Depacon

Before taking this medicine

Do not use Depacon if you have liver disease or significant liver dysfunction, an allergy to valproate sodium, a urea cycle disorder, or a known mitochondrial disorder caused by a POLG gene mutation, such as Alpers-Huttenlocher syndrome. It must not be used in children under two years of age with a suspected POLG-related disorder. Valproate must not be used to prevent migraine headaches during pregnancy or in women who could become pregnant and are not using effective contraception. It can cause birth defects, reduced IQ and neurodevelopmental disorders in children exposed during pregnancy. For epilepsy or bipolar disorder, it should not be used during pregnancy, when planning pregnancy, or in women who could become pregnant unless other medicines have failed to control symptoms adequately or are otherwise unacceptable. Important precautions include serious liver injury, pancreatitis, bleeding and other blood disorders, high blood ammonia levels that can affect brain function, abnormally low body temperature, and severe allergic reactions affecting multiple organs (DRESS). Liver tests, platelet counts and blood-clotting tests require monitoring. Unexplained marked sleepiness, vomiting or changes in mental state require assessment for raised ammonia levels. Taking topiramate alongside valproate also requires attention to ammonia levels and low body temperature. Children under two years of age have a considerably higher risk of fatal liver injury. Older adults need monitoring for excessive sleepiness and adequate food and fluid intake.