Divalproex, Divalproex ER

Medically reviewed by Alex Brewer, PharmD, MBA on May 4, 2023
Written by Helen Marshall, BPharm, MRPharmS

This article describes divalproex’s uses and dosage, ways to save on cost, and more. Below you’ll find some coupon options for divalproex.

This article doesn’t provide coupons for all forms of divalproex. To find coupons for delayed-release (DR) oral tablets, see this article. For coupons for divalproex DR oral capsules, see this article.

Boxed warnings

Divalproex has boxed warnings about the risks of serious liver damage and pancreatitis (inflammation of the pancreas). It also has a boxed warning about the risk of harm to a fetus. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

For details, see the “Interactions and warnings for divalproex” section below.

Divalproex may cause mild or serious side effects. More common mild side effects of divalproex and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about divalproex’s side effects, see this article or ask your doctor or pharmacist. You can also read the prescribing information* for divalproex.

* To view divalproex’s prescribing information, see the “Article resources” section below.

Mild side effects

More common mild side effects reported with divalproex are listed below.

This article doesn’t include all possible mild side effects of the drug. To learn more about divalproex’s side effects based on the form, see the prescribing information* for divalproex.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Mild side effects of divalproex delayed-release (DR)‡ oral tablet, DR oral capsule, and extended-release‡ oral tablet include:

• nausea and vomiting
• sleepiness
• headache
• tremors (shaking)
• mild allergic reaction†

* To view divalproex’s prescribing information, see the “Article resources” section below.
† For details about this side effect, see the “Interactions and warnings for divalproex” section below.
‡ Delayed-release tablets and capsules release the medication all at once, but not until they’ve passed through your stomach. Extended-release tablets release the medication slowly over time instead of all at once.

Serious side effects

Serious side effects of divalproex are listed below. These side effects may differ based on the form of divalproex you take.

This article doesn’t include all possible serious side effects of the drug. To learn more about divalproex’s side effects based on the form, see the prescribing information* for divalproex.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, divalproex’s serious side effects include:

• low level of platelets (cells that help with blood clotting)
• high blood level of ammonia (a chemical made when the body breaks down protein)
• hypothermia (very low body temperature)
• suicidal thoughts or behaviors
• boxed warning: risk of serious liver damage†
• boxed warning: risk of pancreatitis†
• boxed warning: risk of harm to a fetus†
• severe allergic reaction†

* To view divalproex’s prescribing information, see the “Article resources” section below.
† For details about this side effect, see the “Interactions and warnings for divalproex” section below.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

• Ask the tough question: “Are you considering suicide?”
• Listen to the person without judgment.
• Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
• Stay with the person until professional help arrives.
• Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Click here for more links and local resources.

The Food and Drug Administration (FDA) approves prescription drugs such as divalproex for certain conditions. Approved uses for divalproex are described below. These uses differ based on the form of divalproex prescribed.

Use for bipolar disorder

Doctors may prescribe divalproex delayed-release (DR) tablets* for treating manic episodes related to bipolar disorder. They may prescribe divalproex extended-release (ER) tablets* for treating manic or mixed episodes related to bipolar disorder. Divalproex is used for these purposes in adults. It’s usually prescribed for short-term use, but it may be prescribed long term as well.

With bipolar disorder, you have episodes of mania (high mood) and possibly episodes of depression. Some people also have mixed episodes, with symptoms of mania and depression.

With a manic episode, you may feel very excited, self-confident, and restless. You may have racing thoughts, talk very fast, have poor judgement, and take unusual risks. With a mixed episode you may have these symptoms, as well as feeling extremely sad, gloomy, hopeless, or suicidal. Divalproex reduces the symptoms of manic and mixed episodes. It helps return your mood, thoughts, and behavior to usual.

Doctors may not prescribe divalproex for bipolar disorder in certain situations, such as during pregnancy, or if you could become pregnant.† In these situations, they’ll likely only prescribe divalproex if other medications aren’t suitable or haven’t worked for your condition.

