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Introduction About EPIVAL SYRUP 200ML(L)
EPIVAL SYRUP 200ML(L)contains Sodium valproate, which belongs to the group of medicines called Anti-convulsant. It is used in the management of epilepsy (fits). Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations and sometimes loss of awareness. Symptoms include temporary confusion, staring spells, stiff muscles, uncontrollable jerking movements of the arms and legs, loss of consciousness or awareness, fear, anxiety, or déjà vu.
EPIVAL SYRUP 200ML(L) is not recommended for use if you have porphyria (affecting metabolism), liver problems or Alpers-Huttenlocher syndrome. Before taking EPIVAL SYRUP 200ML(L) inform your doctor if you have kidney, brain problems, carnitine palmitoyl transferase type II deficiency, diabetes, systemic lupus erythematosus, urea cycle disorder or a genetic problem caused by a mitochondrial disorder in your family.
Do not consume alcohol while taking EPIVAL SYRUP 200ML(L). EPIVAL SYRUP 200ML(L) is not recommended or used by pregnant women. Inform your doctor if you are a breastfeeding mother. EPIVAL SYRUP 200ML(L) should be used with caution by children. The most common side effects of taking EPIVAL SYRUP 200ML(L) are stomach pain, diarrhea, headache, feeling tired and weight gain. Consult your doctor if symptoms become worse while taking EPIVAL SYRUP 200ML(L).
Uses Of EPIVAL SYRUP 200ML(L)
- Manage epilepsy (fits)
How EPIVAL SYRUP 200ML(L) Works
EPIVAL SYRUP 200ML(L) increases concentrations of gamma-aminobutyric acid (GABA) which reduces neuronal excitability by inhibiting nerve transmission in the brain, probably due to inhibition of the enzymes responsible for the breakdown of GABA.
How to use EPIVAL SYRUP 200ML(L)
Take EPIVAL SYRUP 200ML(L) as advised by your physician. Take the medicine by mouth, dilute it only if your doctor tells you to. Measure the suggested dose using the measuring cup and take it with or after food. Your doctor will decide the right dose and duration depending on your age, body weight and disease condition.
Side Effects Of EPIVAL SYRUP 200ML(L)
Common
- stomach pain, feeling or being sick
- diarrhea
- 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 color or texture of your hair
- irregular or delayed periods
Rare
Stop taking EPIVAL SYRUP 200ML(L) and contact your doctor immediately if you experience any of the following side effects:
- thoughts of harming or killing yourself
- an allergic reaction (rash, joint pain, fever (systemic lupus erythematosus), swallowing or breathing problems, swelling of your lips, face, throat or tongue, lymph node enlargement and possible impairment of other organs
- liver problems and problems of the pancreas may show as a sudden illness (feeling and being sick many times; being very tired, sleepy and weak, stomach pain, jaundice, loss of appetite, swelling of legs, worsening of fits
- skin rash or skin lesions with a pink/red ring and a pale center which may be itchy, scaly or filled with fluid (on the palms or soles of your feet, can be erythema multiforme)
- blistering or bleeding of the skin around the lips, eyes, mouth, nose and genitals, flu-like symptoms and fever (Stevens-Johnson syndrome)
- severe blistering rash where layers of the skin may peel off to leave large areas of raw exposed skin over the body, unwell, fever, chills, and aching muscles (toxic epidermal necrolysis)
- bruising more easily and getting more infections than usual (thrombocytopenia), blood clotting problems
- changes in mood, loss of memory, lack of concentration and coma
- hypothyroidism, which may cause tiredness or weight gain
- breathing difficulty and pain due to inflammation of the lungs
- changes in behavior including being very alert, and sometimes also aggressive, hyperactive and unusual or inappropriate behavior
- changes in the amount of ammonia in the blood (being sick, problems with balance and co-ordination, feeling lethargic or less alert)
- feeling shaky (tremor), sleepy or unsteady when walking or jerky muscle movements.
