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Depakote

Drug Name: Depakote

Drug ID: 68

Nutritional Considerations

  • Do not take this medication with sodas or any carbonated beverage. The carbonation could release valproic acid, which could greatly irritate the mouth and throat.

    1. Rybacki JJ. The Concise Essential Guide to Prescription Drugs, HarperCollins, 1997.
    2. Pronsky, Z Food Medication Interactions, 11th edition, 1999
  • Depakote may cause deficiencies in the amino acid carnitine. Supplementation may be useful with long term use of the medication.

    1. Ohtani Y, Endo F, Matsuda I. Carnitine deficiency and hyperammonemia associated with valproic acid therapy, J Pediatr, 1982; 101:782-785.
    2. Van Wouwe JP. Carnitine deficiency during valproic acid treatment. Internat J Vit Nutr Res 1995;65:211-14.
    3. Farkas V, Bock I, Cseko J, et al: Inhibition of carnitine biosynthesis by valproic acid in rats - the biochemical mechanism of inhibition, Biochem Pharmacol, 1996, 52(9):1429-33.
    4. Matsuda I, Ohtani Y, Ninomiya N: Renal handling of carnitine in children with carnitine deficiency and hyperammonemia associated with valproate therapy, J Pediatr, 1986, 109(1):131-4.
    5. Tein I, DiMauro S, Xie ZW, et al: Valproic acid impairs carnitine uptake in cultured human skin fibroblasts - an invitro model for the pathogenesis of valproic acid-associated carnitine deficiency, Pediatr Res, 1993, 34(3):281-7.
    6. Opala G, Winter S, Vance C, et al: The effect of valproic acid on plasma carnitine levels, Am J Dis Child, 1991, 145(9):999-1001.
    7. De Vivo DC, Bohan TP, Coulter DL, et al: L-carnitine supplementation in childhood epilepsy - current perspectives, Epilepsia, 1998, 39(11):1216-25.
    8. Castro-Gago M, Camina F, Rodriguezx-Segade S. Carnitine deficiency caused by valproic acid. J Pediatr 1992;120:496 [letter].
  • Depakote may also contribute to deficiencies in folic acid, vitamin E, and selenium Long-term usage of Depakote with vitamin D deficiency has been shown to cause osteomalacia. Supplementation may be beneficial.

    1. Hahn TJ, Halstead LR: Anticonvulsant drug-induced osteomalacia: alterations in mineral metabolism and response to vitamin D administration, Calcif Tiss Internat. 1979; 27:13-18.
    2. Mountain KR, Hirsch J, Gallus AS: Neonatal coagulation defect due to anticonvulsant drug treatment in pregnancy, Lancet, 1970; 1:265-268.
    3. Nurge ME, Anderson CR, Bates E. Metabolic and nutritional implications of valproic acid. Nutr Res 1991;11:949-60.
    4. Hendal J, et al. The effects of carbamazepine and valproate on folate metabolism. Acta Neurol Scand 69: 226-231, 1984.
  • Use of alcohol should be avoided.

    1. Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
    2. Pronsky, Z Food Medication Interactions, 11th edition, 1999

Herbal Considerations

  • These herbs may increase the risk of seizures: Borage, Evening Primrose Oil, Ground Ivy and Sage.

    1. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996:21,45,63,282.
  • These herbs may have sedative properties and should be avoided: Chamomile (German), Ginsengs, Goldenseal, Hops, Hydrocotyle (Gotu Kola), Nettle, Passionflower, Sage, Skullcap, Shepherd’s Purse, St. John’s Wort, Valerian, Wild Carrot and Wild Lettuce.

    1. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996:21,45,63,282.
    2. PDR for Herbal Medicines, 2nd edition, Medical Economics Company, 2000
    3. The Review of Natural Products, Clinisphere 2.0, Wolters Kluwer Company, 2000

NDC Codes

00074611411, 00074611413, 00074621211, 00074621213, 00074621411, 00074621413, 00074621453, 00074621511, 00074621513, 00074621553, 00074712611, 00074712613, 00074712671, 00339604121, 00339604214, 00339634511, 00615134453, 00615134463, 00615457753, 00615457763, 00615457853, 00615457863, 51129173401, 54569026100, 54569026103, 54868120800, 54868120801, 54868120802, 54868120803, 54868254300, 54868254400, 54868254401, 54868254402