Use for migraine

Doctors may prescribe divalproex delayed-release (DR) tablets* and extended-release (ER) tablets* to help prevent migraine episodes. Divalproex is used for this purpose in adults. It’s usually prescribed for long-term use.

With a migraine episode, you have a severe, throbbing headache. You may also have nausea, vomiting, and increased sensitivity to light and sound. Some people also have an aura before the headache. This may involve changes to your vision, trouble speaking, or changes in sensation such as tingling. A migraine episode can significantly interfere with your ability to do your usual activities.

Divalproex helps reduce the number of migraine episodes you have.

Doctors may not prescribe divalproex for migraine in certain situations, such as during pregnancy.† If you could become pregnant, your doctor will likely only prescribe divalproex if you’re using effective birth control.

Use for seizures

Doctors may prescribe divalproex delayed-release (DR) tablets*, DR capsules, and extended-release (ER) tablets* to help prevent certain types of seizures. It’s used for this purpose in adults and children ages 10 years and older with epilepsy. It’s usually prescribed for long-term use.

Divalproex is used for focal onset seizure (also known as complex partial seizures). This type of seizure affects one part of your brain. You may have different symptoms, depending on the part of your brain that’s affected. For example, you may have involuntary movements in one part of your body. Or you may have trouble moving, changes in your vision or hearing, or unusual sensations or feelings. During the seizure, you may not be aware of your symptoms or your surroundings.

Divalproex is also used for simple and complex absence seizures. Absence seizures last only a few seconds and can seem like daydreaming. With simple absence seizures, you may stare blankly and have flickering eyelids. With complex absence seizures, you may also have involuntary mouth or hand movements. During the seizure, you may not be aware of your symptoms or your surroundings.

Divalproex helps reduce the number of seizures you have. It may be prescribed alone or together with other antiepileptics for seizure. This depends on the type of seizure the drug is used to treat.

Doctors may not prescribe divalproex for seizures in certain situations, such as during pregnancy, or if you could become pregnant.† In these situations, they’ll likely only prescribe divalproex if other medications aren’t suitable or haven’t worked for your condition.

* Delayed-release tablets and capsules release the medication all at once, but not until they’ve passed through your stomach. Extended-release tablets release the medication slowly over time instead of all at once.
† Divalproex has a boxed warning about the risk of harm to a fetus. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA). For details, see the “Interactions and warnings for divalproex” section below.

Below you’ll find answers to a few commonly asked questions about divalproex.

How does divalproex compare with valproic acid?

Divalproex and valproic acid are very similar medications. In fact, when they’re inside your body, they’re both changed into the same active drug, valproate. They can both cause the same side effects.

The Food and Drug Administration has approved both medications for epilepsy. Unlike valproic acid, divalproex is also approved for bipolar disorder and migraine. (For details, see the “Uses of divalproex” section above.)

To learn more about how divalproex compares with valproic acid or other similar medications, talk with your doctor. They can recommend the best option for you.

Is divalproex a ‘narcotic’?

No, divalproex is not a narcotic. Instead, it’s a type of drug called an anticonvulsant.

Narcotic is a term used for opioid drugs, such as morphine, oxycodone, and fentanyl. These drugs are powerful pain relievers, but they have a high risk of misuse and addiction. Misuse means a drug is taken in a way other than how it’s prescribed. With addiction, you continue taking a substance even if it’s causing harm.

Due to these risks, opioid drugs are classified as controlled substances. This means their use is regulated by the federal government. Divalproex doesn’t act in the same way as opioids. It doesn’t have a risk of misuse or addiction, and it’s not a controlled substance.

If you have questions about what type of drug divalproex is, talk with your doctor or pharmacist.

Can divalproex be used for depression, dementia, or schizophrenia?

The Food and Drug Administration (FDA) hasn’t approved divalproex for depression, dementia, or schizophrenia. But doctors might sometimes prescribe it off-label for people with these conditions. With off-label use, a drug is prescribed for a use that’s not approved by the FDA.

