How does it work?

This medicine contains the active ingredient valproic acid, which is another form of the antiepileptic medicine, sodium valproate. Both can be known simply as valproate. Valproate 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. Valproic acid works in the same way as sodium valproate; 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 natural body 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. Valproic acid is thought to increase the production and prevent the breakdown of GABA in the brain. This enhances the calming action of GABA in the brain, which stabilises the electrical nerve activity and helps prevent fits. In addition to its licensed use for treating epilepsy, valproic acid 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 valproate 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 valproic acid 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?

Generalised tonic-clonic seizures

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

Partial seizures

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 drowsiness. If affected do not drive or operate machinery.

This medicine may interfere with urine tests for substances called ketones, causing the tests to give a "false positive" result, ie the test may say that ketones are present in the urine even if they are not. It is important that people with diabetes who are taking this medicine are aware of this effect.

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 liver disorders, pancreatitis and problems with blood clotting. You should have blood tests to monitor your liver function and blood clotting ability before starting treatment, before any dose increases and at two monthly intervals during treatment. Your blood clotting should also be checked before any surgery. Tell your doctor if you experience any of the following symptoms while taking this medicine: severe abdominal pain, nausea and vomiting, loss of appetite and energy, yellowing of the eyes and skin (jaundice) abnormal bleeding or a tendency to bruise more easily.

Use with caution in

Diabetes

Not to be used in

Liver disease

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.

This medication is to be swallowed whole, not chewed.

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