Valproic Acid is given orally. The recommended starting dose is 15 mg/kg body weight/day, increased at 1 week intervals of 5-10 mg/kg body weight/day until seizures can be controlled or side effects do not become more severe. The maximum recommended dose is 60 mg/kg body weight/day. If the total daily dose exceeds 250 mg, Valproic Acid must be given in several divided doses.
The following table is a guide for starting Valproic Acid daily (15 mg/kg/day) (see table).
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The frequency of side effects could depend on the dose (especially the increase in liver enzymes). Improved seizure control with the use of higher doses must be considered the possibility of greater side effects.
There is no correlation data available between daily dose, serum concentration, and therapeutic effect. However, the serum concentration of therapy in most patients ranges from 50-100 mcg/ml. Sometimes patients can be controlled with serum concentrations lower or higher than that range. If blood levels of Valproic Acid increase, the concentration of Phenobarbital and/or Phenytoin in the blood can be affected. Patients who experience gastrointestinal irritation can be given Valproic acid along with food or by titration of the dose starting from the lowest dose.