From the Guidelines
The loading dose of Depakote (valproate) given intravenously (IV) is up to 30 mg/kg at a maximum rate of 10 mg/kg/min IV 1.
Key Considerations
- The dose is administered intravenously, and the maximum rate is crucial to prevent adverse effects.
- The specific details of the dose, such as the maximum rate, are essential for safe administration.
- The study from the Annals of Emergency Medicine 1 provides the most relevant information for this context.
Administration Details
- The maximum rate of administration is 10 mg/kg/min IV 1.
- The dose should be administered with caution, and the patient should be monitored for any adverse effects, such as transient local irritation at the injection site 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Valproate Sodium Injection is intended for intravenous use only. Epilepsy Complex Partial Seizures in Adults and Children 10 years of age or older: Initial dose is 10 to 15 mg/kg/day, increasing at 1 week intervals by 5 to 10 mg/kg/day to achieve optimal clinical response. Simple and Complex Absence Seizures: Initial dose is 10 to 15 mg/kg/day, increasing at 1 week intervals by 5 to 10 mg/kg/day to achieve optimal clinical response.
The loading dose of Depakote (valproate) given intravenously (IV) is not explicitly stated in the provided drug labels. The labels provide information on the initial dose and dosage adjustments, but do not specify a loading dose. 2 2
From the Research
Loading Dose of Depakote (Valproate) Given Intravenously (IV)
The loading dose of Depakote (valproate) given intravenously (IV) can vary depending on the patient population and the specific clinical scenario.
- In adults with epilepsy, the loading dose of IV valproate has been reported to be around 19.4-24.2 mg/kg 3, 4.
- In patients with chronic daily headache/transformed migraine, a loading dose of 15 mg/kg has been used 5.
- In neonates, the loading dose of IV valproate required to achieve a desired serum concentration is not well established, but a dose of 10-25 mg/kg has been reported to increase serum valproate concentrations to 41-100 microg/mL 6.
- In patients with status epilepticus, a loading dose of 25.2 mg/kg (range, 7-58 mg/kg) has been used, but a high loading dose (>30 mg/kg) was not associated with a greater response rate 7.
Key Findings
- The safety of rapid infusion of valproate to achieve high therapeutic levels has been established 3.
- IV valproate may be used to quickly and efficiently increase serum levels in patients with epilepsy 4.
- The volume of distribution and serum clearance of valproate in neonates have been reported to be approximately 0.245 L/kg and 25 mL/h/kg, respectively 6.
- A dosage of 25-30 mg/kg appears adequate in status epilepticus, and a high loading dose (>30 mg/kg) may not bring additional benefit 7.