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Extreme care needed with sodium valproate and pregnancy and women of childbearing potential

Sodium valproate should not be used:

  • In girls or women of childbearing potential unless other treatments are ineffective or not tolerated.1
  • During pregnancy for the treatment of epilepsy unless there is no suitable alternative treatment.1
  • During pregnancy for the treatment of bipolar disorder.1

As comparison, the risk of congenital malformations was highest with sodium valproate, with approximately 10–11% of pregnancies affected, followed by phenobarbital, phenytoin and carbamazepine.2 There are no antiepileptic medicines risk-free when used during pregnancy.2

If pregnancy occurs, input from O&G, neurology and psychiatry is advised. A useful handout for clinicians is available.3

To prevent pregnancy two forms of effective contraception should be used by women who are taking an antiepileptic medicine; N.B. some hormonal contraceptives interact with enzyme-inducing antiepileptic medicines.2

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