Semisodium valproate for bipolar disorder

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking semisodium valproate it is important that your doctor knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you or a close member of your family have liver problems.
• If you have any problems with the way your kidneys work.
• If you have an inflammatory condition called systemic lupus erythematosus (also called lupus, or SLE).
• If you have a rare inherited blood disorder called porphyria.
• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
• If you have ever had an allergic reaction to a medicine.

• Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about the tablets and it will provide you with a full list of the side-effects which you may experience from taking them.
• Take semisodium valproate exactly as your doctor tells you to. Your dose will be printed on the label of the pack to remind you about what the doctor said. It is usual to be prescribed two or three doses to take each day.
• Semisodium valproate should be taken with food, so take your doses with a snack or just after you have had a meal. Swallow the tablets whole with a drink of water. Do not chew or crush the tablets because they have a special protective coating.
• Try to get into a habit of taking the tablets at the same times each day. This will help you avoid missing any doses.
• If you forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case leave out the missed dose. Do not take two doses together to make up for a forgotten dose.

• Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. You will need to have some blood tests from time to time, particularly during the first few months of treatment.
• Each time you collect a new supply of medicine from your pharmacy, make sure that the tablets look to be the same as you have had before. If they are different, please discuss this with your pharmacist who will advise you.
• While you are taking semisodium valproate, there is a small risk that you may develop mood changes, distressing thoughts and feelings about suicide. If this happens, you must tell your doctor about it straightaway.
• Your doctor is likely to recommend that you do not drink alcohol while you are on semisodium valproate.
• This medicine will not normally be prescribed for you if you are a woman who could become pregnant. This is because semisodium valproate can cause harm to an unborn child.
• If you buy any medicines, always check with a pharmacist that they are suitable to take with your other medicines. Medicines which contain aspirin (such as some cold or flu remedies and painkillers) can interfere with semisodium valproate and may be best avoided.
• Continue to take the tablets until your doctor tells you otherwise. Stopping treatment suddenly can cause problems, so if it becomes necessary for your treatment to stop, your doctor may want you to reduce your dose over a few days.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with semisodium valproate. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Important: semisodium valproate has been associated with a number of serious unwanted effects affecting the blood, pancreas and liver. Although these occur less commonly than some of the side-effects listed above, you must let your doctor know straightaway if you notice any of the following:

• An unexplained cough or sore throat, or any unusual bleeding or bruising.
• Extreme tiredness, tummy (abdominal) pain, sickness, dark urine or yellowing of your skin or the whites of your eyes (jaundice).

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.