Therapeutic Action
Antiseizure (anticonvulsant)
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Drug reference
Antiseizure (anticonvulsant)
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Second-line treatment of convulsive status epilepticus
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Do not administer: to women and girls of childbearing age; to children under 2 years (increased risk of hepatotoxicity); to patients with pancreatitis, hepatic disease or history of hepatic disease. Reduce dosage in patients with renal impairment. May cause: drowsiness, extrapyramidal symptoms, behavioural disturbances, confusional state; menstrual irregularities, gastrointestinal disturbances, thrombocytopenia; rarely: pancreatitis, hepatic disorders (e.g. elevated liver enzymes), prolonged bleeding time, hypersensitivity reactions sometimes severe, hyperammonemic encephalopathy. In these cases, stop treatment. respiratory depression and coma in the event of overdose. Avoid or monitor the combination with: mefloquine, carbapenems, tricyclic antidepressants, rifampicin, protease inhibitors, other antiseizure medications (reduced effect of VPA); acetylsalicylic acid, erythromycin, isoniazid (increased VPA toxicity); benzodiazepines, opioid analgesics, antipsychotics, first-generation antihistamines (hydroxyzine, promethazine), antidepressants, other antiseizure medications, etc. (increased sedation). Pregnancy: do not use except if vital and no alternative is available (risk of neural tube defects; urogenital, limb and facial malformations; neurodevelopmental disorders). Use a safer drug if possible (levetiracetam). Breast-feeding: administer with caution (excreted in milk); monitor the child (risk of hepatotoxicity and bleeding).
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400 mg in 4 ml ampoule (100 mg/ml) for slow IV injection or IV infusion in 0.9% sodium chloride or 5% glucose DO NOT ADMINISTER BY IM INJECTION (risk of necrosis).
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Loading dose: Child 2 years and over: Use diluted solution: add 4 ml (400 mg) of VPA to 6 ml of 0.9% NaCl to obtain 10 ml of solution containing 40 mg of VPA per ml. Administer 20 mg/kg (max. 1.5 g) over 5 minutes by IV infusion using a syringe pump or by slow IV injection. If seizures do not stop after the end of the first dose, readminister the same dose: 20 mg/kg (max. 1.5 g) as above. Do not exceed the total dose of 40 mg/kg or 3 g. Adult: 40 mg/kg (max. 3 g) single dose over 10 minutes Use diluted solution as above (40 mg/ml) if administered by IV infusion using a syringe pump. Use undiluted solution if administered by IV infusion in a bag of 100 ml of 0.9% NaCl. In children and adults, do not exceed an infusion rate of 6 mg/kg/minute. If maintenance treatment is indicated after the loading dose: change to oral route as soon as possible.
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Do not mix with other drugs in the same syringe or infusion.
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– Below 25 °C
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