Divarex
Divarex Uses, Dosage, Side Effects, Food Interaction and all others data.
Divarex shows antiepileptic properties in various types of seizures. The exact mechanism of Divarex is not yet established. However it is suggested that its activity is related to increased brain levels of Gama Amino Butyric Acid (GABA).
| Trade Name | Divarex |
| Generic | Sodium Valproate |
| Weight | 250mg, 500mg |
| Type | Tablet |
| Therapeutic Class | Primary anti-epileptic drugs |
| Manufacturer | Medera Pharmaceuticals (pvt) Ltd, |
| Available Country | Pakistan |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Divarex is used for -
- Epilepsy: All types of epilepsy such as Absence seizure, Myoclonic seizure, Tonic-clonic seizure, Atonic, Mixed, simple or generalized, Secondary generalized seizure etc.
- Mania: For the treatment of manic episodes of bipolar disorders.
- Other: As an alternative treatment for febrile convulsion & migraine prophylaxis.
Dosage
Divarex dosage
Oral:
Adults:
- Initial: 600 mg/day in 2 divided doses, preferably after food. Dose may be increased by 200mg/day at 3 days interval to a maximum of 2.5 gm daily in divided doses until control of seizure is achieved.
- Maintenance dose: Usually 1-2 gm daily (20-30 mg/kg daily).
Children (up to 20 kg):
- Initial: 20 mg/kg daily in divided doses. Dose may be increased in severe cases with proper monitoring of plasma concentration.
Children (over 20 kg):
- Initial: 400 mg/ day (irrespective of weight). Dose may be increased by 20-30 mg/ kg if required to achieve control.
Injection:
Divarex is for intravenous use only. Use of Divarex for periods of more than 14 days has not been studied. Patients should be switched to oral valproate products as soon as it is clinically feasible.
Divarex should be administered as a 60 minute infusion (but not more than 20 mg/min) with the same frequency as the oral products, although plasma concentration monitoring and dosage adjustments may be necessary.
In one clinical safety study, approximately 90 patients withepilepsyand with no measurable plasma levels of valproate were given single infusions of Divarex (up to 15 mg/kg and mean dose of 1184 mg) over 5-10 minutes (1.5-3.0 mg/kg/min). Patients generally tolerated the more rapid infusions well. This study was not designed to assess the effectiveness of these regimens.
Side Effects
Gastric irritation, nausea, ataxia & tremor; hyperammonaemia, increased appetite & weight gain; transient hair loss, oedema, thrombocytopenia, and inhibition of platelet aggregation, impaired hepatic function leading rarely to fetal hepatic failure; rashes; sedation; rarely lethargy and confusion and also increased alertness; rarely pancreatitis, leucopenia, pancytopenia, red cell hypoplasia, fibrinogen reduction; irregular periods, amenorrhoea, gynaecomastia, toxic epidermal necrolysis, hearing loss, Fancoli's syndrome, dementia, Steven's-Johnson syndrome, and vasculitis have also been reported.
Precaution
Liver function should be monitored before therapy and during first six months, especially in those patients who seem most at risk. Blood tests are recommended before surgery. Renal impaired patients, pregnant and brest feeding mother should be specially cared. Valproate is eliminated mainly through the kidney, partly in the form of ketone bodies which may lead to false statement in urine ketone test. Sudden withdrawal of therapy should be avoided
Interaction
Divarex is a non specific inhibitor of drug metabolism. Phenobarbital, Phenytoin, Warfarin, Aspirin etc. interacts with Divarex.
Pregnancy & Breastfeeding use
Divarex crosses the placenta in humans which may lead to neural tube defects such as anencephaly and spina bifida if exposed in the first trimester. Divarex may excrete in breast milk. So treatment with Divarex may cause harm to new born baby.
Contraindication
Divarex is contra-indicated in patients with known hypersensitivity of Divarex, personal or family history of severe active liver disease, hepatic dysfunction, porphyria and known urea cycle disorder.
Storage Condition
Syrup: Store below 30° C, protected from light.
Tablet: Store below 30° C, protected from light. Keep all medicines out of the reach of children.
