Divalproex extended-release dosage form (Divalproex-ER) has been promoted as innovative formulation for the treatment of epilepsy and manic disorders, and for migraine headache prevention, with the advantage of being dosing once a day. Due to a significant decreasing in the peak-trough fluctuation of plasma valproic acid levels, in comparison with the twice-daily dosing of conventional delayed-release formulations (Divalproex-DR), concentration-dependent side effects would be prevented. However the main constraint for Divalproex-ER usage is the need to be administered in a higher daily dose, because of its lower bioavailability, in order to prevent eventual breakthrough seizures when patients are switched from the twice-daily Divalproex DR regimen. Taking into account free plasma drug levels, Divalproex ER/DR relative bioavailability could be assessed as low as 75% in fasting condition. In order to overcome the need of increase Divalproex-ER daily dose, maintenance of the twice-daily regimen is suggested. Divalproex-ER administered every 12 hours not only increases steady state trough concentration to a higher value in comparison with Divalproex-DR, avoiding inefficacy of the treatment, but also achieves the safest manner to treat patients with valproic acid because of reaching practically a plateau profile of drug levels.
Other names for this medication:
Divalproex,
Depakote,
Dicorate,
Divaa,
Desval,
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