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Divalproex Sodium (Depakote) is associated with several important safety considerations that require your attention. Below is crucial information regarding the potential risks, necessary precautions, and special instructions for use:

• Liver Concerns: Divalproex Sodium may lead to serious liver issues, potentially life-threatening, especially within the first six months of treatment. Risk factors include children under two years, multiple anti-seizure medications, severe seizure disorders, certain genetic metabolic conditions, and current or past liver problems. Regular liver function tests are recommended during this period.

• Pancreatitis Risk: This medication has been linked to rare but severe inflammation of the pancreas. Symptoms such as persistent nausea, vomiting, abdominal pain, or fever require immediate medical attention.

• Pregnancy Warnings: Avoid using divalproex if you are pregnant due to risks of birth defects and developmental issues in the unborn child. Discuss contraception options or alternative treatments with your healthcare provider. If pregnancy occurs, contact your provider promptly and consider enrolling in the North American Antiepileptic Drug Pregnancy Registry for monitoring.

• Suicide Risk: As with other anti-epileptic medications, there is an increased risk of suicidal thoughts or behavior. The risk is higher if you have a history of depression. Inform family and friends to monitor for any mood changes and notify your healthcare provider immediately if concerning symptoms arise.

• Blood Cell Counts: In rare cases, divalproex may cause a decrease in blood platelet counts, increasing the risk of bleeding. Regular blood tests are advised, and any signs of unusual bruising should be reported to your healthcare provider.

• Ammonia Levels: Elevated ammonia levels can occur, especially if taken with topiramate, leading to symptoms such as fatigue, vomiting, or confusion. Individuals with a history of metabolic disorders should not use this medication.

• Severe Allergic Reactions: Rare but severe skin and allergic reactions, including rash, blisters, or fever, may occur. Immediate medical help should be sought if these symptoms develop.

• Drug Interactions: Divalproex may interact with other medications, affecting its efficacy and side effect profile. Always inform your healthcare provider of all medications you're taking.

Contraindications: Do not use this medication if you have a history of liver disease, certain genetic disorders (e.g., Alpers-Huttenlocher Syndrome), or are pregnant or could become pregnant without using contraception. It is also contraindicated for migraine prevention during pregnancy.

Always consult your healthcare provider for personalized advice and before making any changes to your medication regimen.

Common side effects:

• Nausea
• Dizziness
• Drowsiness
• Vomiting
• Changes in weight
• Changes in menstrual periods

• Feelings of low energy

  Less common but important to monitor:

• Shakiness
• Blurred vision
• Accidental injuries

• Stomach pain

  Serious side effects:

• Chest pain
• Unexplained bruising
• Irregular heartbeat
• Swelling of hands or feet
• Uncontrolled eye movements
• Severe allergic reaction
• Mood changes
• Depression
• Suicidal thoughts
• Encephalopathy

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Amitriptyline
• Nortriptyline
• Carbapenems (e.g., Imipenem)
• Ethosuximide
• Lamotrigine
• Rufinamide
• Topiramate
• Warfarin
• Vorinostat
• Zidovudine
• Orlistat
• Alcohol
• Marijuana (cannabis)
• Antihistamines (e.g., Cetirizine, Diphenhydramine)
• Alprazolam
• Zolpidem
• Carisoprodol
• Cyclobenzaprine
• Codeine
• Hydrocodone