Innovators Monograph
You find simplified version here Divarex
FAQ
What is Divarex used for?
Divarex used to treat epilepsy and bipolar disorder. It's occasionally used to prevent migraine headaches. This medicine is only available on prescription.
How safe is Divarex?
Many people can take Divarex safely for many months or years. However, there are potential side effects that can happen over a long time. Long-term treatment with Divarex can cause osteoporosis and osteopenia.
How long does it take for sodium valproate to work?
Divarex may take several days to show an initial effect and in some cases may take from two to six weeks for maximum effect. Treatment is started with low doses and may be increased over a couple of weeks according to your child's response.
What are the common side effects of Divarex?
The common side effects of Divarex are include:
- stomach pain, feeling or being sick
- diarrhoea
- dry or sore mouth, or swollen gums
- shakes (tremors) in a part of your body, or unusual eye movements
- feeling tired or sleepy
- headache
- weight gain
- thinning hair, or changes to the colour or texture of your hair
- irregular or delayed periods
How to take Divarex?
Divarex comes as slow release (prolonged or sustained release) tablets, capsules and granules, gastro-resistant tablets, crushable tablets, and as a liquid.
Slow release medicine passes into your body gradually.
When is the best time to take Divarex?
You can take Divarex with or without food, but it's best to stick to the same way each time. Do not take it with food some days and without food on other days.
How often can I take Divarex?
If you're taking Divarex once a day, you can choose a time that suits you. Just try to keep to the same time every day.
If you're taking Divarex twice a day, try to leave a gap of 10 to 12 hours between doses. For example you could take your first dose in the morning (between 7am and 8am) and your second dose in the evening (between 7pm and 8pm).
Is Divarex safe during pregnancy?
Divarex is not recommended in pregnancy, as it can cause birth defects and problems with your baby's learning and behaviour.
If there's a chance you could become pregnant while taking this medicine, your doctor will put you on Prevent, the Divarex prevention programme.
Is Divarex safe during breastfeeding?
If your doctor or health visitor says your baby is healthy you can take Divarex while breastfeeding.
Divarex passes into breast milk in small amounts but it's unlikely to harm your baby so you can continue breastfeeding if your doctor says you need to take it.
How long will I take Divarex?
Once your condition is under control, you'll usually need to keep taking Divarex for many years.
Is Divarex safe to take it for a long time?
Many people can take Divarex safely for many months or years.
However, there are potential side effects that can happen over a long time. Long-term treatment with Divarex can cause osteoporosis and osteopenia.
What will happen when I come off Divarex?
Do not stop taking Divarex suddenly, unless your doctor tells you to.
You're unlikely to get any extra symptoms when you stop taking this medicine. However, if you're taking Divarex for epilepsy, it's possible that you'll get seizures again once you stop taking it. You can prevent these withdrawal seizures by reducing your dose of Divarex gradually.
Can I drink alcohol with Divarex?
Drinking alcohol while taking Divarex may make you feel sleepy or tired. It's best to stop drinking alcohol during the first few days, until you see how the medicine affects you.
Will Divarex affect my fertility?
Divarex can reduce fertility in both men and women. Once you stop taking this medicine, your fertility will return.In men Divarex has been reported to cause infertility.
Will Divarex affect my contraception?
Divarex does not affect any type of contraception, including the combined pill and emergency contraception.If there's a chance you could become pregnant while taking Divarex you must use contraception. Your doctor will put you on Prevent, the valproate pregnancy prevention programme.
Can I drive after taking Divarex?
You may feel sleepy, tired or dizzy when you first start taking Divarex. This may also happen if your dose has increased. If you're affected, do not drive or ride a bike until you feel more alert.
Can I take too much dose of Divarex?
Taking too much Divarex can lead to symptoms such as: feeling or being sick, headaches or feeling dizzy,muscle weakness.
What happen If I missed Divarex?
If you've missed a dose, what you do next depends on whether you usually take your medicine once or twice a day. If you take Divarex once a day ,take the forgotten dose as soon as you remember unless it's within a few hours of the next dose.
Who should not take Divarex?
You should not use Divarex if you are allergic to it.
