Epival-cr
Epival-cr Uses, Dosage, Side Effects, Food Interaction and all others data.
Epival-cr shows antiepileptic properties in various types of seizures. The exact mechanism of Epival-cr 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 | Epival-cr |
| Generic | Sodium Valproate |
| Weight | 500mg |
| Type | Tablet |
| Therapeutic Class | Primary anti-epileptic drugs |
| Manufacturer | Abbott Laboratories (pakistan) Limited, |
| Available Country | Pakistan |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Epival-cr 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
Epival-cr 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:
Epival-cr is for intravenous use only. Use of Epival-cr 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.
Epival-cr 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 Epival-cr (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
Epival-cr is a non specific inhibitor of drug metabolism. Phenobarbital, Phenytoin, Warfarin, Aspirin etc. interacts with Epival-cr.
Pregnancy & Breastfeeding use
Epival-cr crosses the placenta in humans which may lead to neural tube defects such as anencephaly and spina bifida if exposed in the first trimester. Epival-cr may excrete in breast milk. So treatment with Epival-cr may cause harm to new born baby.
Contraindication
Epival-cr is contra-indicated in patients with known hypersensitivity of Epival-cr, 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 Epival-cr
FAQ
What is Epival-cr used for?
Epival-cr 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 Epival-cr?
Many people can take Epival-cr safely for many months or years. However, there are potential side effects that can happen over a long time. Long-term treatment with Epival-cr can cause osteoporosis and osteopenia.
How long does it take for sodium valproate to work?
Epival-cr 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 Epival-cr?
The common side effects of Epival-cr 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 Epival-cr?
Epival-cr 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 Epival-cr?
You can take Epival-cr 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 Epival-cr?
If you're taking Epival-cr 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 Epival-cr 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 Epival-cr safe during pregnancy?
Epival-cr 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 Epival-cr prevention programme.
Is Epival-cr safe during breastfeeding?
If your doctor or health visitor says your baby is healthy you can take Epival-cr while breastfeeding.
Epival-cr 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 Epival-cr?
Once your condition is under control, you'll usually need to keep taking Epival-cr for many years.
Is Epival-cr safe to take it for a long time?
Many people can take Epival-cr safely for many months or years.
However, there are potential side effects that can happen over a long time. Long-term treatment with Epival-cr can cause osteoporosis and osteopenia.
What will happen when I come off Epival-cr?
Do not stop taking Epival-cr 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 Epival-cr 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 Epival-cr gradually.
Can I drink alcohol with Epival-cr?
Drinking alcohol while taking Epival-cr 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 Epival-cr affect my fertility?
Epival-cr can reduce fertility in both men and women. Once you stop taking this medicine, your fertility will return.In men Epival-cr has been reported to cause infertility.
Will Epival-cr affect my contraception?
Epival-cr 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 Epival-cr you must use contraception. Your doctor will put you on Prevent, the valproate pregnancy prevention programme.
Can I drive after taking Epival-cr?
You may feel sleepy, tired or dizzy when you first start taking Epival-cr. 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 Epival-cr?
Taking too much Epival-cr can lead to symptoms such as: feeling or being sick, headaches or feeling dizzy,muscle weakness.
What happen If I missed Epival-cr?
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 Epival-cr 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 Epival-cr?
You should not use Epival-cr if you are allergic to it.
