If you have certain types of seizures, migraine, or mood disorders, your doctor might suggest Depakote or Depakote ER as a treatment option.
Depakote is a prescription medication used to:
- treat focal impaired awareness seizures (also called complex partial seizures) in adults and some children
- treat absence seizures in adults and some children
- treat mania related to bipolar disorder in adults
- prevent migraine episodes in adults
The active ingredient in Depakote and Depakote ER is divalproex sodium. (An active ingredient is what makes a drug work.) These drugs belong to a group of medications called anticonvulsants.
Depakote and Depakote ER are drugs that you swallow. Depakote comes as tablets as well as sprinkle capsules.* Depakote ER† comes as tablets.
This article describes the dosages of Depakote and Depakote ER, as well as their strengths and how to take them. To learn more about Depakote and Depakote ER, see this in-depth article.
Note: This article covers Depakote’s and Depakote ER’s typical dosages, which are provided by the drug’s manufacturer. But when using Depakote or Depakote ER, always take the dosage that your doctor prescribes.
* The sprinkle capsule form of Depakote is only used to treat seizures.
† “ER” stands for extended release. For more information, see the “What are the forms of Depakote and Depakote ER?” section below.
In this section, you’ll learn about the typical dosages of Depakote and Depakote ER. Dosage ranges can vary for these drugs. Your dosage will depend on your body weight and the condition you’re using Depakote to treat.
What are the forms of Depakote and Depakote ER?
Depakote is available in the following forms:
- delayed-release (DR) tablets
- DR sprinkle capsules
These forms are called delayed-release because they won’t dissolve until they pass through your stomach. This allows the drug to reach the right level in your body and helps prevent stomach irritation.
Depakote ER comes as:
- extended-release (ER) tablets
The ER tablets release the drug in your body slowly over the course of 24 hours. This helps keep the drug at a consistent level throughout the day. And it means you’ll only need to take this form of the drug once a day. DR form dosing usually requires that you take the drug more frequently throughout the day.
All forms of Depakote and Depakote ER are taken by mouth. You’ll swallow the tablets whole. As for the capsules, you can either swallow them whole or open them and sprinkle the contents on soft food.
What strengths do Depakote and Depakote ER come in?
Depakote and Depakote ER come in the following strengths:
|Depakote tablets||• 125 milligrams (mg)
• 250 mg
• 500 mg
|Depakote sprinkle capsules||• 125 mg|
|Depakote ER tablets||• 250 mg
• 500 mg
What are the usual dosages of Depakote and Depakote ER?
Usually, your doctor will start you on a low dosage. Then they’ll adjust your dosage over time to reach the right amount for you. Your doctor will ultimately prescribe the lowest dosage that provides the desired effect.
Dosages for Depakote and Depakote ER are often based on body weight in kilograms (kg).* For example, if your Depakote dose is 10 mg/kg, you’ll take 10 mg of the drug for every kg that you weigh.
Your doctor will usually begin with a starting dose that’s low. Then they’ll increase your dosage slowly, either until your condition is managed or you reach the highest dose that’s safe to take.
The maximum dose for the drugs vary depending on the condition you’re treating. But the maximum dose of Depakote is usually the same as the Depakote ER maximum dose. The dose you’ll take might end up a little different from the dose your doctor calculates for you. This is because these drugs are only available in certain strengths.
The information below describes dosages that are commonly used or recommended for adults. But be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Note: For children’s dosages, see “What’s the pediatric (children’s) dosage of Depakote and Depakote ER?” below.
* One kg is about 2.2 pounds (lbs.).
Dosage for episodes of mania related to bipolar disorder
Depakote (tablet only) and Depakote ER are used to treat mania related to bipolar disorder. Mania is a hyperactive, euphoric mood.
For this use, the starting dosages of these drugs are:
- Depakote: 750 mg daily, separated into several doses
- Depakote ER: 25 mg/kg once daily
The manufacturer recommends quickly increasing the dose to a high enough level to manage mania. The maximum dose for either drug is 60 mg/kg daily.
Dosage for seizures
Below are the dosages of Depakote (both tablet and capsule) and Depakote ER for the kinds of seizures they treat: focal impaired awareness seizures (also called complex partial seizures) and absence seizures.
The manufacturer notes that you should not stop taking these drugs suddenly. Doing so may lead to more severe seizures that could be life threatening.
Dosage for focal impaired awareness seizures (complex partial seizures)
For this kind of seizure, you might take Depakote or Depakote ER alone or with another seizure drug.
If you take more than 250 mg of Depakote daily, you’ll divide this dose into smaller doses to take throughout the day. But if you’re prescribed Depakote ER, you can take your entire daily dose at one time.
