OVERDOSE
Overdosage with valproate may result in somnolence, heart
block, and deep coma. Fatalities have been reported; however,
patients have recovered from valproate levels as high
as 2120 mg/ml.
In overdose situations, the fraction of drug not bound
to protein is high and hemodialysis or tandem hemodialysis
plus hemoperfusion may result in significant removal of
the drug. The benefit of gastric lavage or emesis will
vary with the time since ingestion. General supportive
measures should be applied with particular attention to
the maintenance of adequate urinary output.
Naloxone has been reported to reverse the CNS depressant
effects of valproate overdosage. Because naloxone could
theoretically also reverse the antiepileptic effects of
valproate, it should be used with caution in patients
with epilepsy.
CONTRAINDICATIONS
DIVALPROEX SODIUM SHOULD NOT BE ADMINISTERED TO PATIENTS
WITH HEPATIC DISEASE OR SIGNIFICANT HEPATIC DYSFUNCTION.
Divalproex sodium is contraindicated in patients with known
hypersensitivity to the drug.
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