Patient/caregiver was educated on contraindications for using Divalproex Sodium as follows:
- Divalproex is mainly metabolized in the liver to some active metabolites. If liver function is grossly deficient, the metabolism of divalproex can be compromised. This can lead to increased blood levels of the medication for longer periods of time, resulting in increased risk for side-effects and consequent toxicity. So, divalproex is contraindicated in individuals with extreme liver failure and can be used with caution in individuals with history of mild to moderate liver failure, with possible multiple dose adjustments, periodical monitoring for liver functions and close watch for development of any dangerous side-effects and toxicity symptoms.
- The active metabolites of divalproex have some pharmacological actions as the parent compound divalproex and are mainly excreted in the urine. Individuals with renal disease cannot excrete these active metabolites normally, which allows them to stay in blood circulation for longer time, resulting in toxicity and consequent side-effects. So, divalproex must be used with caution in individuals with compromised renal function, with possible multiple dose adjustments, periodical monitoring for renal functions, and close watch for development of any dangerous side-effects and toxicity symptoms.
