Sodium Valproate

Parent or patient Information Leaflet

Dr. C. P. Ravi Kumar

Consultant Paediatric Neurologist
MRCPCH, CCT in Paediatrics (U.K.)
Fellow in Paediatric Epilepsy &
Neurology (London)

Brand names :
Tablet : Valparin, Epival
Syrup : Valparin, Encorate

Delayed-release: Encorate Chrono, Valparin Chrono

Valproate is a medicine used in epilepsy to control several different seizures or convulsions (fits): absences (vacant seizures), generalized tonic-clonic seizures, myoclonic seizures (jerks), atonic seizures, infantile spasms or partial seizures.

Why is Sodium Valproate important for my child’s treatment?

It is important that your child takes sodium valproate regularly so that they have no Seizures or fewer seizures.

Do not stop giving sodium valproate all of a sudden, as it may lead to your child having more seizures.

What is sodium valproate available as?

Sodium Valproate is available in the preparation of Liquid medicine, Tablets, Modified-release tablets (releases medication slowly into blood after it has been consumed.

“Generic Vs Branded Drugs”

When should sodium valproate be given?

Twice a day; morning and evening. Ideally, 10-12 hours apart.

For example, anytime between 7 to 8 am and right after 12 hours between 7 to 8 pm. You can adjust the time slot according to your schedule.

However, there are some exceptions when your doctor may advise to give it thrice a day. Please follow your doctor’s instructions in such case.

It should ideally be given at the same time every day to establish a routine as it minimizes the chances of missing a dose.

What if I miss a dose?

Tablets & liquids: The child can be given the missed dose, if you remember to give it within a lapse of 6 hours. If you fail to give the missed dose within 6 hours, then might as well leave it. It is advisable to wait until the time of next routine dose.

Modified release preparations: If you miss give a dose, you can give it any time within the next 8 hours. If you fail to do so, wait until the next routine dose.

Never and Ever give a double dose of sodium valproate to your child.

If your child vomits out the content within 30 minutes of taking the medicine dosage then you can give the dose again; but if your child vomits after 30 minutes of taking the dose, then just leave it be and do not give it again.

How much of the drug should be given?

Your doctor will work out the accurate amount of Topiramate (the dose) for your child in the prescription.

When you first start giving Sodium Valproate to your child, you are supposed to give them a small amount and then increase the dose little by little over a course of few days or weeks. This helps your child’s body to get use to the medicine. Your doctor will clarify what steps to take.

It is mandatory to follow the instructions given by your doctor about the dosage of medication.

Ultimately, when your child is free of seizures or convulsions (fits) and has no obvious side effects, you will know that the dosage is just correct.

How should I give the medicine ? “Giving Medicines”

Tablets: A whole tablet must be swallowed with a glass of water, juice or milk. You may give it by crushing and mixing it in water/ juice or small serving of yogurt / Curd.

Liquid or syrup: Use an oral syringe or a medicine spoon to measure the adequate amount. You can easily get these from any pharmacy nearby.

Do not use a kitchen teaspoon as it will not give the accurate amount of the drug.

Could this medication have any side effects on my child? Side effects

Although medicines are given to make children feel better, sometimes, they may cause some unwanted side effects.

Side-effects that you must do something about

Pancreatitis: If your child gets bad stomach pains or starts being sick (vomits) often, or both, take them to your doctor or hospital straight away.

Liver disease: If your child’s health deteriorates and falls sick every few hours, suffers from stomachache, skin and eyes are pale yellow in color, feels lethargic and sleepy or increased number of seizures take them to your doctor straight away.

Slight tremor of hands may rarely be seen in children when given a high dosage. However, they disappear following a reduction in dosage.

Occasionally, Sodium Valproate causes a reduction in the blood platelets, which help the blood to clot after cuts. However, this rarely causes a matter of concern, but if your child does develop unexplained bruising or bleeding, you should right away contact your doctor who will arrange a blood test.

Other side effects you should take notice of are:

Some of these side effects may be noticed in first few days after taking sodium valproate. They will be able to settle down within a course of week or so as their body gets used to the medicine.Continue to give sodium valproate to your child as your doctor has directed you to.

Your child may feel unusually dizzy or sleepy, or their behaviour may change.

Your child may be hungrier than usual – this effect can last for many months. Encourage your child to eat food that has more fruits and vegetables, reduce sugar and fat intake, otherwise they will put on a lot of weight.

Your child may loose his/her appetite and feel like vomiting (nausea) or actually vomit. These problems can be avoided by starting with a small dose with food and gradually increasing the dosage given.

Your child may lose some hair that may grow back, but it can be slightly curlier and darker in color than before.

If your child starts developing skin Rash, Stop Medications right there and SEEK IMMEDIATE MEDICAL ADVICE from your DOCTOR

Sometimes your child may experience other side-effects that are not listed above. If you notice any abnormalities with your child’s body or behavior, do not hesitate and immediately contact your doctor.

Despite this long list of side effects, Valproate is a very effective anti-epileptic (anticonvulsant) medicine and has very little effect on the child’s alertness levels, behaviour and learning abilities.

Can other common medicines be given during the course of sodium valproate?

Medications like ibuprofen, paracetamol, antibiotics or any of the other over the counter medicines can be given when necessary, except the ones your doctor has prohibited you from.

Consult with your doctor before giving any other medicines to your child. This includes herbal or complementary medicines.

Some other medicines used to treat epilepsy may affect the efficacy of sodium valproate or may cause side effects. If your child is experiencing more fits or seizures, or any other side effects after using other medications, talk to your doctor immediately.

Sodium valproate and pregnancy

Sodium valproate has the potential to harm fetus, (baby in the womb), hence please speak to your obstetrician or neurologist who has advised sodium valproate.

The oral contraceptive pill is advised and can be consumed safely in women or girls who are taking sodium valproate.

Where should I keep the medication?

Keep the medicine in a cupboard, secured away from heat and direct sunlight. It is not a must to keep the medicine in the refrigerator though.

Make sure the medicine is out of your child’s reach.

Store the medication in the same box it was packed in.

For more information please take a look at the manufacturer’s information leaflet.

References :

1. IAP Drug Formulary Web Update 2020(3) Edition 58, https://www.iapdrugformulary.com/Home
2. Consumer Medicines Information (CMI), https://www.tga.gov.au/consumer-medicines-information-cmi
3. British National Formulary for Children (BNFC), https://www.nice.org.uk/bnfc
4. Food and Drug Administration, USA https://www.fda.gov