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Overview: Valproic acid is used to treat certain types of seizures. Common side effects include trouble with balance or coordination, dizziness, and drowsiness. Do not drive or do other activities that require alertness or coordination until you know how valproic acid affects you. If you can get pregnant, use effective birth control because this medicine can harm a baby. Tell your health care provider right away if you get a rash, vomiting, severe stomach pain, unusual bleeding, or changes in your mood or behavior. Do not stop this medicine or start or stop any other medicine without talking with your health care provider.

Uses

What is valproic acid used for?

Valproic acid is commonly used to treat certain types of seizures.

Valproic acid may also be used for other conditions as determined by your health care provider.

How does valproic acid work (mechanism of action)?

Seizures happen when too many nerve signals are sent between brain cells too quickly. Valproic acid is thought to work by slowing down overactive brain signals and making seizures less likely.

How is valproic acid supplied (dosage forms)?

Brands and other names

  • Depakene
  • Stavzor

Dosage forms and strengths

  • 250 mg oral capsules
  • 250 mg/5 mL oral solution

How should I store valproic acid?

Valproic acid should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Protect from light, moisture, and humidity.

Side Effects

What are the most common side effects of valproic acid?

The most common side effects of valproic acid are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Stomach pain, nausea, and vomiting
  • Dizziness and drowsiness
  • Hair loss
  • Changes in vision, including double or blurred vision
  • Memory problems
  • Trouble with balance or coordination
  • Diarrhea
  • Headache

There may be other side effects of valproic acid that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of valproic acid?

While less common, the most serious side effects of valproic acid are described below, along with what to do if they happen.

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking valproic acid and can be life-threatening. Keep all appointments to have your blood checked. Call your health care provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Inflammation of the Pancreas (Pancreatitis). Valproic acid may cause inflammation of the pancreas, which is called pancreatitis. As this condition can be life-threatening, call your health care provider right away if you have nausea, vomiting, or severe pain in the upper part of your belly that travels to your back.

Suicidal Thoughts and Actions. Valproic acid may cause suicidal thoughts or actions in a small number of people. If you are about to harm yourself, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your health care provider right away if you have any of the following symptoms.

  • New or increased thoughts of suicide or death
  • Suicide attempt
  • New or increased feelings of anxiety, depression, or other unusual changes in mood or behavior

Severely Low Platelet Levels.  Valproic acid can cause you to have a severely low number of platelets in your blood, also called thrombocytopenia. Platelets help to form blood clots. Having a low level of platelets may increase your risk of bleeding. Keep all appointments to have your blood checked. Tell your health care provider if you have any of the following symptoms of low platelet levels.

  • Easy bruising or bleeding
  • Bleeding that does not stop
  • Nosebleeds

High Ammonia Level. Valproic acid can increase ammonia levels in your blood. You may need a blood test to check the amount of ammonia in your blood. Tell your health care provider right away if you develop any of the following symptoms of high ammonia levels.

  • Nausea and vomiting
  • Unexplained tiredness
  • Confusion or slowed thinking
  • Slowed reaction time
  • Trouble with balance or coordination

Hypothermia. Valproic acid can cause hypothermia, a dangerous drop in body temperature. Contact your health care provider right away if you have any of the following symptoms.

  • Shivering
  • Slow, shallow breathing
  • Drowsiness or exhaustion
  • Slurred or mumbled speech
  • Loss of coordination, fumbling hands, stumbling steps
  • A slow, weak pulse

Sleepiness. Valproic acid can make you sleepy, especially in people 65 and older. Do not drive or do other activities that require alertness or coordination until you know how valproic acid affects you.

Severe Allergic Reactions. Valproic acid may cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for drug reaction with eosinophilia and systemic symptoms. It is also sometimes called multi-organ hypersensitivity. This is a reaction that can affect multiple parts of the body including your liver, kidneys, and heart. Get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Shortness of breath, trouble swallowing, or throat tightness
  • Swelling in your feet, ankles, or legs
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Dark-colored pee

Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Warnings & Precautions

Who should not use valproic acid?

Allergies to Ingredients. People who are allergic to any of the following should not take valproic acid.

  • Depakene
  • Divalproex sodium
  • Sodium valproate
  • Stavzor
  • Valproic acid
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific valproic acid products they stock.

