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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by NKP on January 1, 2009, at 10:08:46
Suppose a person were on 600 mg sodium valproate daily, taken as 300 mg in the mornings and 300 mg in the evenings. This person wants to stop the sodium valproate, as it is causing debilitating sedation.
The package insert says that sodium valproate has a half life of 15 hours, and peak plasma levels are achieved in 1 to 4 hours, depending on whether the tablets are taken with food etc.
Should the person first taper down to only 300 mg in the evenings, and none in the mornings? Or is it better to stop both the morning and evening doses at the same time?
Thanks.
Posted by bleauberry on January 2, 2009, at 16:45:51
In reply to I have a question about sodium valproate, posted by NKP on January 1, 2009, at 10:08:46
Are they tablets? If so, you could cut them in half. Do your regular dose schedule, but with half doses. If capsules, you could empty the contents, divide them in half, then reload them into empty gel caps. You didn't mention if they are time released or not, but I am thinking they are not? Even if they were, it wouldn't matter. Cutting the pills would destroy the time release mechanism, but for your purposes here that would not be a factor at all.
Best bet is to go down in dose slowly over time, and do it in the smallest steps you can. If you can cut the pills into quarters, that would be even better. Do 3/4 morning and 3/4 evening for 4 days, then 1/2 morning and 1/2 evening for 4 days, then 1/4 morning and 1/4 evening for 4 days, then 1/4 morning for 4 days.
When we drop the doses too fast or in large steps, we can expect all hell to break loose. Not always, but more often than not.
> Suppose a person were on 600 mg sodium valproate daily, taken as 300 mg in the mornings and 300 mg in the evenings. This person wants to stop the sodium valproate, as it is causing debilitating sedation.
>
> The package insert says that sodium valproate has a half life of 15 hours, and peak plasma levels are achieved in 1 to 4 hours, depending on whether the tablets are taken with food etc.
>
> Should the person first taper down to only 300 mg in the evenings, and none in the mornings? Or is it better to stop both the morning and evening doses at the same time?
>
> Thanks.
This is the end of the thread.
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