Sodium Valproate Dosage and Administration Advice in Status Epilepticus

Sodium valproate 25mg/kg IV, single dose, infuse over 15 minutes. Maximum dose 2500mg.

Contraindications:

• Reproductive risks in all patients <55 years*
• Mitochondrial disease or metabolic disorder predisposing to hepatotoxicity
• Concurrent use with carbapenems e.g. meropenem (major interaction resulting in markedly reduced sodium valproate levels and therapeutic effects)
• Active liver disease
• Porphyria

Cautions: Check concomitant drugs (valproate is an enzyme inhibitor, with immediate effect on half-life of other drugs e.g. lamotrigine)

Administration: Give in 50ml-100ml sodium chloride 0.9% over 15 minutes. Please note this is a faster infusion rate than specified in the current IV monograph but has been approved for administration in this way in NHSGGC.

Please state the infusion time when prescribing on the kardex or HEPMA.

*Sodium valproate reproductive risks: The primary aim in status epilepticus management is the termination of seizures and the preservation of life. The Medicines and Healthcare products Regulatory Agency (MHRA) has issued advice on the use of sodium valproate in female and male patients under 55 years of age. Decisions regarding ongoing treatment once seizures are controlled must be in line with MHRA advice.

Use of sodium valproate in status epilepticus is ‘off-label’ but is approved for use in this way within NHSGGC, an unlicensed medicine form does not need to be completed for use in this indication.

Guideline reviewed: August 2024

Page updated: September 2024