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Precautions and Warnings With Divalproex ER

There are many divalproex ER precautions and warnings to be aware of before starting the drug, including potential side effects or complications that may occur during treatment. Divalproex ER may cause pancreatitis, low platelets in the blood, or liver failure in some people. Among the people who should not take divalproex ER are those who have liver disease, those who are allergic to any components of the medicine, and those who have a urea cycle disorder.

Divalproex ER: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking divalproex ER (Depakote ER®) if you have:
  • Liver disease, such as liver failure or cirrhosis
  • A urea cycle disorder
  • Mental retardation
  • A blood disorder
  • Any allergies, including allergies to food, dyes, or preservatives.
Also let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Warnings and Precautions With Divalproex ER

Some warnings and precautions to be aware of prior to taking divalproex ER include:
  • There have been cases of liver failure caused by divalproex ER. Children under two years old are at particularly high risk, especially children with mental retardation, brain damage or disease, or certain other health problems. Divalproex ER is not approved for children under 10 years old and should rarely be used in young children, due to the risk of liver damage.
  • You should not take divalproex ER if you have liver disease. Also, you should not take divalproex ER if you have a urea cycle disorder (a problem with the enzymes that clear ammonia from the body, leading to high ammonia levels in the blood), as the drug may worsen this condition. You should be evaluated for a urea cycle disorder if you have a history of:


    • A brain disease or a problem associated with pregnancy
    • Unexplained brain disease or problems
    • Unexplained mental retardation
    • High ammonia levels in your blood
    • Vomiting and lethargy that come and go regularly.


  • Divalproex ER can cause pancreatitis (inflammation of the pancreas), which may be very dangerous. Let your healthcare provider know immediately if you have any signs of pancreatitis, including:


    • Severe abdominal pain (or stomach pain)
    • Nausea and vomiting
    • Loss of appetite.


  • Elderly people may be more sensitive to divalproex ER side effects, such as drowsiness. If you are elderly and take divalproex ER, your healthcare provider should monitor you more closely.
  • Divalproex ER can cause low platelets in the blood (thrombocytopenia). Tell your healthcare provider if you have any unusual bruises or bleeding.
  • As with all seizure medications, divalproex ER should not be stopped suddenly (see Depakote Withdrawal).
  • Let your healthcare provider know right away if you have a rash along with a fever or any other symptoms, as this may be a sign of a dangerous allergic reaction.


  • Divalproex ER can cause hypothermia (a body temperature below 95 degrees F), which can be dangerous. Let your healthcare provider know if you develop hypothermia.


  • Divalproex ER can potentially interact with certain other medications (see Drug Interactions With Divalproex ER).
  • Divalproex ER is considered a pregnancy Category D medication. This means that it is probably not safe for pregnant women. Talk with your healthcare provider about the risks and benefits of taking the drug during pregnancy (see Depakote and Pregnancy). Divalproex ER may increase the risk of birth defects and "cognitive impairment" problems (such as lower intelligence).
  • Divalproex ER passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to taking the drug (see Depakote and Breastfeeding).


  • Early evidence suggests that seizure medications, including divalproex ER, may increase the risk of suicidal thoughts or behaviors (see Seizure Medications and Suicide for more information).
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Divalproex Extended Release

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