Valproate Sodium
Complex Partial Seizures
Indicated as monotherapy and adjunctive therapy for complex partial seizures that occur either in isolation or in association with other types of seizures
IV (valproate sodium): 10-15 mg/kg/day IV divided q12hr infused over 1 hr; maximum dose 60 mg/kg/day; do not exceed 14 days (switch to PO as soon as possible)
PO: 10-15 mg/kg/day PO initially; increase by 5-10 mg/kg/day at weekly intervals; may increase dose up to 60 mg/kg/day
Delayed release and extended release formulations
- Delayed release formulations are usually administered at the same daily dose and frequency (BID/QID) as the regular release when converting from regular release to delayed release; once therapy is stabilized, the frequency of the delayed release formulation is adjusted to BID/TID
- Extended release formulation is usually administered once daily in patients who convert from either regular or delayed release formulations; may require an increase in total daily dose between 8-20% to maintain similar serum concentrations
Conversion to monotherapy from adjunctive therapy
- Decrease concomitant antiepileptic drug (AED) by approximately 25% q2wk; may reduce dosage of concomitant AED when valproate therapy is initiated or 1 to 2 weeks following valproate initiation
