
Ask a doctor about a prescription for Depakine Hronosphere 1000
6 6.66 mg + 29.03 mg, prolonged-release granules
Sodium valproate + Valproic acid
This medicinal product is subject to additional monitoring. This will allow for quick identification of new safety information. You can help by reporting any side effects you may get. To learn how to report side effects, see section 4.
Depakine Chronosphere (sodium valproate + valproic acid) used during pregnancy can seriously harm the unborn child. Women of childbearing age should use effective contraception (birth control) without interruption during the entire treatment period with Depakine Chronosphere. The doctor will discuss this with the patient, and the recommendations presented in section 2 of this leaflet should also be followed.
Patients should contact their doctor immediately if they plan to become pregnant or if they suspect they are pregnant.
Depakine Chronosphere should not be discontinued unless advised by a doctor, as the patient's condition may worsen.
Depakine Chronosphere is a prolonged-release granule (containing microgranules with a diameter of 350 µm to 450 µm) and contains sodium valproate and valproic acid as active substances. Depakine Chronosphere is a medicine used to treat epilepsy and mania.
Depakine Chronosphere is used to treat:
Do not take the medicine in the following cases:
Before starting to take Depakine Chronosphere, the patient should discuss it with their doctor.
Depakine Chronosphere should not be used in children and adolescents under 18 years of age for the treatment of mania.
The patient should tell their doctor about all medicines they are currently taking or have recently taken, as well as any medicines they plan to take.
Some other medicines and Depakine Chronosphere may affect each other's action. These medicines include:
The medicine should be taken with a soft food (yogurt, fruit puree, cottage cheese, etc.) or drinks (fruit juices) - cold or at room temperature.
Food does not affect the absorption of the medicine from the gastrointestinal tract.
During treatment with Depakine Chronosphere, the patient should not consume alcohol.
Pregnancy
Bipolar affective disorder
Epilepsy
Risk of taking valproate during pregnancy (regardless of the disease being treated with valproate)
about STARTING TREATMENT WITH DEPAKINE CHRONOSPHERE
about CONTINUING TREATMENT WITH DEPAKINE CHRONOSPHERE WITHOUT TRYING FOR A CHILD
about CONTINUING TREATMENT WITH DEPAKINE CHRONOSPHERE AND BECOMING PREGNANT
If Depakine Chronosphere is prescribed for the first time, the doctor will explain the risks to the unborn child if the patient becomes pregnant. Women of childbearing age should ensure that they use effective contraception throughout the treatment period with Depakine Chronosphere. If the patient needs advice on contraception, they should consult their doctor or a family planning clinic.
If the patient continues treatment with Depakine Chronosphere and does not plan to become pregnant, they must ensure that they use effective contraception throughout the treatment period with Depakine Chronosphere. If the patient needs advice on contraception, they should consult their doctor or a family planning clinic.
If the patient plans to have a child, they should first schedule a visit with their doctor. Do not stop taking Depakine Chronosphere or contraception without discussing it with a doctor. The doctor will provide further guidance.
Children born to mothers who took valproate during pregnancy are at high risk of birth defects and developmental problems that can significantly impair the child. The doctor will refer the patient to a specialist experienced in treating bipolar affective disorder or epilepsy to assess alternative treatment options. The specialist may take steps to ensure the best possible outcome of the pregnancy and minimize the risk to the mother and unborn child.
The specialist may decide to change the dose of Depakine Chronosphere or switch to another medicine or discontinue Depakine Chronosphere well before the patient becomes pregnant - to ensure that the disease is stable.
The patient should ask their doctor about taking folic acid when trying to conceive. Folic acid may reduce the overall risk of spina bifida and early miscarriage, which applies to all pregnancies. However, it is unlikely that taking folic acid will reduce the risk of birth defects associated with valproate treatment.
Do not stop taking Depakine Chronosphere unless advised by a doctor, as the patient's condition may worsen. If the patient is pregnant or suspects they may be pregnant, they should schedule an urgent visit with their doctor. The doctor will provide further guidance.
Children born to mothers who took valproate during pregnancy are at high risk of birth defects and developmental problems that can significantly impair the child.
The patient will be referred to a specialist experienced in treating bipolar affective disorder or epilepsy to assess alternative treatment options.
In exceptional cases, when Depakine Chronosphere is the only available treatment option during pregnancy, the patient will be closely monitored, both in terms of the underlying disease and fetal development. The patient and their partner will receive counseling and support regarding valproate-exposed pregnancy.
The patient should ask their doctor about taking folic acid. Folic acid may reduce the overall risk of spina bifida and early miscarriage, which applies to all pregnancies. However, it is unlikely that taking folic acid will reduce the risk of birth defects associated with valproate treatment.
