• Monotherapy or in adjunctive treatment of complex partial seizures
    • Adults and children >10 years: Initially 10-15mg/kg/day divided BD/TDS.
      • Maintained at 30-60mg/kg/day
      • May increase by 5-10 mg/kg/week to achieve optimal clinical response
      • Max 60mg/kg/day
  • Monotherapy or in adjunctive treatment of simple and complex absence seizures
    • Adults and children >10 years: Initially 10-15mg/kg/day divided BD/TDS.
      • Maintained at 30-60mg/kg/day
      • May increase by 5-10 mg/kg/week to achieve optimal clinical response
      • Max 60mg/kg/day
  • Mania associated with bipolar disorder:
    • 250mg TDS
    • Max 60mg/kg/day
  • Migraine headache prophylaxis:
    • 250mg BD *1/52
    • May increase dose up to 1000mg/day if needed
  • Tablet:
    • 500mg
    • 750mg
  • Give with food
  • Taper dose to discontinue

Anticonvulsant

Exact mechanism is unknown but thought to increases GABA effects which may inhibit glutamate/NMDA receptor-mediated neuronal excitation

  • Headache
  • Nausea & vomiting
  • Asthenia
  • Somnolence
  • Thrombocytopenia
  • Dyspepsia
  • Dizziness
  • Diarrhea
  • Abdominal pain
  • Tremor
  • Alopecia
  • Weight changes
  • Appetite changes
  • Constipation
  • Nervousness
  • Emotional lability
  • Insomnia
  • Peripheral edema
  • Petechiae
  • Ecchymosis
  • Rash
  • Depression
  • Dyspnea
  • Tinnitus
  • Elevated ALT/AST
  • Amnesia
  • Abnormal gait
  • Vision changes
  • Blurred vision
  • Nystagmus
  • Myalgia
  • Photosensitivity
  • Medication residue in stool
  • Hypersensitivity to class/components
  • Hepatic disease
  • Hepatic impairment
  • Urea cycle disorder
  • POLG-related mitochondrial disorder
  • Suspected mitochondrial disorder (patients <2 years)
  • Pregnancy (migraine headache prophylaxis use)
  • Avoid abrupt withdrawal

WARNING:

  • Fatal hepatotoxicity
  • Teratogenic
  • Fatal pancreatitis
  • Amifampridine
  • Bupropion
  • Dalfampridine
  • Metoclopramide

                          Drug Status

Availability Prescription only
Pregnancy Category D
Breastfeeding Not recommended; weigh benefit over risk
Schedule Controlled
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Valtas OD 500mg Tablet 30’s Intas Pharma Accord Healthcare
Valtas OD 750mg Tablet 30’s Intas Pharma Accord Healthcare