Patient/caregiver was educated on contraindications for using Divalproex Sodium as follows:
- Do not take Divalproex, if you ever manifested any allergic response to intake of Divalproex. Discuss your history of allergic response to this medication with your physician, without fail.
- In the event of any current manifestations of any allergic response with this medication, report it to your physician or other health care personnel immediately, to check regarding your safety with continuing on intake of this medication.
- Ammonia is a toxic product produced in the body during normal protein metabolism. Conversion of toxic ammonia to less toxic urea takes place significantly in the liver and to a lesser extent in the kidneys, by action of enzymes of the urea cycle. So, normal function of liver and kidney is very important for this uncompromised detoxification of ammonia to urea. In individuals with compromised liver and kidney function, this conversion can suffer, thus resulting in accumulation of ammonia in the body. Divalproex use can result in hepatic damage and compromised liver function, thus contributing to reduced detoxification of ammonia to urea and elevated ammonia levels in the body. Significantly elevated ammonia levels can be toxic to the brain and result in impaired memory, shortened attention span, severe confusion, disturbed sleep, restlessness, seizures, and in severe cases can result in coma and death. So, divalproex is contraindicated in individuals with history of urea cycle disorder, compromised liver and renal function.