Recommendations for daily starting dose, dose increase, and maximum dose are the same for both Depakote and Depakote ER. Your doctor will likely increase your dose every week until it’s high enough to manage your seizures.
The chart below lists the usual dosages of these drugs for focal impaired awareness seizures. It also gives an example of what the daily doses might be for someone who weighs 60 kg (about 132 lbs.).
|Starting daily dose||Dose increase||Maximum daily dose|
|Daily dose||10 mg/kg to 15 mg/kg||5 mg/kg to 10 mg/kg||60 mg/kg|
|Example daily dose for
a person weighing 60 kg
|600 mg to 900 mg||300 mg to 600 mg||3,600 mg|
Dosage for absence seizures
For treating this type of seizure, recommendations for daily starting dose, dose increase, and maximum dose are the same for both Depakote and Depakote ER.
Your starting dosage will be 15 mg/kg daily. Each week, your doctor may increase your daily dose by 5 mg/kg to 10 mg/kg. The maximum daily dose of Depakote and Depakote ER for treating absence seizures is 60 mg/kg.
Dosage for migraine prevention
Depakote (tablet only) and Depakote ER are used to prevent migraine symptoms, such as severe headaches.
For this use, the starting dosages of these drugs are:
- Depakote: 250 mg taken twice daily
- Depakote ER: 500 mg taken once daily
The maximum daily dose of either drug for migraine is 1,000 mg.
What’s the pediatric (children’s) dosage of Depakote and Depakote ER?
Depakote and Depakote ER can be used to treat focal impaired awareness seizures and absence seizures in children ages 10 years and older. (Focal impaired awareness seizures are also called complex partial seizures.)
Dosages for treating certain seizures in children ages 10 years and older are similar to dosages for adults. See the “Dosage for seizures” section above for details. A doctor will prescribe the dosage that’s best for your child.
It’s not safe for children younger than 10 years to take these drugs. But it’s possible for your child’s doctor to prescribe them off-label for certain conditions. Off-label drug use is when a drug approved by the Food and Drug Administration (FDA) is prescribed for a purpose other than what it’s approved for.
In children younger than 10 years, Depakote dosing may need to be adjusted. In children younger than 2 years, Depakote may cause severe harm to the liver.
If you have questions about your child’s dosage of Depakote or Depakote ER, talk with their doctor or a pharmacist.
Are Depakote and Depakote ER used long term?
Yes, Depakote and Depakote ER are typically used as long-term treatments. If you and your doctor determine that Depakote or Depakote ER is safe and effective for you, it’s likely that you’ll use it long term.
Your doctor may adjust your dosage of Depakote or Depakote ER if you take another medication that can interact with these drugs. They may change the dosage of the other medication or of Depakote or Depakote ER. Before starting treatment, tell your doctor about any other drugs you’re taking.
If you have abnormal fatigue (low energy) or loss of focus, your dosage may need adjusting. Your dosage may also need adjusting if there’s a change in how much you eat or drink.
The manufacturer recommends that older adults start with lower doses.
Below are answers to some frequently asked questions about Depakote and Depakote ER.
Can Depakote and Depakote ER be used to treat anxiety, depression, agitation, or dementia? If so, what dosages are recommended?
The Food and Drug Administration (FDA) hasn’t approved the use of Depakote and Depakote ER for treating anxiety, depression, agitation, or dementia.
But your doctor may prescribe these drugs for uses that aren’t approved by the FDA. This is called an off-label use. When a medication is prescribed off-label, there aren’t specific dosages that the manufacturer recommends.
If you have questions about off-label use of Depakote and Depakote ER, talk with your doctor or pharmacist.
Is Depakote or Depakote ER typically prescribed in a dose of 1,500 mg?
It’s possible that your doctor may prescribe either drug at this dose.
Your doctor may calculate your dose of Depakote or Depakote ER based on your weight in kilograms (kg). For example, if your doctor recommends a dose of 15 mg/kg and you weigh 100 kg (about 220 lbs.), your dose would be 1,500 mg.
The maximum dose for several conditions is 60 mg/kg, so you might take doses of Depakote or Depakote ER that are much higher than 1,500 mg. For more dosage details, see the “What are the usual dosages of Depakote and Depakote ER?” section above.
Although a daily dose of 1,500 mg is possible for these drugs, make sure to take the dose that your doctor prescribes.
What is a loading dose, and does Depakote or Depakote ER require one?
A loading dose usually refers to a larger starting dose that decreases over time. Loading doses are used when a high dose of medication is needed to improve symptoms of a condition quickly.
Unlike medications requiring a loading dose, Depakote and Depakote ER doses typically start low and increase slowly over time. This gives your body a chance to get used to the drug.
