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NERVOUS SYSTEM › ANTIEPILEPTICS › ANTIEPILEPTICS › Hydantoin derivatives
amino(diphenylhydantoin) valeric acid
N03AB03
Forms & Strengths
- Tablets: 50mg, 100mg
- Capsules: 50mg, 100mg, 150mg, 300mg
- Extended-release capsules: 100mg, 200mg, 300mg
- Oral suspension: 25mg/5ml
Adult Dosing
- Initial: 300-400mg/day in 2-3 divided doses
- Maintenance: 300-600mg/day
- Maximum dose: 1200mg/day
Pediatric Dosing
- Neonates: 3-4mg/kg/day in 2 divided doses
- Infants 1-24 months: 4-8mg/kg/day in 2-3 divided doses
- Children 3-12 years: 4-8mg/kg/day in 2-3 divided doses
- Adolescents >12 years: similar to adult dosing
Indications
- Partial seizures
- Generalized tonic-clonic seizures
- Mixed seizures
Mechanism of Action
- Stabilizes inactivated sodium channels
- Decreases post-tetanic potentiation at synapses
- Limits the spread of seizure activity
Contraindications
- Hypersensitivity to valproic acid or its analogs
- Liver disease or significant liver dysfunction
- Pregnancy, especially during the first trimester
Adverse Reactions
- Drowsiness
- Dizziness
- Ataxia
- Nausea
- Vomiting
- Hepatotoxicity
- Teratogenicity
Drug Interactions
- Phenytoin: decreased phenytoin levels
- Carbamazepine: increased risk of hepatotoxicity
- Lamotrigine: increased risk of hepatotoxicity
- Warfarin: increased INR
Curated Content: Needs Vetting Before Put to Clinical Use