Gastrointestinal effects divalproex

The suggestion that divalproex (valproate semisodium) causes fewer gastrointestinal adverse reactions than valproate (SEDA-23, 94) (58) has been challenged (74). In other cited studies divalproex was associated with a higher risk of gastrointestinal effects. 

Divalproex immediate release formulation reduces gastrointestinal side effects compared to generic valproate... 

Divalproex ER Improves gastrointestinal side effects and alopecia compared to immediate release divalproex or generic valproate... 

Valproic acid is available as sodium, magnesium, and calcium salts, as the free acid, and as a coordination compound, valproate semisodium (divalproex sodium), which comprises the sodium salt of valproic acid and free valproic acid in a 1 1 molar ratio. AH share the same active principle (valproic acid) and have virtually identical tolerability, although the formulation influences the incidence of gastrointestinal adverse effects. Valpromide (rINN) is a prodrug of valproate, to which it is converted with a half-hfe of less than 1 hour. Valnoctamide (rINN) is an isomer of valpromide. 

Wagner PG, Welton SR, Hammond CM. Gastrointestinal adverse effects with divalproex sodium and valproic acid. J Clin Psychiatry 2000 61(4) 302-3. 

The most commonly observed side effects for valproate are gastrointestinal (anorexia, nausea, and Indigestion). These effects can be minimized by selecting divalproex sodium, which is enterically coated, and by Initiating therapy at a low dose. More Importantly, however, valproate is associated with the development of fatal hepatotoxicity, especially in children or when coadministered with other AEDs. Frequent monitoring of liver function tests is mandatory for determining the onset of toxicity. 

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