Valproate

Some people cannot take valproate

You should not take valproate if any of these apply to you:

• you are allergic to valproate semisodium or any of its ingredients
• You currently have liver problems
• you or someone in your family has ever had serious liver problems related to medicines
• you have systemic lupus erythematosus (an inflammatory condition also called lupus or SLE)
• you have a rare illness called porphyria which affects your metabolism
• you are trying to get pregnant

Valproate can cause fertility problems in men and young women, and problems in the unborn baby if you do become pregnant. Because of this, valproate is not recommended for young women who could become pregnant. Learn more about this in the Sex, drink, weight and everything else section.

You must go to A&E if you take too much 

What to do if you take too much:

• If you have taken more valproate than it said on the label, you must get help quickly – even if you do not feel any different.
• Go to A&E. Take your medicine with you, to show to the doctors. Tell them how much you have taken.
• Get a friend to go with you, if you can, just in case you feel ill on the way.

You might get any of the following signs:

• being sick
• headache
• blurred eyesight (because the pupils of your eyes get smaller)
• confusion and tiredness
• weak or ‘floppy’ muscles, with no reflexes
• fits (seizures)
• blackouts (loss of consciousness)
• behavioural changes
• breathing difficulties such as fast breathing, shortness of breath or chest pain.

If you have any thoughts of suicide, or of other ways of hurting yourself, go straight to a hospital with your tablets.

This may be a side-effect, and you need urgent help.

Valproate can make some people think about hurting themselves or committing suicide. This can happen to anyone, including people who are under 18.

You must go straight to hospital with your tablets if you have any of these thoughts. You must tell the doctor that you are taking valproate. Although these feelings can be upsetting, they will go away shortly after the medicine is stopped. Do not worry because there are other medicines that can help. 

Valproate can affect your bones if you take it for a long time

Valproate can affect your bone growth.

• It may make the bone thinner over a long time, and make you more likely to get broken bones (fractures).  This is because valproate can affect vitamin D in the body – your doctor might recommend you take a vitamin D supplement
• Talk to your doctor or pharmacist if this worries you.

Your doctor will check your blood while you are taking valproate

Your doctor will do blood tests before you start taking valproate, and if you are on it for a long time

• The blood test will check that your liver and kidneys are working properly
• The doctors should repeat these at least every year you're taking valproate. If you haven't had these checked for a while, talk to your doctor to make sure they're up to date.

Valproate can interact with some other medicines

Do not take valproate if you take:

• medicines for joint pain like aspirin, or any tablets containing anything called ‘salicylates’
• another medicine containing valproate – you need to change over carefully from one to the other

Talk to your doctor or pharmacist if you are taking any of these medicines, as they may not mix well with valproate:

• medicines used to treat fits (epilepsy) such as phenobarbital, primidone, phenytoin, carbamazepine, topiramate, and lamotrigine
• medicines for low mood (depression)
• medicines used for other mental health conditions, like diazepam and olanzapine
• zidovudine (treats HIV infection)
• antibiotics in the ‘carbapenem group’ like imipenem, meropenem, rifampicin and erythromycin
• mefloquine or chloroquine (for malaria)
• warfarin and other medicines used for thinning the blood
• temozolomide (for some types of cancer)
• cimetidine (for stomach ulcers)
• colestyramine (for lowering cholesterol)

Your doctor may change the dose of one of your medicines and watch your treatment closely.

• Always talk to the doctor if you are taking other medicines.
• Tell the pharmacist you are taking valproate if you buy medicines (including things you put on your skin) for common illnesses

Valproate does not mix well with street drugs or legal highs

• Valproate may reduce the amount of methadone in your body. This would be dangerous if you stopped valproate suddenly, as the methadone level would rise.
• We do not know if valproate mixes with cannabis. Feeling sleepy can be a sign that valproate is affecting your liver, so you should watch this carefully as it might not be the cannabis causing that effect.
• We do not know how valproate mixes with cocaine, ecstasy and amphetamines. As these are stimulants, it is possible that they would act against the calming effect of valproate.
• We don't know how valpropate mixes with legal highs.

Stopping the medication causes the balance of chemicals in the brain to alter

Once you start taking valproate, the brain adjusts to having its calming effect. If you stop taking the valproate all at once, the balance starts to change again. You could get your old symptoms back.

Stopping this medicine quickly, or reducing the dose too much at once, may cause uncomfortable symptoms

You can stop taking it safely with your doctor’s help

When you decide with your doctor to stop taking valproate, you will probably reduce the dose slowly over a month to stop you getting any uncomfortable symptoms such as trembling hands, feeling or being sick, and feeling anxious.

Go and speak to your doctor if you have missed a few doses or have decided to stop taking your medication.

When you agree with your doctor to stop the medicine, you will carry on with a lower dose for a month. This will stop you getting uncomfortable symptoms.

Stopping this medicine quickly, or reducing the dose too much at once, may cause uncomfortable symptoms