Depakine

Depakine is an anticonvulsant used to treat various forms of epilepsy.

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Indications Depakine

The drug is indicated for the elimination of minor and generalized epileptic seizures, as well as focal seizures, in which complex and simple symptoms are observed.

It is considered highly effective in the treatment of convulsive syndromes that are observed in organic cerebral pathologies, as well as in behavioral disorders (due to epilepsy).

It is also prescribed to children with tics or febrile seizures.

In psychiatry, Depakine is used for bipolar affective disorder, which is resistant to lithium drugs and other drugs, and in addition to this, in the treatment of specific syndromes - Lennox-Gastaut or West.

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Release form

Available in tablet form with 40 tablets (volume 0.2 g) or 10 tablets (volume 0.5 g) in 1 bottle. In addition, also in the form of sublimated powder for solutions (for parenteral administration), capsules and syrup.

Depakine 400 is a powder for injection solutions. It is used as a temporary remedy against epilepsy in children, as well as adults - as a replacement for oral analogues, if it is temporarily impossible to take the drug orally.

Depakine Enteric 300 is used in monotherapy to eliminate:

• primary form of generalized epilepsy, clonic-tonic seizures (with or without the development of myoclonic seizures), myoclonic seizures alone, absences, combined form of tonic-clonic seizures - with absences;
• benign type of partial epilepsy (including temporal lobe epilepsy).

When used in monotherapy or in combination with other anticonvulsants – to eliminate:

• secondary form of generalized epilepsy;
• partial epileptic seizures (complex or simple forms).

If monotherapy is not effective, it is recommended to take the drug in combination with other anticonvulsants.

The tablets are available in blisters (10 pieces each). One package contains 10 blister strips.

Depakine Chrono 300 is a prolonged-release tablet used to eliminate the manifestations of the primary stage of generalized epilepsy (recommended for monotherapy): minor epileptic seizures/absences, severe bilateral myoclonic seizures, as well as severe epileptic seizures (with or without myoclonus) and photosensitive epilepsy.

Manic manifestations developing as a result of bipolar disorder – when the patient has an intolerance (there are contraindications) to lithium.

Prevention of recurrence of episodes of dysthymia in patients with bipolar disorders who experience a drug reaction to the use of valproates during the treatment of manic syndromes.

One tablet of this drug contains: 199.8 mg of Valproate sodium, as well as 87 mg of valproic acid - the sum of these components corresponds to 300 mg of the substance sodium valproate in 1 tablet.

The bottle of medicine contains 50 tablets. One package contains 2 bottles.

One tablet of Depakine Chrono 500 contains: 333 mg of Valproate sodium, as well as 145 mg of valproic acid - in total, these 2 substances give 500 mg of Valproate sodium in 1 tablet of the drug.

The medicine is contained in a bottle (30 tablets). One package contains 1 bottle with the medicine.

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Pharmacodynamics

The drug has a sedative and central muscle relaxant effect on the body. There is no complete information about the mechanism of action of the drug. There is information that valproate, which is the active component of the drug, helps to increase GABA levels in the central nervous system, and also slows down the activity of the enzyme GABA-transferase. As a result, seizure readiness decreases, as well as the excitability of the motor areas of the cerebral cortex. Depakine has antiarrhythmic activity, improves mood and improves the mental state of the patient.

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Pharmacokinetics

The bioavailability index is about 100%. Valproates are able to pass through the blood-brain barrier, penetrating into the cerebrospinal fluid, as well as the brain.

Depakine begins to exert its medicinal effect upon reaching 40-100 mg/l of plasma concentration of the substance. If this indicator exceeds 200 mg/l, it is necessary to reduce the dose. The drug reaches equilibrium concentration figures after 3-4 days of continuous use of tablets.

Excretion (in conjugated form) occurs mainly in the urine.

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Dosing and administration

Tablets are taken orally - 2-3 times a day, washed down with water. The medicine in syrup form should be mixed with food or some liquid before use.

It is allowed to prescribe it to children weighing 25+ kg, as well as adults. At the initial stage, the daily dosage is 5-15 mg / kg, and then it is gradually increased by 5-10 mg / kg weekly.

