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Sodium valproate for preventing seizures
Sodium valproate for preventing seizures
This leaflet is about the use of sodium valproate to prevent epileptic seizures. (Seizures may also be called convulsions or fits.)
This leaflet is specifically about the use of this medicine in children. The information may differ from that provided by the manufacturer, because their information is usually aimed at adults. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.
Do not stop giving sodium valproate suddenly, as your child may have more seizures.
If your daughter has sex, it is essential that she uses contraception to prevent pregnancy, as sodium valproate can harm a developing baby.
Further information about sodium valproate and pregnancy can be found in the following Medicines for Children information leaflets:
• Advice tailored for girls and young women: www.medicinesforchildren.org.uk/sodium-valproate-and-pregnancy
• Advice tailored for parents and carers: www.medicinesforchildren.org.uk/sodium-valproate-and-pregnancy-information-parents-and-carers
Name of drug
Sodium valproate (or valproic acid)
Brand names: Epilim®, Orlept®, Episenta®, Convulex®
Modified-release: Epilim Chrono®, Epilim Chronosphere®, Episenta®, Epival®
Why is it important for my child to take this medicine?
It is important that your child takes sodium valproate regularly so that they have fewer seizures.
What is sodium valproate available as?
Tablets: 200 mg, 500 mg
Crushable tablets: 100 mg
Modified-release tablets: 200 mg, 300 mg, 500 mg
Capsules: 150 mg, 300 mg, 500 mg
Modified-release capsules: 150 mg, 300 mg,
Modified-release granules: 50 mg, 100 mg, 250 mg, 500 mg, 750 mg, 1 g
Liquid medicine: 200 mg in 5 mL; this may contain a small amount of sugar.
When should I give sodium valproate?
The following advice does not apply to modified release capsules and tablets.
You will usually give sodium valproate twice each day: once in the morning and once in the evening. Ideally, these times are 10–12 hours apart, for example some time between 7 and 8 am, and between 7 and 8 pm.
Your doctor may prescribe modified release tablets (Epilim Chrono or Epival), capsules (Episenta) or granules (Episenta, Epilim Chronosphere). These are usually given once each day in the evening. However, your doctor may have told you to give it in the morning. It may sometimes be given twice a day.
Give the medicine at about the same time(s) each day so that this becomes part of your child’s daily routine, which will help you to remember.
How much should I give?
Your doctor will work out the amount of sodium valproate (the dose) that is right for your child. The dose will be shown on the medicine label.
When you first start giving sodium valproate to your child, you will give them a small amount and then increase the dose bit by bit over a few days or weeks. This helps your child to get used to the medicine. Your doctor will explain what to do.
It is important that you follow your doctor’s instructions about how much to give.
How should I give it?
Tablets: These tablets must be swallowed whole with a glass of water, juice or milk. Do not crush these tablets.
Crushable tablets: Crush the tablet and mix it with a small amount of soft food (e.g. yogurt) or a small drink. Your child should swallow the food or drink straight away, without chewing it. Make sure that they take it all.
Capsules should be swallowed whole with a glass of water, juice or milk. Your child should not chew the capsules.
Granules: Sprinkle or stir the granules into a small amount of soft food (e.g. yogurt) or a small drink. Your child should then swallow the food or drink straight away, without chewing it. Make sure that they take it all.
Liquid or syrup: Measure out the right amount using an oral syringe or medicine spoon. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.
When should the medicine start working?
It may take a few weeks for sodium valproate to work properly, so your child may still have seizures for a while. Continue to give the medicine in the way that you have been told to.
What if my child is sick (vomits)?
- If your child is sick less than 30 minutes after having a dose of sodium valproate, give them the same dose again.
- If your child is sick more than 30 minutes after having a dose of sodium valproate, you do not need to give them another dose. Wait until the next normal dose.
If your child is sick again, seek advice from your GP, pharmacist or hospital. They will decide what to do based on your child’s condition and the specific medicine involved.
What if I forget to give it?
Modified release preparations: Epilim Chrono®, Epilim Chronosphere®, Episenta®, Epival®
If you forget to give a dose, you can give it any time in the next 12 hours. After this time, wait until the next normal dose.
Other tablets, capsules and liquids: Epilim® ,Orlept®, Convulex®. valproic acid, Sodium valproate.