Newborns of mothers who took Depakine Chronosphere during pregnancy may experience coagulation disorders, hypoglycemia, hypothyroidism, and withdrawal symptoms, such as: agitation, irritability, hyperactivity, tremors, seizures, and feeding problems.
Possible risk associated with taking valproate in the 3 months before conception
A study suggests a possible risk of motor disorders and developmental delays (problems in early childhood development) in children whose fathers were treated with valproate in the 3 months before conception. In this study, such disorders occurred in about 5 out of 100 children whose fathers were treated with valproate, compared to about 3 out of 100 children of men treated with lamotrigine or levetiracetam (other medicines that may be used to treat the patient's condition). The risk to children whose fathers stopped taking valproate at least 3 months (the time needed to produce new sperm) before conception is not known. The study has limitations, and therefore, it is not clear whether the suggested increased risk of developmental delays is caused by valproate. The study was not large enough to show what specific types of motor disorders and developmental delays are involved.
Men should not donate sperm while taking valproate and for 3 months after stopping it.
If the patient plans to have a child, they should discuss it with their doctor.
If the patient's partner becomes pregnant while the patient is taking valproate in the 3 months before conception, and the patient has questions about it, they should contact their doctor. Do not stop treatment without consulting a doctor. If the patient stops treatment, their symptoms may worsen.
The patient should regularly visit their doctor. During such a visit, the doctor will discuss with the patient the precautions related to taking valproate and the possibility of using alternative treatment methods for their condition, depending on the individual situation.
The patient should read the patient guide provided by their doctor. The patient will also receive a patient card from the pharmacist to remind them of the possible risk associated with valproate.
Valproate is excreted in small amounts into breast milk. The patient should consult their doctor to determine if they can breastfeed while taking Depakine Chronosphere.
In some patients, especially at the beginning of treatment with Depakine Chronosphere or concomitant treatment with other antiepileptic drugs or benzodiazepines, drowsiness may occur. Before driving or operating machinery, the patient should make sure how they react to the treatment.
Depakine Chronosphere 100 contains less than 1 mmol (23 mg) of sodium per sachet, which means the medicine is considered "sodium-free".
Depakine Chronosphere 250 contains 23.07 mg of sodium (the main component of table salt) per sachet. This corresponds to 1.15% of the maximum recommended daily intake of sodium in the diet for adults.
Depakine Chronosphere 500 contains 46.08 mg of sodium (the main component of table salt) per sachet. This corresponds to 2.30% of the maximum recommended daily intake of sodium in the diet for adults.
Depakine Chronosphere 750 contains 69.20 mg of sodium (the main component of table salt) per sachet. This corresponds to 3.46% of the maximum recommended daily intake of sodium in the diet for adults.
Depakine Chronosphere 1000 contains 92.24 mg of sodium (the main component of table salt) per sachet. This corresponds to 4.61% of the maximum recommended daily intake of sodium in the diet for adults.
Depakine Chronosphere should always be taken as directed by the doctor. In case of doubts, the patient should consult their doctor.
Girls and women of childbearing age
Treatment with Depakine Chronosphere should be initiated and supervised by a doctor specializing in the treatment of epilepsy or bipolar affective disorder.
Male patients
It is recommended that the use of Depakine Chronosphere be initiated and supervised by a specialist with experience in the treatment of epilepsy or bipolar affective disorder - see section 2 "Important advice for male patients".
The pharmaceutical form of Depakine Chronosphere, prolonged-release granules, can be used in all patients, especially in children (if the child can swallow liquid food), adults with swallowing difficulties, and elderly patients.
Depakine Chronosphere can be taken once or twice a day.
The daily dose of the medicine should be determined by the doctor based on the patient's age and weight; individual sensitivity to sodium valproate should also be taken into account.
Starting treatment with Depakine Chronosphere for epilepsy
The initial daily dose is usually 5 to 15 mg/kg body weight; it should then be gradually increased to achieve the optimal dose (see: Starting treatment with Depakine Chronosphere).
This dose is usually between 20 and 30 mg/kg body weight per day. If adequate control of seizures is not achieved, the dose of the medicine can be increased; patients should be closely monitored if they receive a dose above 50 mg/kg body weight.
Children over 17 kg body weight
Usual maintenance dose is 30 mg/kg body weight per day.
Adults
Usual maintenance dose is between 20 and 30 mg/kg body weight per day.
Elderly patients
Although the pharmacokinetics of the medicine may change in elderly patients, this has no significant clinical implications. Dosing should be based on the degree of seizure control.
Mania
Adults:
The daily dose should be determined and verified individually by the doctor.