- rapid, uncontrollable movement of the eyes
- increase in the number and severity of convulsions
- liver damage, inflammation of the pancreas, bedwetting, renal dysfunction, overgrowth of gum tissue, aggression, agitation, disturbance in attention, abnormal behavior, hyperactivity and learning disorder in children
How To Manage Side Effects
Stomach pain:
Try to rest and relax. Eat and drink slowly. Keep a heating pad. Consult your doctor if any of your symptoms get worse or persist.
Diarrhoea:
Drink lots of water or fruit juice to keep yourself hydrated. Consult your doctor if any of your symptoms get worse or persist.
Feeling or being sick:
Stick to simple meals. Avoid eating oily or spicy meals. Consult your doctor if any of your symptoms get worse or persist.
Headache:
Avoid bright lights, take enough rest and drink more water. Consult your doctor if any of your symptoms get worse or persist.
Warning & Precautions
Pregnancy
EPIVAL SYRUP 200ML(L)is not recommended for use in pregnant women or if you are planning to have a baby as it can cause birth defects and behavioral/learning problems in the baby. Consult your doctor before taking EPIVAL SYRUP 200ML(L).
Breastfeeding
Inform your doctor if you are breastfeeding before taking EPIVAL SYRUP 200ML(L) as very little medicine might pass through the breastmilk. Consult your doctor if you can breastfeed or not take the medicine during the> management.
Driving and Using Machines
Do not drive or use machines while taking EPIVAL SYRUP 200ML(L) as it can make you feel sleepy.
Alcohol
Do not consume alcohol while taking EPIVAL SYRUP 200ML(L) as it can worsen the side effects.
Kidney
EPIVAL SYRUP 200ML(L) should be used with caution in patients with kidney disease. Consult your doctor before taking EPIVAL SYRUP 200ML(L).
Liver
EPIVAL SYRUP 200ML(L) is not recommended for use in patients with liver problems or with a family history of liver disease. Consult your doctor before taking EPIVAL SYRUP 200ML(L).
Allergy
Do not take EPIVAL SYRUP 200ML(L) if you are allergic to Sodium valproate or any other ingredients of this medicine.
Others
EPIVAL SYRUP 200ML(L) is not recommended for use if you:
- have a rare illness called porphyria which affects metabolism
- have a known metabolic disorder, i.e., a urea cycle disorder
- have a genetic problem caused by a mitochondrial disorder (Alpers-Huttenlocher syndrome)
- are a woman of birth-giving age and not using contraceptives (birth control)
Before taking EPIVAL SYRUP 200ML(L), inform your doctor if you:
- have diabetes
- have a carnitine palmitoyl transferase type II deficiency
- have a brain disease or a metabolic condition affecting the brain
- have a ‘urea cycle disorder’ where too much ammonia builds up in the body
- have an illness called systemic lupus erythematosus (SLE) (an immune system which affects skin, bones, joints and internal organs)
- genetic problem caused by a mitochondrial disorder in your family
Use in pediatrics:
EPIVAL SYRUP 200ML(L) should be used with caution by children. Consult your doctor for advice.
Use in geriatrics:
EPIVAL SYRUP 200ML(L) should be used with caution by the elderly. Consult your doctor for advice.
Interactions
A. Drug-Drug interactions:
Before taking EPIVAL SYRUP 200ML(L), inform your doctor if you are taking any of the following medicine:
- medicines used for pain and inflammation (salicylates) (Ex. aspirin)
- other medicines used to manage fits (Ex. phenobarbital, primidone, phenytoin, carbamazepine, rufinamide, topiramate, acetazolamide, lamotrigine and felbamate)
- medicines used for thinning the blood (Ex. warfarin)
- zidovudine, lopinavir and ritonavir (to manage HIV infection)
- temozolomide (to manage cancer)
- medicines for depression (monoamine oxidase inhibitors (MAOI) such as moclobemide, selegiline, linezolid)
- medicines used to calm emotional and mental health problems (Ex. quetiapine, diazepam and olanzapine)
- nimodipine (to manage hemorrhage)
- propofol (used for anesthesia)
- oestrogen-containing products (including some birth control pills)
- medicines to manage malaria (Ex. mefloquine and chloroquine)
- cimetidine (for stomach ulcers)
- carbapenem agents (antibiotics used to manage bacterial infections) Ex. imipenem, meropenem, rifampicin and erythromycin
- cholestyramine used to lower blood fat (cholesterol) levels
- metamizole (to manage pain and fever)
Overdosage:
If you or anyone else accidentally take too much of EPIVAL SYRUP 200ML(L), consult your doctor immediately or visit the nearby hospital. Symptoms of overdose are feeling sick or being sick, pupils of the eye becoming smaller, dizziness, loss of consciousness, weak muscles and poor reflexes, breathing problems, headaches fits (seizures), confusion, memory loss and unusual or inappropriate behavior, shortness of breath and chest pain.
