Brand Name Choices
What Depakote is and what it is used for
The name of your medicine is Depakote 250mg or 500mg Tablets (called Depakote in this leaflet).Depakote contains a medicine called valproate semisodium. This belongs to a group of medicines called mood stabilisers. It works by stabilising the levels of chemicals in your brain that affect your mood. Depakote can be used to manage or control mania (feeling highly excited, enthusiastic, being overactive and easily irritated or distracted) caused by bipolar disorder. Bipolar disorder is where the mood changes between feeling very high (mania) and very low (depression). Depakote can be used when lithium cannot be used.
How to take Depakote
Always take Depakote exactly as your doctor has told you. Your doctor will decide your daily dose. You should check with your doctor or pharmacist if you are not sure. Depakote treatment must be started and supervised by a doctor specialised in the treatment of bipolar disorders. How to take your medicine
• Take this medicine by mouth.
• Swallow the tablets whole with a drink of water. Do not crush or chew them.
• This medicine can be taken with or after a meal.
• If you feel the effect of your medicine is too weak or too strong, do not change the dose yourself, but ask your doctor. How much to take The normal dose is: Adults including the elderly
• Starting dose is 750mg on the first day. This is usually taken as 2 or 3 divided doses.
• The usual dose is then increased to between 1000mg and 2000mg each day.
• Your doctor may decide to increase your dose depending on your illness. If you have kidney problems
• Your doctor may decide to lower your dose. Children and adolescents under 18 years of age Depakote should not be used in children and adolescents under 18 years of age for the treatment of mania. Tests Your doctor may do regular blood tests and liver function tests before and during your treatment with this medicine. If you take more Depakote than you should If you or someone else has taken more Depakote than you should, talk to a doctor or go to your nearest hospital casualty department straight away. Remember to take the medicine pack with you. This is so the doctor knows what you have taken. The following effects may happen: being sick, headache, blurred eyesight due to pupils of the eyes becoming smaller, lack of reflexes, confusion and tiredness. You may also have weak or ‘floppy’ muscles, fits (seizures), loss of consciousness, behavioural changes and breathing difficulties such as fast breathing, shortness of breath or chest pain. If you forget to take Depakote If you forget to take a dose at the right time, take it as soon as you remember. Do not take a double dose to make up for a forgotten dose. If you stop taking Depakote Keep taking your medicine until your doctor tells you to stop. Do not stop taking Depakote just because you feel better. If you stop, your illness may return. When your doctor says that you can stop taking Depakote, your dose will be lowered gradually. Your doctor will help you to do this. If you have any further questions on the use of this product, ask your doctor or pharmacist.
Possible side effects
Like all medicines, Depakote can cause side effects, although not everybody gets them. Side effects are more likely to happen at the start of treatment. Allergic reactions If you have an allergic reaction, stop taking Depakote and see a doctor or go to a hospital straight away. The signs may include: rash, joint pain, fever (systemic lupus erythematosus), swallowing or breathing problems, swelling of your lips, face, throat or tongue. Hands, feet or genitals may also be affected. More severe allergic reactions can lead to lymph node enlargement and possible impairment of other organs. Stop taking Depakote and see your doctor or go to a hospital straight away if you notice a combination of any of the following serious side effects:
The following side effects may be signs of problems with your liver or pancreas and may show as a sudden illness:
• Feeling weak, general feeling of being unwell
• Loss of or decreased appetite (anorexia)
• Feeling drowsy, confused or tired
• Swelling of the feet and legs (oedema)
• Nausea (feeling sick)
• Vomiting (being sick)
• Stomach pain. Sometimes may be severe and reach through to your back.
• Recurrence of fits (seizures) for patients with epilepsy
• Yellowing of the eyes or skin
The following side effects may be signs of problems with your blood cells:
• Bruising more easily, spontaneous bruising or bleeding
• Frequent infections such as fever, severe chills, sore throat or mouth ulcers
• Getting more infections than usual
• Feeling weak, tired, faint, dizzy or having an unusually pale skin These could be caused by a blood disorder called ‘thrombocytopenia’. It can be due to a fall in the number of white blood cells, bone marrow depression or another condition that affects red blood cells, white blood cells and platelets (pancytopenia) or how the blood clots. Other serious side effects which need urgent medical attention:
• Fits (seizures), loss or reduction of consciousness, seeing or hearing things that are not there (hallucinations)
• Memory problems, reduced ability to perform mental tasks, being unable to concentrate
• Difficulty in speaking or slurred speech
• Muscle weakness, lack of co-ordination, muscle twitching or sudden jerks and shaking
• Difficulty in walking or unusual involuntary movements, such as unusual eye movements
• Blistering, peeling, bleeding, scaling or fluid filled patches on any part of your skin. This includes your lips, eyes, mouth, nose, genitals, hands or feet. You may also have flu-like symptoms and fever, joint aches and pains, swollen joints, headaches, chest pain and shortness of breath
• Underactive thyroid gland, which may cause tiredness or weight gain (hypothyroidism)
• Breathing difficulty and pain due to inflammation of the lungs (pleural effusion)
• Rapid, uncontrollable movement of the eyes
• An increase in the number and severity of convulsions in patients with epilepsy Tell your doctor as soon as possible if you have any of the following side effects:
• Unusual behaviour including being very alert, and sometimes also aggressive, hyperactive and showing bad behaviour
• Water retention which may cause swollen arms or legs
• Bleeding a lot from a wound Tell your doctor or pharmacist if any of the following side effects get serious or lasts longer than a few days:
• Swelling of gums or sore mouth
• Nail and nail bed disorders
• Increased levels of some hormones (androgens), which may lead to increased hair growth on the face, breasts or chest, acne or thinning hair.
• Hair disorders (changes in texture, colour or growth), temporary hair loss
• Night sweats or joint pain
• Irregular periods or a lack/absence of menstrual periods
• Breast enlargement in men
• Loss of hearing
• Kidney disease, kidney problems, blood in the urine, bed wetting or increased need to pass urine, urinary incontinence (unintentional passing of urine)
• Obesity, weight gain – as your appetite may be increased
• Seeing or hearing things that are not there (hallucinations)
• Aggression, agitation, disturbance in attention, abnormal behaviour, restlessness/hyperactivity, and learning disorder
• Tingling or numbness in the hands and feet
• Lowering of normal body temperature
• Abnormal blood clotting factors
• Muscle pain and weakness (rhabdomyolysis) Bone disorders There have been reports of bone disorders including osteopenia and osteoporosis (thinning of the bone) and fractures. Check with your doctor or pharmacist if you are on long-term anti-epileptic medication, have a history of osteoporosis, or take steroids. Tests Depakote can change levels of liver enzymes, salts or sugars shown up on blood and urine tests. Male fertility Taking Depakote can be a contributing factor in male infertility.
Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.
How to Store Depakote
In addition, there are other side effects that are known for the active
2 to 3 weeks on average
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