What is Divalproex? Uses, warnings & side effects

Take this medicine as prescribed. The dose may need to be changed in the first weeks of treatment. 

Do not take more divalproex than prescribed. If the medicine is not working, talk to the prescriber.

Please read the Medication Guide that comes with this medicine.

Divalproex can be taken with or without food. Try taking it with food if the tablet or capsule causes nausea or stomach upset.

How to take divalproex delayed-release tablets:

• Tablets are taken two or three times daily.

• Swallow the tablet whole with a drink of water. Do not crush, break, or chew it.

• Store divalproex delayed-release tablets at room temperature below 86˚F.

How to take divalproex extended-release tablets:

• Take only one dose daily.

• Swallow the tablet whole with a drink of water. Do not crush, break, or chew it.

• Talk to the prescriber if you cannot swallow the tablet.

• Store divalproex ER tablets at room temperature.

How to take divalproex delayed-release capsules (sprinkles):

• Divalproex capsules are for the treatment of seizures only.

• Divalproex capsules are taken two or three times daily.

• Swallow the capsule with a drink of water.

• The capsule can also be opened and sprinkled on soft food in a cup or bowl.

• Use food such as applesauce or pudding.

• To open the capsule, hold it so that the half marked “THIS END UP” is at the top and the arrow next to the lettering is pointing up.

• Hold the capsule over the food.

• Gently twist off the top of the capsule.

• If any pellets fall on the table or counter, throw away the capsule and start over.

• Empty the pellets onto the food.

• Gently stir the pellets into the food.

• Administer the mixture immediately. Swallow the mixture without chewing.

• Drink water immediately after swallowing the dose.

• Store divalproex delayed-release capsules at room temperature below 77˚F.

Do not stop taking doses until you consult with the prescriber.

Take a dose as soon as it’s remembered. 

If it is almost time for the next dose, wait until then and take a regular dose. 

Do not take two doses to make up for a missed dose.

This medicine is not right for everyone. 

Do not use it if you have had an allergic reaction to divalproex, valproate sodium, or valproic acid. 

Do not use divalproex if you have:

• Liver disease

• Genetic disorders that affect liver function (mitochondrial disorders)

• A genetic disorder called urea cycle disorder

Women who are pregnant should not use divalproex for migraines.

Tell any doctor or healthcare professional treating you about taking divalproex. It can alter the results of some important blood tests.

The prescribing clinician will need to visit with you regularly to monitor your progress and perform blood tests. Keep all appointments.

Divalproex can harm an unborn baby.

• Tell the prescriber if you’re pregnant or planning to become pregnant before starting divalproex. 

• Immediately inform the prescribing healthcare provider if you become pregnant while on divalproex.

Before taking divalproex, tell the prescriber if you are breastfeeding or if you have:

• Liver disease or a history of liver disease

• A mitochondrial disorder or urea cycle disorder

• Blood disease

• Pancreas problems

• A viral infection (including HIV or cytomegalovirus infection)

• A history of depression, suicide, or other mental health problems

Tell the prescriber if you drink alcohol.

Divalproex can cause serious side effects, including: 

• Liver problems

• Pancreatitis (swelling of the pancreas)

• High ammonia levels in the blood

• Depression or thoughts of suicide

• Hypothermia (low body temperature)

• Bleeding problems

Divalproex can make people depressed or suicidal. Talk with the prescriber immediately if you notice any thoughts or behavior changes that concern you. 

Divalproex can make people dizzy or drowsy. Do not drive or do anything else that requires alertness until you know how this medicine affects you.

Divalproex can reduce male fertility. Men who are trying to have children with their partner should talk to the prescriber. 

In very rare cases, divalproex can cause a serious allergic reaction that affects vital organs such as the heart, liver, or kidneys. Immediately contact the prescriber if you notice symptoms such as rash, swollen lymph nodes, fever, and other signs.

Do not stop using this medicine suddenly until talking to the prescriber. Abrupt discontinuation of divalproex can bring on seizures unless the dose is gradually reduced.

If there’s any tablet residue in your stool, contact the prescriber.

To avoid possible drug interactions, tell the doctor about all prescription drugs, over-the-counter medications, and supplements you take or plan to take, particularly:

• Other anticonvulsants, particularly carbamazepine, diazepam, ethosuximide, felbamate, lamotrigine, phenobarbital, phenytoin, primidone, or topiramate

• Carbapenem antibiotics

• Estrogen-containing contraceptives

• Cannabinoids (CBD)

• Drugs that make you sleepy, such as narcotic pain medications or sedatives

• Amitriptyline, aspirin, felbamate, methotrexate, Paxlovid, propofol, rifampin, ritonavir, rufinamide, tolbutamide, warfarin, zidovudine

Do not drink alcohol when taking divalproex.