劑量
每 24 小時平均劑量如下：
孩童：30mg/kg (建議使用口服液劑)。
青少年及成人：20~30mg/kg(建議使用錠劑或持續性藥效錠之劑型給藥)。
處方應以 mg 為單位，每瓶的帝拔癲口服液隨藥附有一支有劑量(mg)刻度指示的調劑針筒。
用法
口服使用。僅可使用瓶內所附的調劑針筒量取。
每日劑量分次服用如下，建議與餐點同時服用。
一歲以下的病人分兩次服用。
一歲以上的病人分三次服用。
帝拔癲口服液應以少量非發泡性飲料稀釋後服用。

Absorption
Valproic acid is rapidly absorbed in the GI tract. Divalproex dissociates into valproic acid in the GI tract. T max is 4 to 17 h (extended-release [ER] tablets).

Distribution
Vd of total or free valproic acid is 11 and 92 L per 1.73 m 2 , respectively. 80% to 90% protein bound (concentration-dependent).

Metabolism
Metabolized primarily in the liver.

Elimination
30% to 50% excreted as glucuronide conjugate in the urine. The t ½ is 9 to 16 h for valproate.

Special Populations
Renal Function Impairment
Protein binding in renal failure patients is substantially reduced.

Hepatic Function Impairment
Cl may be decreased and unbound fraction of valproate may be increased.

Elderly
Intrinsic Cl is reduced 39%; the free fraction is increased 44%.

Alcohol, CNS depressants
Enhanced CNS depression.

Amitriptyline/Nortriptyline, barbiturates, diazepam, ethosuximide, hydantoins (eg, phenytoin), phenobarbital, primidone, zidovudine
Plasma levels of these drugs may be increased.

Carbamazepine
Carbamazepine plasma levels may be decreased while carbamazepine-10,11-epoxide levels may be increased; decreased valproic acid levels.

Charcoal, cholestyramine, meropenem, rifampin
May decrease valproic acid levels.

Chlorpromazine, cimetidine, erythromycin, felbamate, fluoxetine, salicylates
May increase valproic acid levels.

Clonazepam
Absence status may be induced in patients with a history of absence type seizures.

Lamotrigine
Decreased valproic acid levels; increased lamotrigine levels.

Lorazepam
Lorazepam plasma levels may be increased.

Olanzapine
Risk of hepatic adverse reactions may be increased; olanzapine levels may be decreased.

Topiramate
Coadministration with valproic acid has been associated with hyperammonemia with and without encephalopathy. Plasma levels of both drugs may be decreased.

Warfarin
Warfarin may be displaced from its protein binding site, transiently increasing the anticoagulant effect.

1.對本藥過敏者

2.嚴重肝疾病患者

3.本品服用期間請勿併服Carbapenem系抗生素