Divalproex and topiramate

What does the divalproex label say about topiramate?

Divalproex label, drug interactions

Monitoring of valproate concentrations is recommended ( 7.1 ) Co-administration of valproate can affect the pharmacokinetics of other drugs (e.g., diazepam, ethosuximide, lamotrigine, phenytoin) by inhibiting their metabolism or protein binding displacement ( 7.2 ) Patients stabilized on rufinamide should begin valproate therapy at a low dose, and titrate to clinically effective dose ( 7.2 ) Dosage adjustment of amitriptyline/nortriptyline, propofol, warfarin, and zidovudine may be necessary if used concomitantly with Depakote ( 7.2 ) Topiramate:

Divalproex label, warnings and precautions

Measure ammonia level if unexplained lethargy and vomiting or changes in mental status, and also with concomitant topiramate use; consider discontinuation of valproate therapy ( 5.6 , 5.9 , 5.10 ) Hypothermia:

Depakote Sprinkles label (AbbVie Inc., March 31, 2026), warnings and precautions

Antiepileptic drugs, including Depakote Sprinkle Capsules, increase the risk of suicidal thoughts or behavior ( 5.7 ) Bleeding and other hematopoietic disorders: monitor platelet counts and coagulation tests ( 5.8 ) Hyperammonemia and hyperammonemic encephalopathy: measure ammonia level if unexplained lethargy and vomiting or changes in mental status, and also with concomitant topiramate use; consider discontinuation of valproate therapy ( 5.6 , 5.9 , 5.10 ) Hypothermia:

Source: FDA drug label (Depakote Sprinkles, NDA019680), AbbVie Inc., effective March 31, 2026 (SPL set 4619aff4-0f80-444f-858d-42e4137aa809), via openFDA

What does the topiramate label say about divalproex?

Topiramate label, drug interactions

Concomitant administration of valproic acid and topiramate has been associated with hypothermia and hyperammonemia with and without encephalopathy.

Topiramate label, warnings and precautions

Discontinue topiramate if an alternative etiology cannot be established (5.11, 5.12, 5.13) Hyperammonemia/encephalopathy: measure ammonia if encephalopathic symptoms occur (5.14) Kidney stones: avoid use with other carbonic anhydrase inhibitors, drugs causing metabolic acidosis, or in patients on a ketogenic diet (5.15) Hypothermia has been reported with and without hyperammonemia during topiramate treatment with concomitant valproic acid use

Qudexy Xr label (Upsher-Smith Laboratories, LLC, September 3, 2026), warnings and precautions

Discontinue QUDEXY XR if an alternative etiology cannot be established. ( 5.12, 5.13 , 5.14 ) Hyperammonemia/encephalopathy: measure ammonia if encephalopathic symptoms occur ( 5.15 ) Kidney stones: avoid use with other carbonic anhydrase inhibitors, drugs causing metabolic acidosis, or in patients on a ketogenic diet ( 5.16 ) Hypothermia has been reported with and without hyperammonemia during topiramate treatment with concomitant valproic acid use

Eprontia label (Azurity Pharmaceuticals, Inc., November 13, 2025), warnings and precautions

Encephalopathy (Without and With Concomitant Valproic Acid Use) EPRONTIA treatment can cause hyperammonemia with or without encephalopathy [see Adverse Reactions ( 6.2 )].

Source: FDA drug label (Qudexy Xr, NDA205122), Upsher-Smith Laboratories, LLC, effective September 3, 2026 (SPL set 46f54677-3a22-4c38-9b92-923020164e15), via openFDA

Source: FDA drug label (Eprontia, NDA214679), Azurity Pharmaceuticals, Inc., effective November 13, 2025 (SPL set e2a4df59-fead-4a01-9021-9eda02c48010), via openFDA

Both medicines on the record

What next?

Divalproex: the full record

Topiramate: the full record

Check more medicines together

up to five at once