Liver Problems. Valproic acid should not be used if your liver is not working as well as it should be. If there is a concern about the health of your liver, your health care provider may do tests to determine if it is working well enough to take this medicine.

Mitochondrial Disorders. Valproic acid should not be used in people with known or suspected genetic disorders affecting the mitochondria, including Alpers-Huttenlocher syndrome.

Urea Cycle Disorders. Valproic acid should not be used in people with urea cycle disorders, a group of conditions that make it hard for your body to digest proteins and get rid of waste products.

Migraine Prevention in Certain People. Valproic acid should not be used to prevent migraine headaches if you are pregnant or can become pregnant and you are not using effective birth control. 

What should I know about valproic acid before using it?

Do not take valproic acid unless it has been prescribed to you by a health care provider. Take it as prescribed.

Taking valproic acid with food may help avoid stomach pain and irritation. 

Swallow the capsules whole. Do not crush or chew the capsules.

If you are taking the liquid formulation, u​se an accurate measuring device to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device.

Do not share valproic acid with other people, even if they have the same condition as you. It may harm them.

Keep valproic acid out of the reach of children.

While valproic acid helps make seizures less likely, it does not cure them. Do not stop taking valproic acid without talking to your health care provider. Stopping valproic acid suddenly may cause an increase in seizure activity, which can be serious.

White taking valproic acid, some birth control may not work as well. Talk with your health care provider about the best birth control options for you.

Valproic acid may affect the results of urine ketone tests. If you plan to test for urine ketones, talk to your health care provider about the best way to do this while you are taking this medicine. 

People who are 65 and older can be at greater risk for some side effects from valproic acid. Talk to your health care provider about your risks if you are in this age group.

What should I tell my health care provider before using valproic acid?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if valproic acid is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Liver problems
  • Genetic condition affecting the mitochondria 
  • Blood problems
  • Mental health problems
  • HIV or AIDS
  • Cytomegalovirus infection
  • Alcohol use disorder

Other Medicines and Supplements. Valproic acid may interact with other medicines and supplements. Before taking valproic acid, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Valproic acid can cause harm to an unborn baby. Due to this risk, if you can get pregnant, talk with your health care provider about other possible treatments before taking valproic acid. If you and your health care provider decide that you should take valproic acid, you should use effective birth control while taking it. Talk with your health care provider about the best birth control for you. Tell your health care provider right away if you are pregnant, think you may be pregnant, or plan to become pregnant. If you become pregnant while taking valproic acid, you can sign up for the North American Antiepileptic Drug Pregnancy Registry by calling 888-233-2334 or at www.aedpregnancyregistry.org. This registry collects safety information about the use of seizure medicines during pregnancy.

Breastfeeding. Valproic acid passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should take valproic acid while breastfeeding.

Interactions

Does valproic acid interact with foods or drinks?

There are no known interactions between valproic acid and foods or drinks.

It is unknown if drinking alcohol will affect valproic acid. The risk of dizziness and drowsiness may be increased if you drink alcohol while taking valproic acid. It is best to avoid drinking alcohol while you are taking this medicine.

Does valproic acid interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking valproic acid.

  • A medicine for HIV or AIDS
  • Felbamate (Felbatol), which is a medicine that may be used to treat seizures
  • Phenobarbital or primidone, which are medicines that may be used to treat seizures
  • Phenytoin (Dilantin, Phenytek, and others), which is a medicine to control seizures
  • Carbamazepine (Carbatrol, Tegretol, and others), which is a medicine commonly used to treat seizures or nerve pain
  • Aspirin, which is in many prescription and OTC products, including those for pain, swelling, and fever 
  • Ertapenem, imipenem, or meropenem, which are antibiotics used to treat bacterial infections 
  • Estrogen, which is found in certain birth control pills, patches, creams, rings, or vaginal suppositories
  • Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, or medicines for anxiety
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis
  • A tricyclic antidepressant, such as amitriptyline or nortriptyline, even if it is not used for depression
  • Lamotrigine (Lamictal), a medicine for seizures and other conditions
  • Warfarin, which is a blood thinner
  • Topiramate (Qudexy XR, Topamax, Trokendi XR), which is a medicine commonly used to treat seizures or prevent migraine

Many other medicines may alter the blood levels of valproic acid, and vice versa. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with valproic acid. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much valproic acid?

If you or someone else has used too much valproic acid, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of valproic acid?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.