| Migraine Disorders

Depakote vs Inderal LA

Side-by-side clinical, coverage, and cost comparison for migraine disorders.

Deep comparison between: Depakote vs Inderal 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 signalsInderal has a higher rate of injection site reactions vs Depakote based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Inderal but not Depakote, including UnitedHealthcare

Category

Depakote

Inderal

At A Glance

RouteOral

FrequencyDaily in divided doses

ClassValproate anticonvulsant

RouteOral

FrequencyOnce daily

ClassNonselective beta-blocker

Indications

Bipolar Disorder
Complex partial seizures
Absence Epilepsy
Migraine Disorders

Hypertensive disease
Coronary Arteriosclerosis
Migraine Disorders
Idiopathic hypertrophic subaortic stenosis

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.

Hypertensive disease Initial 80 mg once daily; may increase to 120 mg or higher; usual maintenance 120-160 mg once daily; up to 640 mg may be required.

Coronary Arteriosclerosis Start 80 mg once daily; increase at 3-7 day intervals; average optimal dose 160 mg once daily; maximum established dose 320 mg once daily.

Migraine Disorders Initial 80 mg once daily; usual effective range 160-240 mg once daily; discontinue if no response within 4-6 weeks at maximal dose.

Idiopathic hypertrophic subaortic stenosis Usual dosage 80-160 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

Cardiogenic shock
Sinus bradycardia and greater than first-degree block
Bronchial asthma
Known hypersensitivity to propranolol hydrochloride

Drug Interactions

1212View drug interactions

1398View drug interactions

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

Cardiovascular Bradycardia, congestive heart failure, intensification of AV block, hypotension, paresthesia of hands, thrombocytopenic purpura, arterial insufficiency (Raynaud type)

Central Nervous System Light-headedness, mental depression, insomnia, lassitude, weakness, fatigue, catatonia, visual disturbances, hallucinations, vivid dreams, disorientation, short-term memory loss, emotional lability

Gastrointestinal Nausea, vomiting, epigastric distress, abdominal cramping, diarrhea, constipation, mesenteric arterial thrombosis, ischemic colitis

Allergic Hypersensitivity reactions including anaphylactic/anaphylactoid reactions, pharyngitis, agranulocytosis, erythematous rash, fever with aching and sore throat, laryngospasm, respiratory distress

Respiratory Bronchospasm

Hematologic Agranulocytosis, nonthrombocytopenic purpura, thrombocytopenic purpura

Autoimmune Systemic lupus erythematosus

Skin and Mucous Membranes Stevens-Johnson Syndrome, toxic epidermal necrolysis, dry eyes, exfoliative dermatitis, erythema multiforme, urticaria, alopecia, SLE-like reactions, psoriasisiform rashes

Genitourinary Male impotence, Peyronie's disease

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).

Propranolol is a nonselective beta-adrenergic receptor-blocking agent that competitively blocks beta-receptor-stimulating agents, reducing chronotropic, inotropic, and vasodilator responses to beta-adrenergic stimulation; at doses greater than required for beta blockade, it also exerts a quinidine-like membrane action affecting the cardiac action potential.

View Full FDA Information

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Most Common Insurance

Anthem BCBS

Depakote