Epirate
Epirate Uses, Dosage, Side Effects, Food Interaction and all others data.
Epirate shows antiepileptic properties in various types of seizures. The exact mechanism of Epirate 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 | Epirate |
| Generic | Sodium Valproate |
| Weight | 200mg/5ml, 200mg |
| Type | Syrup, Tablet |
| Therapeutic Class | Primary anti-epileptic drugs |
| Manufacturer | Wilsons Pharmaceuticals |
| Available Country | Pakistan |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Epirate 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
Epirate 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:
Epirate is for intravenous use only. Use of Epirate 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.
Epirate 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 Epirate (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
Epirate is a non specific inhibitor of drug metabolism. Phenobarbital, Phenytoin, Warfarin, Aspirin etc. interacts with Epirate.
Pregnancy & Breastfeeding use
Epirate crosses the placenta in humans which may lead to neural tube defects such as anencephaly and spina bifida if exposed in the first trimester. Epirate may excrete in breast milk. So treatment with Epirate may cause harm to new born baby.
Contraindication
Epirate is contra-indicated in patients with known hypersensitivity of Epirate, 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
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FAQ
What is Epirate used for?
Epirate 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 Epirate?
Many people can take Epirate safely for many months or years. However, there are potential side effects that can happen over a long time. Long-term treatment with Epirate can cause osteoporosis and osteopenia.
How long does it take for sodium valproate to work?
Epirate 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 Epirate?
The common side effects of Epirate 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 Epirate?
Epirate 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 Epirate?
You can take Epirate 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 Epirate?
If you're taking Epirate 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 Epirate 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 Epirate safe during pregnancy?
Epirate 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 Epirate prevention programme.
Is Epirate safe during breastfeeding?
If your doctor or health visitor says your baby is healthy you can take Epirate while breastfeeding.
Epirate 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 Epirate?
Once your condition is under control, you'll usually need to keep taking Epirate for many years.
Is Epirate safe to take it for a long time?
Many people can take Epirate safely for many months or years.
However, there are potential side effects that can happen over a long time. Long-term treatment with Epirate can cause osteoporosis and osteopenia.
What will happen when I come off Epirate?
Do not stop taking Epirate 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 Epirate 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 Epirate gradually.
Can I drink alcohol with Epirate?
Drinking alcohol while taking Epirate 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 Epirate affect my fertility?
Epirate can reduce fertility in both men and women. Once you stop taking this medicine, your fertility will return.In men Epirate has been reported to cause infertility.
Will Epirate affect my contraception?
Epirate 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 Epirate you must use contraception. Your doctor will put you on Prevent, the valproate pregnancy prevention programme.
Can I drive after taking Epirate?
You may feel sleepy, tired or dizzy when you first start taking Epirate. 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 Epirate?
Taking too much Epirate can lead to symptoms such as: feeling or being sick, headaches or feeling dizzy,muscle weakness.
What happen If I missed Epirate?
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 Epirate 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 Epirate?
You should not use Epirate if you are allergic to it.
