Depakote

Do NOT use Depakote if:

• you are allergic to any ingredient in Depakote
• you have liver problems or a urea cycle disorder.

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Depakote. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, are breast-feeding, or are of childbearing age
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have a history of alcohol abuse, liver problems, metabolic disease, blood disease, HIV infection, cytomegalovirus (CMV) infection, high blood levels of ammonia or glutamine, low body temperature, low levels of albumin, brain problems (eg, organic brain disease), mental retardation, inflammation of the pancreas, kidney problems, or low levels of white blood cells, or if you are scheduled for surgery
• if you have a history of ornithine transcarbamylase deficiency or unexplained coma
• if you have a family history of urea cycle disorders or unexplained infant deaths
• if you have a history of mental or mood problems (eg, depression), or suicidal thoughts or actions
• if you take any other medicine for seizures.

Some medicines may interact with Depakote. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Benzodiazepines (eg, diazepam), carbamazepine, erythromycin, felbamate, fluoxetine, guanfacine, isoniazid, ketoconazole, risperidone, or salicylates (eg, aspirin) because the risk of serious side effects of Depakote, including changes in vision or other vision problems, clumsiness or unsteadiness, drowsiness, nausea, or vomiting, may be increased
• Clonazepam because the risk of seizures may be increased
• Topiramate because the risk of high ammonium levels, brain problems, or an unusual drop in body temperature may be increased
• Acyclovir, cancer medicines, carbapenem antibiotics (eg, ertapenem, imipenem, meropenem), cholestyramine, hydantoins (eg, phenytoin), mefloquine, nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), oral contraceptives (eg, birth control pills), or rifampin because they may decrease Depakote's effectiveness
• Anticoagulants (eg, warfarin), barbiturates (eg, phenobarbital), ethosuximide, lamotrigine, methylphenidate, primidone, tolbutamide, tricyclic antidepressants (eg, amitriptyline), or zidovudine because the risk of their side effects may be increased by Depakote.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Depakote may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Important safety information:

• Depakote may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Depakote with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Depakote; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
• Inflammation of the pancreas is a potentially life-threatening illness associated with Depakote. Symptoms include stomach pain, vomiting, or loss of appetite. Contact your doctor at once if any of these symptoms occur.
• Patients who take Depakote may be at increased risk for suicidal thoughts or actions. The risk may be greater in patients who have had suicidal thoughts or actions in the past. Patients who have bipolar (manic-depressive) illness may also have an increased risk for suicidal thoughts or actions. Watch patients who take Depakote closely. Contact the doctor at once if new, worsened, or sudden symptoms, such as depressed mood; anxious, restless, irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
• Depakote may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.
• Tell your doctor or dentist that you take Depakote before you receive any medical or dental care, emergency care, or surgery.
• Diabetes patients - Depakote may cause the results of some tests for urine ketones to be wrong. Ask your doctor before you change your diet or the dose of your diabetes medicine.
• Depakote may increase the ammonia levels in your blood. Contact your doctor right away if you experience unexplained sluggishness and vomiting or mental changes.
• Depakote 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.
• Depakote may interfere with certain lab tests, including thyroid function. Be sure your doctor and lab personnel know you are taking Depakote
• Lab tests, including complete blood cell counts, blood ammonia levels, and liver function, may be performed while you use Depakote. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Use Depakote with caution in the elderly; they may be more sensitive to its effects, especially drowsiness.
• Depakote should be used with extreme caution in children younger than 10 years old; safety and effectiveness in these children have not been confirmed. Children younger than 2 years old may be at increased risk of serious liver problems.
• Pregnancy and breast-feeding: Depakote has been shown to cause harm to the fetus. Use an effective form of birth control while you take Depakote. If you think you may be pregnant or if you wish to become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Depakote while you are pregnant. Depakote is found in breast milk. Do not breast-feed while you are taking Depakote.

All medicines may cause side effects, but many people have no, or minor, side effects.

Check with your doctor if any of these most common side effects persist or become bothersome:

Change in appetite; constipation; diarrhea; dizziness; drowsiness; hair loss; headache; indigestion; nausea; stomach cramps or pain; trouble sleeping; vomiting; weakness; weight changes.

Seek medical attention right away if any of these severe side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal thinking; change in menstrual period; changes in behavior; chest pain; confusion; dark, tarry, or bloody stools; dark urine; difficulty speaking; difficulty urinating or other urination problems; extreme tiredness; fast or irregular heartbeat; hallucinations; hearing loss; involuntary movements of the arms and legs; involuntary movements or chewing movements of the face, jaw, mouth, or tongue; joint pain; lack of energy; loss of appetite; loss of coordination; loss of seizure control; memory loss; new or worsening mental or mood changes (eg, aggressiveness, agitation, anxiety, depression, exaggerated feeling of well-being, hostility, impulsiveness, inability to sit still, irritability, panic attacks, restlessness); nosebleed; pounding in the chest; red, swollen, blistered, or peeling skin; severe or persistent nausea, vomiting, or stomach pain; shortness of breath; suicidal thoughts or actions; swelling of the arms or legs; symptoms of infection (eg, fever, chills, sore throat); tremor; unusual bleeding or bruising; unusual weakness; vision changes or blurred vision; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects.