Dosing and titration of Depakote ER
Most doctors start patients on 5 to 12.5 mg/kg (250-750 mg) of Depakote ER per day, in one dose. The dosage then can be increased each week by 5 to 10 mg/kg until seizures stop or the patient experiences too many side effects. Most patients take a total of 750 to 3,000 mg each day. Taking more than 4,000 mg per day is seldom recommended.
Patients who have been taking regular Depakote or Depakene will need to take 8% to 20% more Depakote ER to achieve the same effect. A conversion table appears in the package insert for Depakote ER.
Children may require higher doses and seniors usually need less.
A therapeutic blood level of valproate is generally considered to be 50-100 mcg/mL (lower for seniors), but adjustments should depend on clinical response.
