to either another antiepileptic drug or to no antiepileptic drugs. motrin
Bond DJ, Lam RW, Yatham LN 2010. "Divalproex sodium versus placebo in the treatment of acute bipolar depression: a systematic review and meta-analysis". J Affect Disord. Do not crush, chew, break, or open a delayed-release or extended-release tablet or capsule. Swallow it whole. Inflammation of the pancreas is a potentially life-threatening illness associated with divalproex delayed-release tablets. Symptoms include stomach pain, vomiting, or loss of appetite. Contact your doctor at once if any of these symptoms occur. It can be given or by mouth. Long and short acting formulations exist. Panjehshahin MR, Bowmer CJ, Yates MS. Effect of valproic acid, its unsaturated metabolites and some structurally related fatty acids on the binding of warfarin and dansylsarcosine to human albumin. discount asacol in usa
Klonopin clonazepam can increase the frequency of seizures. Drinking alcohol may increase certain side effects of divalproex sodium. Neural tube defects are the congenital malformation most strongly associated with maternal valproate use. If you miss a dose of divalproex sprinkle capsules, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
The effectiveness of divalproex sodium for the treatment of acute mania was demonstrated in two 3-week, placebo controlled, parallel group studies. Swelling, redness, pain, or soreness at the injection site may occur. Upset stomach, headache, nausea, vomiting, or diarrhea may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. These data show up to a five-fold increased risk for any major malformation following valproate exposure in utero compared to the risk following exposure in utero to other antiepileptic drugs taken in monotherapy.