Synopsis
| Drug | : |
Sodium Valproate |
| Pharmacological Category | : |
Anti-convulsant |
| Therapeutic Indication | : |
Epilepsy (fits) |
| Dosage Forms | : |
Tablet, Injection, Syrup, Oral solution, Granules |
More Information
- Keep EPIVAL SYRUP 200ML(L) out of reach from children
- Store at room temperature
FAQs About EPIVAL SYRUP 200ML(L)
What is EPIVAL SYRUP 200ML(L) used for?
EPIVAL SYRUP 200ML(L) is used in the management of epilepsy (fits). Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations and sometimes loss of awareness.
Can EPIVAL SYRUP 200ML(L) be used in pregnant women?
EPIVAL SYRUP 200ML(L)is not recommended for use in pregnant women or if you are planning to have a baby as it can cause birth defects and behavioral/learning problems in the baby. Consult your doctor before taking EPIVAL SYRUP 200ML(L).
What if I miss a dose of EPIVAL SYRUP 200ML(L)?
If you forget to take a dose of EPIVAL SYRUP 200ML(L), take it as soon as you remember. However, if it is nearly time for the next dose, skip the missed dose. Do not take a double dose of EPIVAL SYRUP 200ML(L).
Can I drive while taking EPIVAL SYRUP 200ML(L)?
Do not drive or use machines while taking EPIVAL SYRUP 200ML(L) as it can make you sleepy and weaken your ability to drive. Consult your doctor for more information.
Can EPIVAL SYRUP 200ML(L) be used in kidney patients?
EPIVAL SYRUP 200ML(L)should be used with caution in patients with kidney disease. The dose will be adjusted by your doctor. Consult your doctor before taking EPIVAL SYRUP 200ML(L).
References
1. KD Tripathi. Antiepileptic Drugs. Essentials of medical pharmacology. Eighth Edition. 2019. Page – 444.
2. H. M. Emrich, D. v. Zerssen, W. Kissling, H. -J. Möller & A. Windorfer. Effect of sodium valproate on mania. [Accessed on 19th July 2022] https://link.springer.com/article/10.1007/BF00343800
3. R. M. Pinder, R. N. Brogden, T. M. Speight & G. S. Avery. Sodium Valproate: A Review of its Pharmacological Properties and Therapeutic Efficacy in Epilepsy. [Accessed on 19th July 2022] https://link.springer.com/article/10.2165/00003495-197713020-00001
4. Unither Liquid Manufacturing. Electronic Medicines Compendium (EMC). [Revised in January 2022] [Accessed on 19th July 2022] https://www.medicines.org.uk/emc/files/pil.516.pdf
5. NHS. Sodium Valproate [Revised in August 2021] [Accessed on 19th July 2022] https://www.nhs.uk/medicines/sodium-valproate/
6. Pubchem. Sodium Valproate. [Accessed on 19th July 2022] https://pubchem.ncbi.nlm.nih.gov/compound/Sodium-valproate#:~:text=Valproate%20sodium%20is%20converted%20into,for%20the%20catabolism%20of%20GABA.
7. Mayoclinic. Sodium valproate. [Revised in October 2021] [Accessed on 19th July 2022] https://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/syc-20350093#:~:text=Epilepsy%20is%20a%20central%20nervous,races%2C%20ethnic%20backgrounds%20and%20ages.
Useful Diagnostic Tests
- Blood tests
- Liver function test
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