Valpros Pedia Dosage/Direction for Use

Sodium valproate syrup is administered orally. The recommended initial dose is 15 mg/kg/day, increasing at one week intervals by 5-10 mg/kg/day, until seizures are controlled or when occurrence of adverse effects prevent further dose increase. The maximum recommended dose is 60 mg/kg/day. If the total daily dose exceeds 250 mg, it should be given in a divided regimen.
The initial daily dose of sodium valproate syrup (15 mg/kg/day) is tabulated as follows. (See table.)

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The frequency of adverse effects (particularly elevated liver enzymes) may be dose-related. When adjusting the dose, the benefit of adequate seizure control should therefore be weighed against the possibility of a greater incidence of adverse reactions.
A good correlation has not been established between daily dose, serum level, and therapeutic effect. However, therapeutic serum levels for most patients range from 50 to 100 mcg/mL. Some patients may be controlled with serum levels lower or higher than this range.
Special Populations: Elderly: Due to a decrease in unbound clearance of valproate and possibly a greater sensitivity to somnolence in the elderly, the starting dose should be reduced. Dose should be increased more slowly and with regular monitoring for fluid intake, dehydration, somnolence, urinary tract infection, and other adverse events.
Elderly patients who experience excessive somnolence and those with decreased food or fluid intake should consult their physician for possible dose reduction or discontinuation of therapy. Therapeutic dose should be based on both the patient's tolerability and clinical response.
Renal Insufficiency: It may be necessary to decrease the dose. Dose should be adjusted according to clinical monitoring since monitoring of plasma concentrations may be misleading.