Sodium Valproate โ€” NZ Medication Guide

What is Sodium Valproate?

Sodium valproate is a broad-spectrum anticonvulsant and mood stabiliser used for epilepsy and bipolar disorder. This medication is funded by Pharmac for epilepsy and bipolar disorder.

What is Sodium Valproate Used For?

Used for generalised epilepsy (tonic-clonic, absence, myoclonic seizures), focal seizures, Lennox-Gastaut syndrome, and mania in bipolar disorder.

How Does Sodium Valproate Work?

Increases brain GABA levels by inhibiting its breakdown enzyme, and blocks voltage-gated sodium channels โ€” reducing neuronal excitability. Its mood-stabilising mechanism may involve ion channel and gene regulatory effects.

How to Take Sodium Valproate

Doses range from 600โ€“2500 mg/day in divided doses. Modified-release (Epilim Chronoยฎ) is taken once or twice daily and may be better tolerated. Take with food. Do not crush modified-release tablets.

Common Side Effects of Sodium Valproate

  • Weight gain
  • Hair loss (alopecia โ€” usually reversible)
  • Tremor
  • Nausea and gastric upset
  • Liver enzyme elevation
  • Sedation
  • Peripheral oedema

Serious Side Effects โ€” Seek Medical Attention

Contact your doctor or call 111 immediately if you experience any of the following:

  • Teratogenicity (HIGHLY SIGNIFICANT โ€” neural tube defects, autism, developmental delay โ€” must not be used in women of childbearing potential without exceptional circumstances)
  • Hepatotoxicity (including fatal liver failure โ€” mostly young children on polytherapy)
  • Pancreatitis
  • Hyperammonaemia with encephalopathy
  • Thrombocytopaenia

Drug Interactions

Sodium Valproate may interact with other medicines. Always inform your doctor and pharmacist of all medications you are taking. Key interactions include:

  • Lamotrigine (doubles lamotrigine levels)
  • Carbapenem antibiotics (meropenem โ€” dramatically reduce valproate levels โ€” avoid)
  • Aspirin (displaces from protein binding)
  • Warfarin (enhanced anticoagulant effect)

New Zealand Prescribing Information

Sodium valproate (Epilimยฎ, Epilim Chronoยฎ and generics) is funded by Pharmac. Medsafe has implemented a Valproate Pregnancy Prevention Programme in NZ. Women of childbearing potential must not be prescribed valproate without documented risk acknowledgement, effective contraception, and annual specialist review.

Frequently Asked Questions

Is valproate safe in pregnancy?

No โ€” it is highly teratogenic, causing neural tube defects and developmental problems in up to 30โ€“40% of exposed children. It must not be used in women who are or may become pregnant unless absolutely no alternative exists.

Can I drink alcohol on sodium valproate?

Alcohol should be avoided โ€” both suppress the CNS, increasing sedation and falls risk. Alcohol also worsens seizure control and mood instability.

Reviewed by a Registered Pharmacist NZ

References & Further Information

The following New Zealand and international resources were used to inform this page:

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