Divalproex is prescribed for epilepsy, bipolar disorder, and migraine. For details about divalproex’s approved uses, see the “Uses of divalproex” section above.

To find out more about off-label uses for divalproex, talk with your doctor.

Are side effects of the extended-release (ER) form of divalproex different than those seen with the delayed-release (DR) forms of the drug?

No, it’s unlikely. Similar side effects have been reported* with all forms of divalproex.

Divalproex comes as a delayed-release (DR) oral tablet, DR oral capsule, and extended-release (ER) oral tablet. DR forms release the medication all at once, but not until they’ve passed through your stomach. ER forms release the medication slowly over time instead of all at once.

To learn about the side effects of these forms of divalproex, see the “Side effects of divalproex” section above. You can also talk with your doctor or pharmacist.

* For more information, see the prescribing information of divalproex in the “Article resources” section below.

Is withdrawal possible with divalproex?

Stopping divalproex doesn’t cause withdrawal symptoms. (Withdrawal symptoms are side effects that occur if you suddenly stop taking a drug that your body depends on.) However, suddenly stopping divalproex could worsen your condition. If you have epilepsy, suddenly stopping divalproex could cause seizures that don’t stop.

You should not suddenly stop taking divalproex without first talking with your doctor. If you’d like to stop taking the drug, your doctor will advise how to do so safely. They may also recommend switching to a different medication for your condition.

How does divalproex work? And how long does it take to start working?

Doctors don’t fully understand how divalproex works for epilepsy, bipolar disorder, and migraine. With all these conditions, there’s increased activity in the nerve cells in certain parts of your brain.

Divalproex increases the level of a chemical called gamma-aminobutyric acid (GABA) in your brain. GABA is a chemical that calms activity in your nerve cells. By increasing levels of GABA in your brain, divalproex reduces the excessive nerve activity that causes manic symptoms, seizures, and migraines. This helps prevent seizures and migraines. For treating bipolar disorder, divalproex may work by helping GABA work more efficiently in your brain.

Divalproex usually starts working within 1 to 2 weeks, but it may take longer to work in some people.

Talk with your doctor if you have questions about how divalproex works or what to expect while taking divalproex.

The dosage of divalproex your doctor prescribes may vary based on your condition and certain other factors. Talk with your doctor about the dosage you should take.

Taking divalproex

Divalproex delayed-release (DR)* oral tablet, extended-release (ER)* oral tablet, and DR oral capsule are taken by mouth. They can be taken with or without food.

Divalproex DR and ER tablets should be swallowed whole. Do not crush, split, or chew the tablets.

Divalproex DR capsules should be swallowed whole. Alternatively, you can open the capsule and take the contents on a spoonful of soft food such as applesauce, without chewing.

Your doctor will talk with you about how to take divalproex. They’ll explain how much to take and how often. Always follow your doctor’s recommendation.

*Delayed-release tablets and capsules release the medication all at once, but not until they’ve passed through your stomach. Extended-release tablets release the medication slowly over time instead of all at once.

Overdose of divalproex

You should not take more divalproex than your doctor prescribes. For some drugs, doing so may lead to serious side effects or overdose.

If you think you’ve taken too much divalproex, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Below, you’ll find information about divalproex’s possible interactions and warnings.

Interactions of divalproex

For some medications, certain things may affect how the drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take divalproex, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription medications
• over-the-counter medications
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for divalproex” section below.

Warnings for divalproex

Divalproex should not be taken by certain people and should be taken cautiously by certain other people.

Boxed warnings

Divalproex has boxed warnings about the risk of serious liver damage and pancreatitis. It also has a risk of harm to a fetus. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

To learn more about these warnings, read below. You can also talk with your doctor or pharmacist.

Risk of serious liver damage. Divalproex may cause serious liver damage, especially in the first 6 months of taking the drug. Rarely, liver damage may lead to death.

Symptoms may include feeling weak or unwell, nausea, vomiting, loss of appetite, and facial swelling. You may also have abdominal pain, pale stools, dark-colored urine, and yellowing of your skin or whites of your eyes.

