How does it work?

This medicine contains the active ingredient sodium valproate, which is a medicine that is used mainly to treat epilepsy. It works by stabilising electrical activity in the brain. The brain and nerves are made up of many nerve cells that communicate with each other through electrical signals. These signals must be carefully regulated for the brain and nerves to function properly. When abnormally rapid and repetitive electrical signals are released in the brain, the brain becomes over-stimulated and normal function is disturbed. This results in fits or seizures. Sodium valproate prevents epileptic fits by preventing the excessive electrical activity in the brain. It is thought to achieve this by increasing the activity of a neurotransmitter called GABA in the brain. Neurotransmitters are chemicals that are stored in nerve cells and are involved in transmitting messages between the nerve cells. GABA is a neurotransmitter that acts as a natural 'nerve-calming' agent. It helps keep the nerve activity in the brain in balance. Sodium valproate is thought to increase the production and prevent the breakdown of GABA in the brain. This increases the calming activity of GABA in the brain, which stabilises the electrical nerve activity and helps prevents fits. Sodium valproate may also stabilise the electrical nerve activity by preventing sodium from entering the nerve cells when they begin to fire rapid and repetitive electrical signals. A build up of sodium in the nerve cells is necessary for an electrical signal to build up and be passed on, so sodium valproate may also prevent fits in this way. In addition to its licensed use for treating epilepsy, sodium valproate is used off-licence by specialists as a mood stabiliser for treating people with the psychiatric illness, bipolar affective disorder. This use is not licensed, but the medicine has been shown to be effective for controlling episodes of mania in this condition, and for helping prevent future episodes of ill health. It is not fully understood how sodium valproate works as a mood stabiliser in bipolar disorder, but is thought to be to do with the increased activity of GABA in the brain.

What is it used for?

Epilepsy

Maintenance treatment as a mood stabiliser in bipolar disorder to help prevent episodes of ill health (unlicensed use)

Treatment of acute manic episodes in bipolar affective disorder (unlicensed use)

Warning!

You should not suddenly stop taking this medicine unless your doctor tells you otherwise.

This medicine may cause blood, liver or pancreatic disorders. You should have blood tests to monitor your liver function and blood cell count before you start treatment. Your liver function should be monitored for the first six months of treatment, and your blood cell count should be checked before any surgery. Tell your doctor if you experience any of the following symptoms during treatment: lack of appetite and energy, weakness, drowsiness, nausea, vomiting, abdominal pain, swelling of ankles or hands, yellowing of the skin and eyes (jaundice) and bruising or bleeding with no obvious cause.

People with diabetes should be aware that Epilim syrup contains sucrose, and that sodium valproate may cause false positive results in urine tests for ketones.

This medicine can cause some people to put on weight. Talk to your doctor about this before you start treatment so that you can discuss strategies, such as diet and exercise, for minimising any weight gain.

This medicine may cause drowsiness, especially if it is taken with other antiepileptic medicines, or with benzodiazepines such as lorazepam. This may affect your ability to drive or operate machinary.

Use with caution in

Decreased kidney function

Diabetes

Disorders of urea production in the liver (urea cycle disorders)

History of liver disease

Long-term inflammation of skin and some internal organs (systemic lupus erythematosus)

Not to be used in

Active liver disease

Family history of liver disease, particularly liver disease caused by medications

Life long inherited blood diseases which can cause a variety of symptoms, including mental health problems (porphyrias)

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

It is very important for women with epilepsy to talk to the doctor responsible for their epilepsy treatment before becoming pregnant. Antiepileptic medicines are associated with an increased risk of developmental disorders and malformations in the baby. However, stopping antiepileptic treatment during pregnancy runs the risk of the mother having seizures, which can harm both the mother and the foetus. This risk may be higher than that from continuing the medication. It is important that all the risks and benefits of treatment are weighed up. Seek medical advice from your doctor.

This medicine passes into breast milk in small amounts. Seek medical advice from your doctor before breastfeeding.

Label warnings

Do not stop taking this medication except on your doctor's advice.

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