Depakene is an anti-epileptic drug indicated for: 

• Monotherapy and adjunctive therapy of complex partial seizures; sole and adjunctive therapy of simple and complex absence seizures; adjunctive therapy in patients with multiple seizure types that include absence seizures

• Most common adverse reactions (reported >5%) are abdominal pain, alopecia, amblyopia/blurred vision, amnesia, anorexia, asthenia, ataxia, bronchitis, constipation, depression, diarrhea, diplopia, dizziness, dyspepsia, dyspnea, ecchymosis, emotional lability, fever, flu syndrome, headache, increased appetite, infection, insomnia, nausea, nervousness, nystagmus, peripheral edema, pharyngitis, rhinitis, somnolence, thinking abnormal, thrombocytopenia, tinnitus, tremor, vomiting, weight gain, weight loss. 
• The safety and tolerability of valproate in pediatric patients were shown to be comparable to those in adults

• Hepatic enzyme-inducing drugs (e.g., phenytoin, carbamazepine, phenobarbital, primidone, rifampin) can increase valproate clearance, while enzyme inhibitors (e.g., felbamate) can decrease valproate clearance. Therefore increased monitoring of valproate and concomitant drug concentrations and dosage adjustment are indicated whenever enzymeinducing or inhibiting drugs are introduced or withdrawn 
• Aspirin, carbapenem antibiotics: Monitoring of valproate concentrations is recommended 
• Co-administration of valproate can affect the pharmacokinetics of other drugs (e.g. diazepam, ethosuximide, lamotrigine, phenytoin) by inhibiting their metabolism or protein binding displacement 
• Patients stabilized on rufinamide should begin valproate therapy at a low dose, and titrate to clinically effective dose 
• Dosage adjustment of amitriptyline/nortriptyline, propofol, warfarin, and zidovudine may be necessary if used concomitantly with Depakene 
• Topiramate: Hyperammonemia and encephalopathy

• Hepatotoxicity; evaluate high risk populations and monitor serum liver tests 
• Birth defects and decreased IQ following in utero exposure; only use to treat pregnant women with epilepsy if other medications are unacceptable; should not be administered to a woman of childbearing potential unless essential 
• Pancreatitis; Depakene should ordinarily be discontinued 
• Suicidal behavior or ideation; Antiepileptic drugs, including Depakene, increase the risk of suicidal thoughts or behavior 
• Bleeding and other hematopoietic disorders; monitor platelet counts and coagulation tests 
• Hyperammonemia and hyperammonemic encephalopathy; measure ammonia level if unexplained lethargy and vomiting or changes in mental status, and also with concomitant topiramate use; consider discontinuation of valproate therapy 
• Hypothermia; Hypothermia has been reported during valproate therapy with or without associated hyperammonemia. This adverse reaction can also occur in patients using concomitant topiramate 
• Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)/Multiorgan hypersensitivity reaction; discontinue Depakene 
• Somnolence in the elderly can occur. Depakene dosage should be increased slowly and with regular monitoring for fluid and nutritional intake