Indications 

Depakote CR is a prescribed medication used for: 

• Managing manic or mixed episodes linked to bipolar disorder, whether with or without psychotic symptoms. 
• Treating complex partial seizures, simple and complex absence seizures, and as an additional treatment for patients with various seizure types, including absence seizures. 
• Preventing migraine headaches. 

As an anticonvulsant and a mood stabilizer, Depakote CR works by regulating specific natural brain substances, known as neurotransmitters, to restore balance in the brain. 

Uses and Dosage 

Before taking Depakote CR, thoroughly review the accompanying medication guide and patient information leaflet. Consult your doctor or pharmacist for guidance if you have any questions or need additional information. 

The appropriate dosage of this medication is determined based on factors such as age, body weight, medical condition, response to treatment, and concurrent use of other medicines. 

Typically, Depakote CR is taken once a day as prescribed by the doctor. It may be taken with food if stomach upset occurs. 

Ingest the tablet whole, without cutting, crushing, or chewing, to prevent the rapid release of the entire medication, which could raise the likelihood of side effects. 

For optimal results, take Depakote CR exactly as directed at around the same times each day. Do not modify the recommended dosage or frequency of intake without obtaining approval from your doctor. 

Moreover, do not discontinue this medication without consulting your doctor, as abrupt cessation can worsen your condition. It may be necessary to reduce your dose gradually. 

Side Effects 

The potential adverse effects of Depakote CR are outlined below. Should any of these symptoms continue or worsen, promptly inform your doctor. 

Common Side Effects 

• Nausea, vomiting, stomach pain, diarrhea, constipation 
• Headache, back pain 
• Dizziness, drowsiness, weakness, tremors 
• Memory problems, mood swings, trouble sleeping 
• Bruising or bleeding 
• Runny nose, sore throat, cough, wheezing, trouble breathing 
• Fever, flu symptoms 
• Problems with walking or coordination 
• Swelling in the hands or feet 
• Blurred vision, double vision, unusual eye movements 
• Ringing in the ears 
• Rash, hair loss 
• Changes in weight or appetite 

Serious Side Effects 

• Easily bruised skin, abnormal bleeding (nasal, oral, or gum bleeding), or the appearance of purple or red pinpoint spots on the skin 
• Fever, swollen lymph nodes, or mouth ulcers 
• Confusion, fatigue, cold sensations, vomiting, or alterations in mental status 
• Profound drowsiness 
• Worsening of seizure 
• Indications of liver or pancreas issues, including: 
  • Appetite loss 
  • Persistent upper abdominal pain (which may radiate to the back) 
  • Prolonged nausea or vomiting 
  • Darkened urine 
  • Facial swelling 
  • Jaundice (yellowing of the skin or eyes) 

If you experience any of the serious side effects above, promptly contact your doctor.  

Notify your doctor of any emerging or exacerbated symptoms, including: 

• Mood or behavioral shifts 
• Depression, anxiety, or panic episodes 
• Sleep disturbances 
• Impulsive behavior 
• Irritability, agitation, or aggression 
• Restlessness or hyperactivity (either mentally or physically) 
• Suicidal thoughts or self-harming ideation 

Drug Reactions 

Immediate medical attention must be sought if you experience a severe drug reaction with widespread effects on your body, such as symptoms like: 

• Skin rash 
• Fever 
• Swollen glands 
• Muscle aches 
• Pronounced weakness 
• Unusual bruising 
• Yellowing of the skin or eyes 

Skin Reactions 

Promptly seek emergency medical help if you exhibit indications of a severe skin reaction such as: 

• Fever 
• Sore throat 
• Burning eyes 
• Skin pain 
• Development of a red or purple rash with blisters and peeling 

Allergic Reactions 

In rare cases, Depakote CR may trigger a severe allergic response. Promptly seek medical assistance if you notice any indications of such a reaction, including: 

• Breathing difficulties 
• Swelling (especially in the face, tongue, or throat) 
• Hives 

This list does not cover all side effects of Depakote CR. Should you observe any unlisted effects, inform your doctor. 

Cautions 

Before starting treatment with Depakote CR, inform your doctor if you have any known allergies, particularly to divalproex, valproic acid, or any of the inactive ingredients in this tablet. 

Disclose to your doctor your medical background before taking Depakote CR to determine its suitability for your condition, particularly if you have a history of: 

• Liver disease 
• Pancreatitis 
• Specific metabolic disorders (urea cycle disorders, Alpers-Huttenlocher syndrome) 
• Alcohol abuse 
• Bleeding disorders 
• Dementia 
• Kidney disease 
• Dehydration 
• Nutritional deficiencies 

Depakote CR may interact with various products, including: 

• Specific antidepressants: 
  • Amitriptyline 
  • Nortriptyline  
  • Phenelzine 
• Certain antibiotics: 
  • Carbapenems such as imipenem 
• Iirinotecan 
• Mefloquine 
• Orlistat 
• Other seizure medications: 
  • Ethosuximide 
  • Lamotrigine 
  • Rufinamide  
  • Topiramate 
• Vorinostat 
• Warfarin 
• Zidovudine 

Disclose your complete medication regimen, including prescriptions, over-the-counter products, vitamins, and herbal supplements to all healthcare providers to minimize the risk of drug interaction with Depakote CR. 

Follow your doctor’s instructions and continue taking low-dose aspirin for specific medical purposes, such as preventing heart attacks or strokes (usually 81-162 milligrams daily). If you are using aspirin for any other reason, consult your doctor or pharmacist for guidance. 

Carefully read the labels of all your medications, including allergy or cough-and-cold products, as they may contain ingredients that can cause drowsiness. Consult your pharmacist for guidance on the safe use of these products, especially if you are taking: 

• Alcohol 
• Marijuana (cannabis) 
• Antihistamines (such as cetirizine or diphenhydramine)  
• Sleep or anxiety medications (such as alprazolam or zolpidem) 
• Muscle relaxants (such as carisoprodol or cyclobenzaprine) 
• Opioid pain relievers (such as codeine or hydrocodone) 

Depakote CR may cause interference in certain lab tests (urine ketone tests).  Notify lab personnel and your healthcare providers about your medication usage. 

Refrain from operating vehicles or engaging in hazardous activities until you know the impact of Depakote CR on your abilities, as it may impair your reactions. 

The use of Depakote CR during pregnancy may elevate the risk of significant birth defects, which can manifest in the early stages of pregnancy, possibly even before pregnancy is recognized. Moreover, later in life, it can impact a child’s cognitive abilities, including reasoning, intelligence, and problem-solving. 

Nonetheless, experiencing a seizure during pregnancy could pose risks to both the mother and the baby. 

If you are not pregnant, employ reliable contraception methods to avert pregnancy when taking Depakote CR. Inform your doctor if you initiate or discontinue hormonal contraception containing estrogen (e.g., birth control pills, injections, implants, skin patches, and vaginal rings), as estrogen may interact with this medication and diminish its efficacy in seizure prevention. 

Before nursing, seek professional advice concerning breastfeeding safety in conjunction with Depakote CR.