Initial dose:
The recommended initial daily dose is 750 mg.
Average daily dose:
The average daily dose is usually between 1000 mg and 2000 mg.
Method of administration
Depakine Chronosphere has no taste and should be administered by pouring it into a soft food (yogurt, fruit puree, cottage cheese, etc.) or drinks (fruit juices) - cold or at room temperature.
Depakine Chronosphere should not be administered with hot or warm foods or drinks (soup, coffee, tea, etc.).
If necessary, the contents of the sachet can also be administered directly into the mouth, and then the mouth should be rinsed with a small amount of cold drink.
Depakine Chronosphere should not be administered in a baby bottle with a nipple, as the microgranules may clog the nipple hole.
When administering the product Depakine Chronosphere with liquids, it is recommended to rinse the glass with a small amount of water and drink it, as the microgranules may stick to the sides of the glass.
The prepared medicine should be taken immediately and not chewed.
The medicine should not be left for later use.
Duration of treatment
The medicine should be taken for as long as the doctor recommends.
Do not stop treatment or change the dose of the medicine without consulting a doctor.
If the patient feels that the effect of Depakine Chronosphere is too strong or too weak, they should consult their doctor.
Patients with renal impairment
The doctor may decide to modify the dose in the patient.
Clinical symptoms of severe overdose are usually: coma with decreased muscle tone, hyporeflexia (weak reflexes), miosis (constricted pupils), and respiratory disorders, seizures. Metabolic acidosis, hypotension, and acute cardiovascular failure may also occur. The presence of sodium in valproate formulations may lead to increased sodium levels in the blood in case of overdose.
Treatment of overdose is symptomatic and should be performed in a hospital. Treatment includes: gastric lavage (up to 10-12 hours after taking the medicine) and monitoring of cardiovascular and respiratory function.
In a few cases, the use of naloxone has been shown to be effective.
In case of taking a higher dose of the medicine than recommended, the patient should immediately consult their doctor or pharmacist.
In case of missing a dose, the patient should take it as soon as possible, unless it is close to the time of the next dose. Do not take two doses of the medicine at the same time or in a short period.
In case of doubts, the patient should consult their doctor.
Without consulting a doctor, the patient should not stop treatment with Depakine Chronosphere or change the dose of the medicine.
Stopping treatment without consulting a doctor may worsen the patient's condition.
Like all medicines, Depakine Chronosphere can cause side effects, although not everybody gets them. Patients may need appropriate treatment for some side effects.
Depakine Chronosphere sachets should be stored at a temperature below 25°C in the original packaging, in a dry place. The medicinal product should be kept out of the reach and sight of children. The medicinal product should not be used after the expiry date stated on the packaging. Medicines should not be disposed of via wastewater or household waste. The patient should ask their pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.
Depakine Chronosphere 100
1 sachet contains as active substances:
sodium valproate
66.66 mg
valproic acid
29.03 mg
which corresponds to a total of 100 mg of sodium valproate.
Depakine Chronosphere 250
1 sachet contains as active substances:
sodium valproate
166.76 mg
valproic acid
72.61 mg
which corresponds to a total of 250 mg of sodium valproate.
Depakine Chronosphere 500
1 sachet contains as active substances:
sodium valproate
333.30 mg
valproic acid
145.14 mg
which corresponds to a total of 500 mg of sodium valproate.
Depakine Chronosphere 750
1 sachet contains as active substances:
sodium valproate
500.06 mg
valproic acid
217.75 mg
which corresponds to a total of 750 mg of sodium valproate.
Depakine Chronosphere 1000
1 sachet contains as active substances:
sodium valproate
666.60 mg
valproic acid
290.27 mg
which corresponds to a total of 1000 mg of sodium valproate.
In addition, the medicinal product contains: paraffin, dibehenyl glycerol, colloidal silicon dioxide.
Depakine Chronosphere is a prolonged-release granule.
The package contains 30 sachets of Depakine Chronosphere.
Marketing authorization holder:
Sanofi Sp. z o.o.
ul. Marcina Kasprzaka 6
01-211 Warsaw
Manufacturer:
Sanofi-Winthrop Industrie
196, avenue du Marechal Juin
45200 Amilly
France
To obtain more detailed information about this medicinal product, please contact the marketing authorization holder:
Sanofi Sp. z o.o.
ul. Marcina Kasprzaka 6
01-211 Warsaw
tel.: +48 22 280 00 00
Date of last update of the leaflet:December 2024
Detailed and up-to-date information about this medicinal product is available by scanning the QR code on the leaflet and the outer packaging with a smartphone. The same information is also available on the website: www.qr.walproinianija.pl
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