| Migraine Disorders

Depakote vs Zavzpret

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

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

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

Category

Depakote

Zavzpret

At A Glance

RouteOral

FrequencyDaily in divided doses

ClassValproate anticonvulsant

RouteIntranasal

FrequencyAs needed

ClassCGRP receptor antagonist

Indications

Bipolar Disorder
Complex partial seizures
Absence Epilepsy
Migraine Disorders

Migraine Disorders

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.

Migraine Disorders 10 mg as a single spray in one nostril as needed; maximum 10 mg (one spray) per 24-hour period; safety of treating more than 8 migraines in a 30-day period has not been established.

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

History of hypersensitivity reaction to zavegepant or any component of ZAVZPRET, including anaphylaxis

Drug Interactions

1212View drug interactions

57View 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

Most common (>=2%) Taste disorders (dysgeusia, ageusia), nausea, nasal discomfort, vomiting

Serious Hypersensitivity including facial swelling and urticaria (less than 1%)

Postmarketing Hypersensitivity (anaphylaxis), hypertension, Raynaud's phenomenon

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).

Zavegepant is a calcitonin gene-related peptide (CGRP) receptor antagonist; it blocks CGRP receptor signaling implicated in migraine pathophysiology.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Depakote