Dicorate ER 500 (Divalproex Sodium) 500 mg, 100 tablets: profile, composition and research

Reference page for Dicorate ER 500 (Divalproex Sodium) 500 mg, 100 tablets. Active substance: Дивалпроекс натрия / Divalproex sodium.

Key facts

What divalproex sodium is

Dicorate ER 500 is an extended-release tablet of divalproex sodium. In the body this compound splits into sodium valproate and valproic acid, so by its action it belongs to the valproate group. Each tablet contains 500 mg, and a pack holds 100 tablets.

Valproates have been known since the 1960s: their anticonvulsant properties were found by chance while the substance was used as a solvent for other medicines. Since then they have remained among the basic drugs in neurology and psychiatry.

The prolonged-release form is designed so that the blood level of the substance changes more smoothly than with ordinary tablets. The coating and the structure of the tablet are meant to release the active substance gradually.

How valproate works

Effect on GABA

Valproate raises the level of gamma-aminobutyric acid, the main inhibitory messenger of the nervous system. This is linked to its action on the enzymes that build this acid and slow its breakdown.

Ion channels

The medicine acts on voltage-gated sodium channels, limiting repeated discharges of neurons. This reduces how far pathological excitation spreads in the cerebral cortex.

Seizure threshold

The combination of the inhibitory and channel effects raises the threshold at which neurons begin to fire in a seizure. This is what the preventive action in epilepsy and migraine is linked to.

Mood stabilisation

In bipolar disorder the medicine is regarded as a mood stabiliser: it smooths the shifts between manic and depressive phases, although the exact mechanism is not fully explained.

Approved uses

The prescribing information lists three main directions. In epilepsy the medicine is used in generalised seizures and absence seizures, on its own or together with other anticonvulsants.

In bipolar disorder it is used to treat acute manic and mixed episodes. The third direction is prevention of migraine attacks in adults.

This is a prescription medicine. The dose is chosen by a doctor individually; during treatment liver function, blood counts and the clinical state are monitored. Extended-release tablets are swallowed whole, not crushed or chewed.

What the research shows

The large British SANAD study compared valproate with lamotrigine and topiramate in generalised epilepsy and noted an advantage of valproate in how often seizures were controlled.

In psychiatry, systematic reviews and network meta-analyses of acute mania treatment have been pooled, in which valproate is among the drugs studied alongside lithium and antipsychotics.

Data on migraine prevention are collected in a network meta-analysis in which valproate was compared with other medicines. Separately, the risks to the unborn child from valproate exposure in pregnancy are documented and reflected in clinical guidelines.

Published research

Primary sources, verified against PubMed:

• The SANAD study of effectiveness of valproate, lamotrigine, or topiramate for generalised and unclassifiable epilepsy: an unblinded randomised controlled trial., PubMed 17382828 (Lancet (London, England), 2007).
• The efficacy of valproate in acute mania, bipolar depression and maintenance therapy for bipolar disorder: an overview of systematic reviews with meta-analyses., PubMed 39500601 (BMJ open, 2024).
• The comparative effectiveness of migraine preventive drugs: a systematic review and network meta-analysis., PubMed 37208596 (The journal of headache and pain, 2023).
• Teratogenesis, Perinatal, and Neurodevelopmental Outcomes After In Utero Exposure to Antiseizure Medication: Practice Guideline From the AAN, AES, and SMFM., PubMed 38748979 (Neurology, 2024).

Listed for reference. Publication of a study is not a claim about this particular product.

Precautions

• This is a prescription medicine. Prescribing, dose changes and withdrawal belong to a physician.
• Valproate medicines carry a risk to the unborn child: neural tube defects and developmental disorders are possible. Pregnancy and family planning should be discussed with a doctor in advance.
• During treatment regular monitoring of liver function, blood counts and ammonia level is required.
• Treatment must not be stopped abruptly: sudden withdrawal can provoke a seizure.
• Extended-release tablets are swallowed whole, not crushed, chewed or split.
• Tell your doctor about every medicine you take: interactions with anticoagulants, aspirin and other anticonvulsants are possible.
• With unusual weakness, repeated vomiting, yellowing of the skin or eyes, dark urine or increasing drowsiness a doctor should be contacted urgently.

Frequently asked