List of adverse effects of valproic acid

List of adverse effects of valproic acid by frequency:^[1][2][3][4]

Very common (>10%)

• Nausea
• Vomiting
• Diarrhea
• Headache
• Low platelet count (dose-related)
• Tremor (dose-related)
• Hair loss (usually temporary)
• Drowsiness
• Dizziness
• Hyperandrogenism in females
• Seeing double
• Indigestion
• Lazy eye
• Infection
• Tinnitus

• Elevated aminotransferase concentrations (dose-related; indicative of liver injury)

Common (1-10%)

• Paresthesia
• Abdominal pain
• Tremor
• Increased appetite
• Weight gain
• Ataxia
• Polycystic ovaries
• Memory impairment
• Menstrual irregularities
• Rash
• Back pain
• Mood changes
• Anxiety
• Confusion
• Abnormal gait
• Hallucinations
• Catatonia
• Dysarthria
• Tardive dyskinesia
• Vertigo

• High blood levels of ammonia without symptoms

Uncommon (0.1-1%)

• Peripheral edema
• Syndrome of inappropriate secretion of antidiuretic hormone

Rare (<0.1% frequency)

• Liver failure
• Pancreatitis (these two usually occur in first 6 months and can be fatal)
• Leukopenia (low white blood cell count)
• Neutropenia (low neutrophil count)
• Pure red cell aplasia
• Agranulocytosis
• Extrapyramidal syndrome (including parkinsonism, may be reversible)
• Brain problems due to high ammonia levels
• Low body temperature
• Hypersensitivity reactions including multi-organ hypersensitivity syndrome
• Eosinophilic pleural effusion
• Bone fractures (reduced BMD with long-term use)

References

1. "Depakene, Stavzor (valproic acid) dosing, indications, interactions, adverse effects, and more". Medscape Reference. WebMD. Retrieved 13 February 2014.
2. Rossi, S, ed. (2013). Australian Medicines Handbook (2013 ed.). Adelaide: The Australian Medicines Handbook Unit Trust. ISBN 978-0-9805790-9-3.
3. Joint Formulary Committee. British National Formulary (BNF) (65 ed.). London, UK: Pharmaceutical Press. ISBN 978-0-85711-084-8.
4. "Valpro sodium valproate" (PDF). TGA eBusiness Services. Alphapharm Pty Limited. 16 December 2013. Retrieved 14 February 2014.