Valproic acid
| Drug Category | Drug | IHD Dosing | Administration Timing Around HD Session |
|---|---|---|---|
| Psychotropics | Valproic acid | Normal Dose based on indication; titrate according to target free valproic acid level | Administer Post-HD, if feasible; For divided dosing in seizure indication, may require supplemental dose post-HD |
Molecular Weight (Da) | Excreted Unchanged (%) | Normal Half-Life (Hours) | ESRD Half-Life (Hours) | Plasma Protein Binding (%) | Volume of Distribution (L/kg) | Dialytic Plasma Clearance (ml/min) | % Dialyzed |
|---|---|---|---|---|---|---|---|
| 144 | <5 | 6-15 | Unchanged | 80-90 (increased free fraction due to reduced protein binding in ESRD) | 0.19-0.23 | N/A | 37-57 (high flux) |
References:
- Aronoff GR, Bennett WM, Berns JS, Brier ME, Kasbekar N, Mueller BA, et al. Drug Prescribing in Renal Failure. Philadelphia: American College of Physicians;2007.
- DrugBank [Online]. 2012 Apr 12 [cited 2012 May 6]; Available from: URL: http://www.drugbank.ca/drugs/DB00313xxx Meek M, Broekroelofs J, Yska J, et al. Valproic acid intoxication: sense and non-sense of haemodialysis. The Netherlands journal of medicine. 2004;62(9):333-6.
- Thanacoody RHK. Extracorporeal elimination in acute valproic acid poisoning. Clinical toxicology (Philadelphia, Pa.). 2009;47(7):609-16.