Epival is a prescription anti-epileptic medicine whose main salt is sodium valproate or valproic acid. It’s manufactured primarily by Sun Pharma Laboratories Ltd and comes as tablets, CR/ER prolonged-release tablets, and oral syrup/solution.
What Is Epival Used For?
Primary indications
- Epilepsy / Seizure disorders: Used alone or with other anti-epileptics to treat various forms of epilepsy characterized by abnormal brain activity, uncontrolled jerking, fits, and loss of consciousness.
- Manic episodes in bipolar disorder: Helps prevent extreme mood swings by stabilizing abnormal brain signals.
- Migraine prophylaxis: Off-label/secondary use to prevent migraine headaches with severe headache, eye pain, nausea, and vomiting.
How it works
Epival belongs to the anti-epileptic class. It increases GABA levels in the brain and blocks voltage-gated sodium channels, which calms overactive nerve signals that trigger seizures and mood swings.
Available Forms & Strengths
|
Form |
Common Strengths |
Key Notes |
|---|---|---|
|
Epival Tablet |
200 mg, 500 mg |
Immediate release |
|
Epival CR |
300 mg, 500 mg prolonged-release |
Swallow whole, do not crush/chew |
|
Epival Oral Solution/Syrup |
200 mg/5 mL |
For patients who can’t take tablets |
Dosage Guidelines
Always follow your doctor’s prescription. Dosing is individualized by age, weight, condition, and response.
For Epilepsy – Adults
- Starting dose: Usually 15 mg/kg/day, taken after meals.
- Maintenance: Gradually increased by 5–10 mg/kg per week if needed. Typical range 1000–2000 mg/day, but doses >45 mg/kg/day need careful monitoring.
- CR tablets: Can be given once or twice daily. Initial dose for mania is 750 mg/day, or 20 mg/kg body weight.
For Bipolar Mania – Adults
- Initial: 750 mg/day or 20 mg/kg/day.
- Usual maintenance: 1000–2000 mg/day, titrated to lowest effective dose.
Children & Adolescents
- Epival CR is not recommended for treating mania in patients <18 years. For epilepsy, pediatric dosing is weight-based and must be decided by a pediatric neurologist.
Elderly
- Same initial dose: 15 mg/kg/day, with slower titration due to increased sensitivity.
Administration tips
- Take with or after food if stomach upset occurs.
- CR tablets must be swallowed whole with fluid; may be halved but not chewed/crushed.
- Do not stop suddenly – can worsen seizures. Taper under medical supervision.
Missed dose: Take as soon as you remember, but skip if it’s almost time for the next dose. Never double up.
Overdose: Symptoms include nausea, vomiting, dizziness, CNS/respiratory depression. Seek emergency care immediately.
Key Benefits
- Seizure control: Reduces frequency and severity of generalized, absence, and partial seizures.
- Mood stabilization: Prevents manic episodes in bipolar disorder and reduces extreme mood swings.
- Migraine prevention: Decreases frequency of migraine attacks when used prophylactically.
- Broad use: Can be used as monotherapy or add-on with other anti-epileptics.
Side Effects
Side effects are dose-dependent and often reduce as your body adjusts.
Common:
- Hair fall/loss, headache, dizziness, drowsiness, sleepiness
- Nausea, vomiting, diarrhea, stomach upset, loss of appetite
- Weight gain, tremors of hands/feet, blurred vision
- Rash, difficulty sleeping, anxiety, muscle pain
Serious – Contact your doctor immediately:
- Liver problems: Yellow eyes/skin, unusual tiredness.
- Pancreatitis: Severe stomach pain, vomiting.
- Low platelet count / bleeding: Unexplained bruising.
- Suicidal thoughts or depression.
- Osteoporosis: Long-term use may weaken bones, increasing fracture risk.
- Hyperammonemia: Confusion, lethargy.
Other reported: Loss of smell, peripheral edema, palpitations, back pain, dry mouth, constipation.
Warnings & Precautions
Before starting Epival, tell your doctor if you have:
- Liver disease, kidney problems, or history of pancreatitis – contraindicated in severe hepatic dysfunction.
- Depression, suicidal thoughts, or meningitis.
- Pregnancy or breastfeeding: Can harm the fetus – causes birth defects. Use only if benefits outweigh risks; dose adjustment needed. Effect in pregnancy is “Severe”.
- Taking contraceptive pills or other meds – many drug interactions.
Lifestyle
- Avoid driving/biking if you feel drowsy or dizzy.
- Alcohol can increase drowsiness and liver risk – best avoided.
- Regular blood tests are needed to monitor liver function and drug levels.
Drug interactions:
Epival interacts with lamotrigine, carbamazepine, phenytoin, aspirin, warfarin, oral contraceptives, and others. Always share your full medication list with your doctor.
Price – Bangladesh & India
Prices vary by country, pharmacy, strength, and pack size.
India
- Epival 200 mg Tablet (10 tablets): MRP ₹38.23, selling ~₹29.44; ₹2.94/tablet.
- Epival 200 mg Syrup 200 mL: ₹129.92.
Bangladesh
Epival CR and regular tablets are available via Sun Pharma and local distributors. Prices fluctuate, but as of 2025-2026:
- Epival 500 mg CR Tablet: ~BDT 15–20 per tablet, ~BDT 150–200 per 10-tab strip.
- Epival 200 mg Tablet: ~BDT 8–12 per tablet.
Check with local pharmacies like Lazz Pharma, Tamanna Pharmacy, or online platforms for current BDT rates, as prices are not fixed.
Substitutes / Alternatives
Same salt – Sodium Valproate/Valproic Acid:
- Valparin, Valprol, Torvate, Senval, Valcip, Valtec, Napilex, Valpex, Valprid, Valrate.
Frequently Asked Questions
Q1: How long does Epival take to work?
It may take several weeks of regular use to see full benefit for seizures/mood.
Q2: Can I stop Epival once I feel better?
No. Stopping suddenly can cause more or worse seizures. Always taper under medical guidance.
Q3: Is Epival addictive?
No, it is not addictive in nature.
Q4: Can pregnant women take it?
Only if clearly needed. It carries a high risk of birth defects and is rated “Severe” in pregnancy. Use contraception and discuss with your doctor.
Q5: Does it cause weight gain?
Yes, weight gain is a listed side effect.
Important Note
Epival is a prescription-only medicine. Self-medication can be dangerous due to risks of liver damage, pancreatitis, and birth defects. Dose must be individualized by a neurologist/psychiatrist. Have regular liver function and blood count tests while on therapy.
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