Brand name : DIVAA ( Divaa, DIVALPROEX )
Pronounced: DEP-uh-coat
Generic name: Divalproex sodium (Valproic acid)
Why is Divaa prescribed?

Divaa, in both delayed-release tablet and capsule form, is used to treat certain types of seizures and convulsions. It may be prescribed alone or with other epilepsy medications.

The delayed-release tablets are also used to control the manic episodes--periods of abnormally high spirits and energy--that occur in bipolar disorder (manic depression).

An extended-release form of Divaa, Divaa ER, is prescribed to prevent migraine headaches. The delayed-release tablets are also used for this purpose.
Most important fact about Divaa

Divaa can cause serious or even fatal liver damage, especially during the first 6 months of treatment. Children under 2 years of age are the most vulnerable, especially if they are also taking other anticonvulsant medicines and have certain other disorders such as mental retardation. The risk of liver damage decreases with age; but you should always be alert for the following symptoms: loss of seizure control, weakness, dizziness, drowsiness, a general feeling of ill health, facial swelling, loss of appetite, vomiting, and yellowing of the skin and eyes. If you suspect a liver problem, call your doctor immediately.

Divaa has also been known to cause life-threatening damage to the pancreas. This problem can surface at any time, even after years of treatment. Call your doctor immediately if you develop any of the following warning signs: abdominal pain, loss of appetite, nausea, or vomiting.
How should you take Divaa?

Take the tablet with water and swallow it whole (don't chew it or crush it). It has a special coating to avoid upsetting your stomach.

If you are taking the sprinkle capsule, you can swallow it whole or open it and sprinkle the contents on a teaspoon of soft food such as applesauce or pudding. Swallow it immediately, without chewing. The sprinkle capsules are large enough to be opened easily.

Divaa can be taken with meals or snacks to avoid stomach upset. Take it exactly as prescribed.

If you miss a dose...

If you take Divaa once a day, take your dose as soon as you remember. If you don't remember until the next day, skip the missed dose and return to your regular schedule. Never take 2 doses at the same time.

If you take more than one dose a day, take your dose right away if it's within 6 hours of the scheduled time, and take the rest of the day's doses at equal intervals during the day. Never take 2 doses at the same time.

Storage instructions DIVAA ( DEPAKOTE, DIVALPROEX )

Store at room temperature.
Divaa side effects

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Because Divaa is often used with other antiseizure drugs, it may not be possible to determine whether a side effect is due to Divaa alone. Only your doctor can determine if it is safe for you to continue taking Divaa.

* Side effects may include:
Abdominal pain, abnormal thinking, breathing difficulty, bronchitis, bruising, constipation, depression, diarrhea, dizziness, emotional changeability, fever, flu symptoms, hair loss, headache, incoordination, indigestion, infection, insomnia, loss of appetite, memory loss, nasal inflammation, nausea, nervousness, ringing in the ears, sleepiness, sore throat, tremor, vision problems, vomiting, weakness, weight loss or gain

Why should Divaa not be prescribed?

You should not take Divaa if you have liver disease or your liver is not functioning well, or if you have a genetic abnormality known as urea cycle disorder (UCD).

If you are sensitive to or have ever had an allergic reaction to Divaa, you should not take Divaa.
Special warnings about Divaa

This medication can severely damage the liver (see "Most important fact about Divaa"). Your doctor will test your liver function before you begin taking Divaa and at regular intervals thereafter.

Also remember that the drug can damage the pancreas (see "Most important fact about Divaa"). This problem can worsen very rapidly, so be sure to contact your doctor immediately if you develop any symptoms.

In people with a rare set of genetic abnormalities called urea cycle disorders, Divaa may adversely effect the brain. Signs of a developing problem include lack of energy, repeated attacks of vomiting, and mental changes. If you suspect a problem, see your doctor immediately. Divaa may have to be discontinued.

Divaa causes some people to become drowsy or less alert. You should not drive or operate dangerous machinery or participate in any hazardous activity that requires full mental alertness until you are certain the drug does not have this effect on you.

Do not abruptly stop taking this medicine without first consulting your doctor. A gradual reduction in dosage is usually required.

Divaa prolongs the time it takes blood to clot, which increases your chances of serious bleeding.

This drug can also increase the effect of painkillers and anesthetics. Before any surgery or dental procedure, make sure the doctor knows you are taking Divaa.

If you are taking Divaa to prevent migraine, remember that it will not cure a headache once it has started.

Some coated particles from the capsules may appear in your stool. This is to be expected, and need not worry you.
Possible food and drug interactions when taking Divaa

Divaa depresses activity of the central nervous system, and may increase the effects of alcohol. Do not drink alcohol while taking Divaa.

If Divaa without prescriptions is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Divaa with the following:

Amitriptyline (Elavil)
Aspirin
Barbiturates such as phenobarbital and Seconal
Blood thinners such as Coumadin
Cyclosporine (Sandimmune, Neoral)
Merrem IV (meropenem for injection)
Nortriptyline (Pamelor)
Other seizure medications, including carbamazepine (Tegretol), clonazepam (Klonopin), ethosuximide (Zarontin), felbamate (Felbatol), lamotrigine (Lamictal), phenytoin (Dilantin), and Primidone (Mysoline)
Rifampin (Rifater, Rimactane)
Sleep aids such as Halcion
Tolbutamide (Orinase)
Tranquilizers such as Valium and Xanax
Zidovudine (Retrovir)
Special information if you are pregnant or breastfeeding

Divaa may produce birth defects if it is taken during pregnancy. If you are pregnant or plan to become pregnant, inform your doctor immediately. Divaa appears in breast milk and could affect a nursing infant. If Divaa is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with Divaa is finished.
Recommended dosage for Divaa

EPILEPSY
Overdosage

Any medication taken in excess can have serious consequences. An overdose of Divaa can be fatal. If you suspect an overdose, seek medical attention immediately.

* Symptoms of Divaa overdose may include:
Coma, extreme sleepiness, heart problems