The therapeutic range for valproic acid is 50-100 mcg/mL. The toxic level is >100 mcg/mL.
What is the normal range for Depakote?
Dosage formulations for acute bipolar mania
| DEPAKOTE Delayed-Release Tablets | DEPAKOTE ER Tablets | |
|---|---|---|
| MAXIMUM RECOMMENDED DOSE | 60 mg/kg/day | |
| THERAPEUTIC BLOOD RANGE | Clinical response was dosed at trough plasma concentrations between 50-125 μg/mL | 85 to 125 μg/mL |
What is a safe Depakote level?
Ordinarily, optimal clinical response is achieved at daily doses below 60 mg/kg/day. If satisfactory clinical response has not been achieved, plasma levels should be measured to determine whether or not they are in the usually accepted therapeutic range (50 to 100 mcg/mL).
Is 2000 mg of Depakote a lot?
The mean daily dose usually ranges between 1000 – 2000 mg valproate. Patients receiving daily doses higher than 45 mg/kg/day body weight should be carefully monitored. Continuation of treatment of manic episodes in bipolar disorder should be adapted individually using the lowest effective dose.
What happens when Depakote levels are too high?
Symptoms of overdosage of Depakote include changes in consciousness, fainting, and slow or irregular heartbeat. Contact your doctor urgently if you experience stomach pain that spreads to your back, nausea and vomiting, dark urine, facial swelling, loss of appetite, or yellowing of the skin or eyes.
What happens if your Depakote level is too low?
Some people will experience seizures, mood swings, or migraines at the low end of the therapeutic range while some people will experience excessive side effects at the upper end.
When do you draw Depakote levels?
It is recommended that trough levels for the DR version be drawn immediately prior to the morning dose, assuming a twice-daily dosing strategy. For once-daily divalproex ER regimens, the ideal time to draw serum levels is immediately prior to the next scheduled dose.
What is the therapeutic range for carbamazepine?
Carbamazepine (Tegretol) is an iminostilbene that has been used as a first-line medication for both generalized and partial complex seizure disorders. The therapeutic reference range of carbamazepine is 4-12 mg/L. The minimum toxic level is 10 mg/kg.
What is a normal phenytoin level?
The therapeutic ranges for most adults have been established at 10.0-20.0 mcg/mL for total phenytoin (bound plus unbound) and 1.0-2.0 mcg/mL for free phenytoin (unbound only). This reference range for unbound phenytoin (free) was established based on an assumed 10% unbound drug fraction.
When do you draw clozapine levels?
Clozapine reaches a steady-state concentration at 5-7 days. Levels should be drawn 12 hours (± 2 h) after the last dose. Clozapine blood levels are correlated with both clozapine effectiveness and side effects.
Is 500mg of Depakote a lot?
Depakote ER is indicated for prophylaxis of migraine headaches in adults. The recommended starting dose is 500 mg once daily for 1 week, thereafter increasing to 1000 mg once daily.
How long does it take Depakote to reach therapeutic levels?
Peak levels of valproate in the blood are reached in 7 to 14 hours. At equal doses, the bioavailability of Depakote ER is about 89% that of regular Depakote. To achieve equivalent bioavailability, the once-daily dose of Depakote ER needs to be 8% to 20% higher than the total multiple daily doses of Depakote.
How long does it take for Depakote ER to kick in?
The highest level of medicine in the blood is reached in 7 to 14 hours after Depakote ER is taken. The highest levels are not as high as with regular Depakote, and the lowest levels are not as low. This difference may reduce side effects at the highest levels and improve seizure control when the levels are lowest.
Do you need to fast for a Depakote level?
No Fasting Required. No other special preparations required.
What color tube does a Depakote level go in?
Specimen Requirements
Red-top tube or green-top (heparin) tube. Do not use a gel-barrier tube. The use of gel-barrier tubes is not recommended due to slow absorption of the drug by the gel. Depending on the specimen volume and storage time, the decrease in drug level due to absorption may be clinically significant.
What are signs of Depakote toxicity?
CNS findings in cases of VPA overdose may include the following:
- Coma.
- Confusion.
- Somnolence.
- Worsened seizure control.
- Dizziness.
- Hallucinations.
- Irritability.
- Headache.
When should phenytoin levels be checked?
Administration of phenytoin and interpretation of serum phenytoin levels vary depending on the clinical scenario. Loading doses to achieve rapid therapeutic levels should be checked 1 hour after an intravenous loading dose and 24 hours after an oral loading dose.
What can increase carbamazepine levels?
The metabolism of carbamazepine can be increased by drugs such as phenobarbital, primidone, and phenytoin, decreasing carbamazepine concentrations in the blood.
What type of seizure is status epilepticus?
A seizure that lasts longer than 5 minutes, or having more than 1 seizure within a 5 minutes period, without returning to a normal level of consciousness between episodes is called status epilepticus. This is a medical emergency that may lead to permanent brain damage or death.
Is a higher or lower therapeutic index better?
The larger the therapeutic index (TI), the safer the drug is. If the TI is small (the difference between the two concentrations is very small), the drug must be dosed carefully and the person receiving the drug should be monitored closely for any signs of drug toxicity.
What is a high Dilantin level?
Signs and symptoms of phenytoin toxicity typically correspond to the serum level, and progress from occasional mild nystagmus at 10-20 mcg/mL (the therapeutic range) to coma and seizures at levels above 50 mcg/mL (see Presentation and Workup).
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