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This medication may infrequently lead to serious, potentially fatal liver complications, typically within the initial six months of treatment. To mitigate this risk, lab tests are necessary before beginning treatment and should continue periodically, particularly during this time frame. The likelihood of severe liver issues is heightened in children under 2, especially those with inherited metabolic disorders, severe seizure disorders coupled with mental retardation, organic brain disease, or those on multiple seizure medications. It is crucial to discuss the potential risks and benefits of this medication with a healthcare provider for children in this age group.

Individuals with specific inherited metabolic disorders, such as Alpers-Huttenlocher syndrome, should not use this medication due to increased liver risk. Children under 2 suspected of having these disorders should avoid this medication, while those older than 2 should be closely monitored if treated with divalproex sodium. Consult your healthcare provider for further guidance.

In rare instances, this medication has been associated with severe, sometimes fatal pancreatitis, which can occur anytime during treatment and may rapidly escalate. Immediate medical attention is required if symptoms indicative of liver problems or pancreatitis arise, such as persistent nausea/vomiting, unusual tiredness, weakness, facial swelling, abdominal pain, loss of appetite, darkened urine, or yellowing of the eyes and skin.

Use of this medication during pregnancy can lead to birth defects, may impair your child's IQ, and could increase the likelihood of brain or mental disorders like autism or ADHD. Both men and women using this medication should consult with their healthcare provider about its risks and benefits, alternative treatments, and effective birth control options. If you plan to become pregnant, or if pregnancy occurs or is suspected, contact your doctor immediately. Divalproex sodium is contraindicated for migraine prevention during pregnancy. For those taking it for seizure control or mental/mood disorders, such as bipolar disorder, do not discontinue use without a doctor’s directive, as untreated conditions pose significant risks to both the pregnant individual and the unborn child.

When taking this medication, some common side effects like diarrhea, dizziness, drowsiness, hair loss, blurred or double vision, changes in menstrual cycles, ringing in the ears, shakiness, unsteadiness, and weight fluctuations might occur. These effects are generally mild, but if they persist or worsen, consider consulting a healthcare professional.

It is important to be aware that a few individuals on anticonvulsants may experience serious mental health issues, such as depression or suicidal thoughts. If you or those around you notice sudden changes in mood or behavior, seek medical advice immediately.

Rarely, a severe brain disorder called encephalopathy can manifest, particularly in those with specific metabolic conditions. Symptoms like unexplained weakness, vomiting, or sudden confusion should prompt immediate medical consultation.

Serious side effects requiring urgent medical attention include chest pain, easy bruising or unexplained bleeding, irregular heartbeat, swelling of extremities, uncontrolled eye movements, feeling cold, rapid breathing, or loss of consciousness.

Allergic reactions to this medication are rare but can be severe. If you experience symptoms like fever, swollen lymph nodes, rash, severe dizziness, difficulty breathing, or swelling of the face, tongue, or throat, seek emergency medical help.

While this list covers several potential side effects, it is not exhaustive. If you notice any other unusual symptoms, reach out to a healthcare provider for guidance.

This medication can interact with certain other drugs, so it's important to be aware of potential combinations. These include some antidepressants like Amitriptyline, Nortriptyline, and phenelzine; antibiotics such as imipenem from the carbapenems group; the antimalarial drug Mefloquine; the weight-loss medication Orlistat; and other seizure medications including Ethosuximide, Lamotrigine, Rufinamide, and Topiramate. Additionally, interactions may occur with vorinostat, Warfarin, and Zidovudine.

It's also crucial to inform your doctor or pharmacist if you are using other products that may cause drowsiness. These can include alcohol, cannabis, antihistamines like Cetirizine and diphenhydramine, sleep or anxiety medications such as Alprazolam and Zolpidem, muscle relaxants like Carisoprodol and Cyclobenzaprine, and opioid pain relievers such as codeine and hydrocodone.

Always check the labels of all your medicines, including those for allergies or colds, to ensure they do not contain ingredients that could cause drowsiness. Consult your pharmacist for guidance on how to use these products safely.

Moreover, this medication might affect the results of certain laboratory tests, like urine ketones. Ensure that laboratory staff and your healthcare providers are informed that you are taking this medication.