The daily dosage for adolescents and adults is 20-30 mg/kg. To obtain a stable medicinal effect, it is allowed to increase the dosage by 200 mg per day with an interval of 3-4 days. The maximum daily dosage is 50 mg/kg.

For small children and newborns, the dosage is determined individually.

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Use Depakine during pregnancy

Depankin should not be used by pregnant women, because in approximately 1-2% of all cases the drug can cause neural tube defects in the fetus, resulting in the formation of a spinal cleft, as well as a spinal hernia.

Contraindications

Among the contraindications of the drug:

• patient intolerance to the drug;
• hepatitis (in acute or chronic stage);
• liver failure;
• disorders of the pancreas;
• porphyria disease;
• severe form of thrombocytopenia;
• hemorrhagic diathesis;
• breastfeeding period;
• children under 3 years of age.

It is prescribed with caution if the patient has signs of suppression of hematopoiesis processes in the bone marrow (such as thrombocytopenia or leukopenia, anemia and organic pathologies of the central nervous system, as well as renal failure, childhood mental retardation, as well as a congenital form of enzymopathy).

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Side effects Depakine

The use of the drug may cause the following side effects:

• digestive system organs: aching pain in the epigastrium, nausea, liver dysfunction, increased or, conversely, decreased appetite, development of a tendency to diarrhea (rarely - to constipation), and in addition to this, manifestations of pancreatitis, which can reach a severe stage of disruption of the pancreas;
• CNS organs: tremors often occur, and in addition, behavioral disorders, mood instability, sometimes reaching depression, and aggressiveness develop. In addition, psychoses, hyperactivity, tonic-clonic seizures, hallucinations, and isolated stupor are observed. Symptoms may also include dizziness with headaches, severe drowsiness, dysarthria with encephalopathy, and along with this, disorders of consciousness, reaching a comatose state, and ataxia;
• organs of the hematopoietic system and homeostasis: prolongation of bleeding time, thrombocytopenia, decrease in blood fibrinogen levels. Isolated cases - leukopenia or anemia;
• metabolism: weight loss or gain;
• organs of vision: double vision may occur, spots or stars may appear in the eyes, and nystagmus may also develop;
• skin: allergies in the form of urticaria, rashes, Quincke's edema, as well as photosensitivity and Stevens-Johnson syndrome;
• endocrine system organs: secondary amenorrhea, dysmenorrhea or galactorrhea, and in addition, an increase in the size of the mammary glands;
• Others: hair loss may occasionally begin, leading to the development of baldness.

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Overdose

As a result of an overdose, the patient may fall into a coma. In addition, a sharp decrease in blood pressure, respiratory distress, and the appearance of miosis or hyporeflexia are possible.

To eliminate these symptoms, gastric lavage should be performed (but only if the medicine was taken no more than 10-12 hours before). In addition, osmotic diuresis is necessary, and it is also necessary to monitor blood pressure, pulse rate and respiratory rhythm, and at the same time correct the function of the cardiovascular system (if necessary). Hemodialysis can also be performed, but only if indicated.

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Interactions with other drugs

Due to the similarity of metabolic processes, it is not recommended to combine the drug with salicylates.

As a result of the simultaneous use of Depakine with antidepressants or neuroleptics, their effect on the body increases, as well as the symptoms of side effects.

Combined use with phenthoin reduces the concentration of the latter, while increasing its concentration in free form - this can provoke the development of manifestations of an overdose of the drug.

The use of anticonvulsants that induce microsomal liver enzymes reduces serum drug concentrations. If a patient requires concomitant use of such drugs, dosages should be adjusted according to concentrations.

Depakine enhances the properties of antipsychotics, anticonvulsants, barbiturates, antidepressants, and also ethanol and MAO inhibitors. When combined with hepatotoxic drugs and ethanol, the likelihood of liver damage increases, resulting in liver failure.

Does not reduce the effectiveness of oral contraception.

Combination with myelotoxic drugs increases the risk of suppression of hematopoietic processes.

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Storage conditions

The medicine is kept in standard conditions - a dark, dry place. The temperature should not exceed 25°C.

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Shelf life

Depakine is suitable for use for 3 years from the date of manufacture, but after opening the bottle it cannot be used for longer than 1 month.

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