If you experience symptoms of liver damage, tell your doctor. They’ll likely recommend you stop taking divalproex and switch to a different medication for your condition.

Risk of pancreatitis. Divalproex may cause pancreatitis (inflammation of your pancreas) that could lead to death. This side effect was reported rarely in studies* of divalproex.

Symptoms may include abdominal pain, nausea, vomiting, and loss of appetite.

If you experience symptoms of pancreatitis, tell your doctor right away or seek urgent medical care. They’ll likely recommend you stop taking divalproex and switch to a different medication for your condition.

Risk of harm to a fetus. For more information about this risk, see the “Pregnancy or breastfeeding and divalproex” section below.

Other warnings

Divalproex could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether divalproex is a safe option for you. These warnings may differ based on the form of divalproex you take.

Ask your doctor about specific warnings for divalproex, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

* For more information, see the prescribing information of divalproex in the “Article resources” section below.

Allergic reaction

Divalproex can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to divalproex or any of its ingredients, your doctor will likely not prescribe divalproex. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

In addition to the reactions above, an allergic reaction called drug rash with eosinophilia and systemic symptoms (DRESS) can rarely occur with divalproex. DRESS is a potentially life threatening emergency requiring immediate medical attention. DRESS symptoms may occur weeks after you begin taking divalproex. Symptoms include:

• fever
• swelling in your lymph nodes
• skin rash that “erupts”
• inflammation (swelling) affecting an internal organ in your body, such as your liver or kidneys

If you have an allergic reaction to divalproex, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Pregnancy or breastfeeding and divalproex

Information about divalproex and pregnancy and breastfeeding is described below.

Divalproex and pregnancy

There are risks to taking divalproex during pregnancy. But there are also risks with having untreated epilepsy or bipolar disorder while pregnant.

If you’re pregnant or planning a pregnancy, talk with your doctor about medication options for epilepsy or bipolar disorder during pregnancy. Together, you can discuss the risks and benefits of your medication options and decide whether you should take divalproex during pregnancy.

Note: Divalproex should not be taken to prevent migraine during pregnancy.

Risk of harm to a fetus

Divalproex has a boxed warning about the risk of harm to a fetus if taken during pregnancy. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

If you take divalproex during pregnancy, it may harm the fetus. Divalproex may cause problems with fetal development (commonly known as birth defects). These include abnormalities of the skull, face, heart, or limbs, and other problems such as spina bifida. It may also increase the risk of developmental disorders in your child. These include autism spectrum disorder and lower than usual intelligence quotient (IQ).

If you could become pregnant, your doctor will likely recommend birth control options to use while you’re taking divalproex.

If you become pregnant while taking divalproex, tell your doctor right away. They can discuss the risks and benefits of continuing divalproex for your condition. They may recommend stopping divalproex and switching to a different medication for your condition.

To learn more, talk with your doctor or pharmacist.

Divalproex and breastfeeding

It’s not known whether divalproex should be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication.

You may be able to save money on your prescription for divalproex by using our Perks discount coupons. They can be found at the end of this article.

If you have questions about how to pay for divalproex, talk with your doctor or pharmacist.

Note: Optum Perks coupons cannot be used with insurance copays or benefits.

This article describes divalproex’s uses and dosage, ways to save on cost, and more. Let your doctor know if you have questions about divalproex or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• Will I need to take other medications with divalproex?
• How does divalproex compare with other medications for my condition?
• If I have side effects with divalproex, how will they be managed?

• Divalproex sodium delayed-release capsules, for oral use. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/388fd4bc-f12f-4e55-a1e7-72aa585519fa/spl-doc
• Divalproex sodium er tablet, extended release. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/f86f185b-4acb-43b5-e053-6394a90a681c/spl-doc
• Divalproex sodium tablet, delayed release. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/02304a23-4a5f-47bc-9687-4044b43f7a20/spl-doc
• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• Taylor MJ, et al. (2006). Long-term prophylaxis in bipolar disorder. https://pubmed.ncbi.nlm.nih.gov/16599648/

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.