| Bipolar Disorder
Depakote vs Depakote ER
Side-by-side clinical, coverage, and cost comparison for bipolar disorder.Deep comparison between: Depakote vs Depakote with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsDepakote has a higher rate of injection site reactions vs Depakote based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Depakote but not Depakote, including UnitedHealthcare
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Category
Depakote
Depakote
At A Glance
Oral
Daily in divided doses
Valproate anticonvulsant
Oral
Once daily
Valproate anticonvulsant
Indications
- Bipolar Disorder
- Complex partial seizures
- Absence Epilepsy
- Migraine Disorders
- Bipolar Disorder
- Epilepsy
- Absence Seizures
Dosing
Bipolar Disorder 750 mg/day initially in divided doses, titrated rapidly to clinical response; max 60 mg/kg/day; oral.
Complex partial seizures 10-15 mg/kg/day initially, increased by 5-10 mg/kg/week to optimal response; max 60 mg/kg/day; divide doses if total daily dose exceeds 250 mg; oral.
Absence Epilepsy 15 mg/kg/day initially, increased at one-week intervals by 5-10 mg/kg/day until seizures are controlled; max 60 mg/kg/day; divide doses if total daily dose exceeds 250 mg; oral.
Migraine Disorders 250 mg twice daily; some patients may benefit from doses up to 1,000 mg/day; oral.
Bipolar Disorder Initial dose 25 mg/kg/day once daily, titrated to clinical response (trough 85-125 mcg/mL); maximum 60 mg/kg/day.
Epilepsy Initial dose 10-15 mg/kg/day once daily, increased by 5-10 mg/kg/week to optimal response; maximum 60 mg/kg/day.
Absence Seizures Initial dose 15 mg/kg/day, increased weekly by 5-10 mg/kg/day until seizures are controlled; maximum 60 mg/kg/day.
Migraine prophylaxis 500 mg once daily for 1 week, then 1,000 mg once daily.
Contraindications
- Hepatic disease or significant hepatic dysfunction
- Mitochondrial disorders caused by mutations in mitochondrial DNA polymerase gamma (POLG; e.g., Alpers-Huttenlocher Syndrome) and children under two years of age suspected of having a POLG-related disorder
- Known hypersensitivity to divalproex sodium, sodium valproate, or valproic acid
- Known urea cycle disorders
- Migraine prophylaxis in pregnant women or in women of childbearing potential not using effective contraception
- Hepatic disease or significant hepatic dysfunction
- Known mitochondrial disorders caused by POLG mutations (e.g., Alpers-Huttenlocher Syndrome) and children under two years of age suspected of having a POLG-related disorder
- Known hypersensitivity to divalproex sodium, sodium valproate, or valproic acid
- Known urea cycle disorders
- Pregnancy or women of childbearing potential not using effective contraception (migraine prophylaxis indication only)
Adverse Reactions
Most common (>=5%) Nausea, vomiting, somnolence, dizziness, tremor, asthenia, alopecia, headache, abdominal pain, dyspepsia, diarrhea, weight gain
Serious Hepatic failure, birth defects, pancreatitis, hyperammonemic encephalopathy, suicidal behavior and ideation, bleeding and hematopoietic disorders, hypothermia, DRESS/multiorgan hypersensitivity, serious dermatologic reactions, angioedema
Postmarketing Toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme, parkinsonism, aplastic anemia, pancytopenia, fractures, decreased bone mineral density, polycystic ovary disease, male infertility, angioedema
Most common (>=5%) Somnolence, nausea, vomiting, diarrhea, dizziness, tremor, asthenia, dyspepsia, abdominal pain, alopecia, thrombocytopenia
Serious Hepatic failure, pancreatitis, hyperammonemic encephalopathy, suicidal behavior and ideation, thrombocytopenia, birth defects and neurodevelopmental disorders (in utero exposure), hypothermia, DRESS/multiorgan hypersensitivity, serious dermatologic reactions, angioedema
Postmarketing Toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme, aplastic anemia, agranulocytosis, pancytopenia, decreased bone mineral density, osteoporosis, acute cognitive decline, encephalopathy, polycystic ovary disease, Fanconi syndrome
Pharmacology
Divalproex sodium dissociates to the valproate ion in the gastrointestinal tract; its therapeutic mechanisms have not been fully established, but its anticonvulsant activity is thought to relate to increased brain concentrations of gamma-aminobutyric acid (GABA).
Divalproex sodium dissociates to the valproate ion in the gastrointestinal tract; its antiepileptic activity is thought to be related to increased brain concentrations of gamma-aminobutyric acid (GABA), though the precise mechanism of therapeutic action has not been established.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Depakote
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (9/12)
Depakote
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Depakote
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Depakote
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Depakote
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Depakote
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Depakote.
No savings programs available for Depakote.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.