Valpros/Valpros i-IV Overdosage

Valpros: Cases of accidental and deliberate overdosage have been reported. Fatalities are rare.
At plasma concentrations of up to 5 or 6 times the maximum therapeutic levels, there are unlikely to be any symptoms other than nausea, vomiting and dizziness. Symptoms of overdosage may include serious CNS depression and impairment of respiration. In cases of overdosage, long half-lives up to 30 hours have been reported. Signs of an acute massive overdose usually
include coma, with muscular hypotonia, hyporeflexia and miosis, impaired respiratory functions and metabolic acidosis, hypotension and circulatory collapse/shock. Symptoms may however
be variable and seizures have been reported in the presence of very high plasma levels. Cases of intracranial hypertension related to cerebral edema have been reported. Deaths have occurred following massive overdose. Hospital management of overdose including assisted ventilation and other supportive measures are recommended. The presence of sodium content in the valproate formulations may lead to hypernatremia when taken in overdose.
Establish airway and breathing and evaluate circulatory status. Assisted mechanical ventilation may be required in cases of respiratory depression. For ingested medicine, activated charcoal
may reduce the absorption of the medicine if given within one or two hours after ingestion. In patients who are not fully conscious or have impaired gag reflex, consideration should be given to administering activated charcoal via nasogastric tube, once the airway is protected. Hemodialysis and hemoperfusion have been used successfully. Intravenous naloxone has been used sometimes in association with activated charcoal given orally.
Full recovery usually occurs provided that adequate supportive treatment is given. Particular attention should be given to the maintenance of an adequate urinary output. Hepatic and pancreatic function should be monitored.
Valpros i-IV: Cases of accidental and suicidal overdosage have been reported. Fatalities are rare.
Signs and symptoms of overdosage include somnolence, heart block or deep coma. At plasma concentrations of up to 5 or 6 times the maximum therapeutic levels, there are unlikely to be any symptoms other than nausea, vomiting and dizziness. Signs of acute massive overdose (with plasma concentrations of 10 to 20 times the maximum therapeutic levels), usually include CNS depression or coma, with muscular hypotonia, hyporeflexia, miosis, impaired respiratory function, and metabolic acidosis. Symptoms may however be variable and seizures have been reported in the presence of very high plasma levels. There have also been cases of intracranial hypertension related to cerebral edema. Deaths have occurred after massive overdose.
Management of overdose should consist of general supportive therapy, particularly maintenance of adequate urinary output. Establish airway and breathing and evaluate circulatory status. Assisted mechanical ventilation may be required in cases of respiratory depression. Hemodialysis and hemoperfusion have been used successfully.
Provided that adequate supportive treatment is given, full recovery usually occurs. Particular attention should be given to the maintenance of an adequate urinary output. Hepatic and pancreatic function should be monitored.