| Complex partial seizures
Depakote vs Sabril
Side-by-side clinical, coverage, and cost comparison for complex partial seizures.Deep comparison between: Depakote vs Sabril 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 signalsSabril has a higher rate of injection site reactions vs Depakote based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Sabril but not Depakote, including UnitedHealthcare
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Category
Depakote
Sabril
At A Glance
Oral
Daily in divided doses
Valproate anticonvulsant
Oral
Twice daily
GABA-T inhibitor
Indications
- Bipolar Disorder
- Complex partial seizures
- Absence Epilepsy
- Migraine Disorders
- Complex partial seizures
- Infantile Spasm
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.
Complex partial seizures Adults: initiate at 1000 mg/day (500 mg twice daily) orally; recommended dose 3000 mg/day (1500 mg twice daily). Pediatric patients 2-16 years: weight-based dosing in two divided doses, starting 350-500 mg/day and maintenance 1050-2000 mg/day; patients >60 kg follow adult dosing.
Infantile Spasm Initiate at 50 mg/kg/day orally in two divided doses (25 mg/kg twice daily); titrate by 25-50 mg/kg/day every 3 days up to a maximum of 150 mg/kg/day (75 mg/kg twice 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
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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%) Headache, somnolence, fatigue, dizziness, convulsion, nasopharyngitis, weight gain, upper respiratory tract infection, visual field defect, depression, tremor, nystagmus, nausea, diarrhea, memory impairment, insomnia, irritability, abnormal coordination, blurred vision, diplopia, vomiting, influenza, pyrexia, rash
Serious Permanent vision loss, MRI abnormalities in infants, neurotoxicity, suicidal behavior and ideation, anemia, peripheral neuropathy, somnolence and fatigue, weight gain, edema
Postmarketing Congenital cardiac defects, deafness, developmental delay, gastrointestinal hemorrhage, cholestasis, dystonia, encephalopathy, acute psychosis, Stevens-Johnson syndrome, toxic epidermal necrolysis, angioedema, alopecia
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).
Vigabatrin is an irreversible inhibitor of gamma-aminobutyric acid transaminase (GABA-T), the enzyme responsible for the catabolism of the inhibitory neurotransmitter GABA, resulting in increased GABA levels in the central nervous system; the duration of effect is dependent on the rate of GABA-T enzyme re-synthesis rather than on the rate of drug elimination from the systemic circulation.
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)
Sabril
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (0/12) · Qty limit (11/12)
UnitedHealthcare
Depakote
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Sabril
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (8/8)
Humana
Depakote
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Sabril
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Depakote.
$10/momo
Sabril SHAREPlus Copay Assistance ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Next Steps for Your Patient
DepakoteView full Depakote profile
SabrilView full Sabril profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.