Do Depakote or Depakote ER come in a liquid form to be given by IV?
Depakote and Depakote ER only come as medications that you take by mouth.
A similar medication, valproate sodium, comes as a solution for intravenous (IV) infusions (an injection into your vein over a period of time). This drug is only used to treat certain seizures. It isn’t used to treat mania related to bipolar disorder or prevent migraine.
If you’re interested in hearing more about valproate sodium, talk with your doctor.
The dosage of Depakote or Depakote ER you’re prescribed may depend on several factors. These include:
- the type and severity of the condition you’re using Depakote or Depakote ER to treat
- your age
- the form of Depakote or Depakote ER you’re using
- whether you’re having side effects from taking either drug
- other medications you’re taking
- other conditions you may have (see “Dosage adjustments” under “What is Depakote’s and Depakote ER’s dosage?”)
Depakote comes as tablets and sprinkle capsules, and Depakote ER comes as tablets. To take these medications, you swallow them whole. You can take them with or without food. If you notice belly pain after taking either medication, try taking it with food.
You can open Depakote sprinkle capsules and sprinkle the contents on soft food, such as applesauce. If you take a capsule this way, make sure you’ve emptied all of its contents. You should also take the food right away and avoid chewing the sprinkles.
If you have trouble swallowing capsules or tablets, see this article for tips on how to take this form of medication.
How often you’ll take your dose depends on which drug your doctor prescribes. You would take Depakote ER once per day. You would take Depakote tablets or sprinkle capsules several times throughout the course of a day.
Your dosage will likely increase in the beginning until your symptoms are managed. Your doctor may also have you take blood tests to make sure your blood levels of Depakote are in a safe range.
For information on Depakote and Depakote ER expiration, storage, and disposal, see this article.
Accessible drug containers and labels
If you find it hard to read the prescription label on your medication, tell your doctor or pharmacist. Some pharmacies may provide medication labels that:
- have large print or use braille
- feature a code that you can scan with a smartphone to change the text to audio
Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.
If you have trouble opening medication bottles, let your pharmacist know. They may be able to supply Depakote or Depakote ER in an easy-open container. Your pharmacist may also have some tips that can help make it simpler to open the drug’s container.
If you miss your Depakote or Depakote ER dose, take it as soon as you remember. If it’s almost time for your next dose, skip the dose you missed and take your next dose. Don’t take two doses at one time.
If you need help remembering to take your dose of Depakote or Depakote ER on time, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.
Don’t use more Depakote or Depakote ER than your doctor prescribes. Using more than this can lead to serious side effects.
Symptoms of overdose
Symptoms caused by an overdose can include:
- twitching muscles
- feeling extremely tired
- irregular heartbeat
What to do in case you take too much Depakote or Depakote ER
Call your doctor right away if you think you’ve taken too much Depakote or Depakote ER. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use its online resource. But if you have severe symptoms, call 911 (or your local emergency number) immediately or go to the nearest emergency room.
The sections above describe the typical dosages provided by the drug manufacturer. If your doctor recommends Depakote or Depakote ER for you, they’ll prescribe the dosage that’s right for you.
Remember, you shouldn’t change your dosage of Depakote or Depakote ER without your doctor’s recommendation. Only take Depakote and Depakote ER exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.
Here are some examples of questions you may want to ask your doctor:
- How fast will my Depakote dose be increased?
- Which soft foods can I use with Depakote sprinkle capsules?
- Will my dose of benzodiazepines change when I start taking Depakote?
- Will a higher dose of Depakote mean I take a lower dose of my other seizure medications?
- Which would be better for treating my condition, Depakote or Depakote ER?
If you have bipolar disorder, consider signing up for Healinggeeks’s online newsletter for advice on mood management and mental wellness.
Healinggeeks also has a migraine newsletter that delivers guidance on treating this condition to your email inbox. And if you’re looking to join a supportive community of people who live with migraine, check out Bezzy Migraine.
I was prescribed Depakote for preventing migraine episodes. Why is my dose so low?
For preventing migraine episodes, your doctor will prescribe a lower dose of Depakote based on studies of the drug.
The dose for this purpose isn’t based on a person’s weight as it is for other uses. The starting dose of Depakote tablets for preventing migraine episodes is 250 mg twice daily. Your doctor can increase this to a maximum daily dose of 1,000 mg. Similarly, the starting dose for Depakote ER tablets is 500 mg daily for 1 week. Then your dose may increase to a maximum of 1,000 mg.
If you have questions about changing your dosage of Depakote, be sure to talk with your doctor.
Melissa Badowski, PharmD, MPH, FCCPAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Disclaimer: Healinggeeks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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