If you remember within 6 hours, give your child the missed dose. For example, if you usually give a dose at 7 am, you can give the missed dose at any time up to 1 pm. If you remember after this time, do not give the missed dose. Wait until it is time to give the next normal dose.
Never give a double dose of sodium valproate.
What if I give too much?
If you think you may have given your child too much sodium valproate, contact your doctor or local NHS services (details at end of leaflet) or take your child to hospital. Take the medicine container or pack with you, even if it is empty. This will be useful to the doctor. Have the packet with you if you telephone for advice.
Are there any possible side-effects?
We use medicines to make our children better, but sometimes they cause effects that we don’t want (side-effects).
Side-effects that you must do something about
If your child gets bad stomach pains or starts being sick (vomits) often, or both, take them to your doctor or hospital straight away. Your child may have a serious problem called pancreatitis.
Children occasionally get serious liver disease when taking sodium valproate. If your child starts being sick every few hours, has stomach pains, is very sleepy, gets jaundice (the skin or eyes look yellowy) or has more seizures than usual, take them to your doctor or hospital straight away.
- Your child’s hands may shake. Contact your doctor if this happens.
- If you notice any unusual bleeding or bruising, contact your doctor.
Other side-effects you need to know about
Your child may get these side-effects when they first start taking sodium valproate. They will usually settle down within a week or so as their body gets used to the medicine. Continue to give sodium valproate to your child as your doctor has told you to.
- Your child may be unusually 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 is low in fat and sugar, otherwise they will put on a lot of weight.
- Your child may feel less hungry (lose their appetite), and feel sick (nausea) or be sick (vomit). This should get better after a week or so.
- Your child may lose some hair. It will grow back, but it may be slightly curlier and darker than before.
There may, sometimes, be other side-effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side-effects to a UK safety scheme at www.mhra.gov.uk/yellowcard
Can other common medicines be given at the same time as sodium valproate?
- You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
- Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.
- Some other medicines used to treat epilepsy may affect how well sodium valporate works, or may cause side-effects. If you are worried about side-effects, or if your child seems to be having more fits, contact your doctor or epilepsy nurse.
Epilepsy and pregnancy
- Pregnancy presents a risk to both the mother with epilepsy and her unborn baby. If your daughter has sex, it is essential that she uses adequate contraception to prevent an unplanned pregnancy.
- If your daughter is worried that she may be pregnant, it is important that she sees your family doctor as early as possible. Your daughter should keep taking her medication until she sees her doctor.
Sodium valproate and pregnancy
- Women and girls taking sodium valproate should not become pregnant, because the unborn baby may be harmed.
- If your daughter is sexually active, it is vital that she uses adequate contraception to avoid pregnancy. Your doctor will provide advice on the best types of contraception.
General advice about medicines for epilepsy
Do not suddenly stop giving any of these medicines to your child, as they may have a seizure. If you are worried, talk to your doctor but carry on giving the medicine to your child as usual.
- If your child seems to have more seizures than usual, contact your doctor or your epilepsy nurse.
- If your doctor decides to stop a particular medicine, they will discuss this with you. They will usually reduce the dose bit by bit.
- It is best that your child always has the same brand of each medicine, as there may be differences between brands. Keep a record of which medicines your child has. If you have any questions or concerns, speak with your child's doctor or pharmacist.
- Try to give medicines at about the same times every day, to help you remember.
- Only give the medicine(s) to your child. Never give them to anyone else, even if their condition appears to be the same, as this could do harm.
- Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
- Make sure that the medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.
- Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
- Make sure that children cannot see or reach the medicine.
- Keep the medicine in the container it came in
Do not change the dose of any drug without talking to your doctor first.
If you think someone else may have taken the medicine by accident, contact your doctor straight away.
Where should I keep this medicine?
Who to contact for more information
Your child’s doctor, epilepsy nurse or pharmacist will be able to give you more information about sodium valproate and other medicines used to treat epilepsy.
You can also get useful information from:
- England: NHS 111
- Scotland: NHS 24
- Wales: NHS Direct
Tel 0845 46 47 (2p per minute) or 111 (free)
- Northern Ireland: NI Direct
- Young Epilepsy
Helpline 01342 831 342
- Epilepsy Society
Helpline 01494 601 400
- Epilepsy Action
Helpline 0808 800 5050
Version 2.3, March 2015 (March 2019). © NPPG, RCPCH and WellChild 2011, all rights reserved. Review by: March 2018.
The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk
We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.