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Pharmacokinetics and Clinical Utility of Valproic Acid Administered via Continuous Infusion

CNS Drugs volume 30, pages 71–77 (2016)Cite this article

Abstract

Introduction

Valproic acid is a versatile antiepileptic drug that is often used in the acute care setting. Intravenous valproic acid lends itself well to a continuous infusion as it exhibits a relatively short half-life. We evaluated the pharmacokinetics and clinical efficacy of continuous infusion valproic acid in hospitalized patients with migraine and seizures.

Methods

A retrospective cohort study was performed utilizing information from the medical records of patients receiving an intravenous continuous infusion of valproic acid. Patients were included if they were aged 1 month to 85 years and they received a continuous infusion of valproic acid. Therapeutic response, common adverse effects, and the pharmacokinetic profile of valproic acid were evaluated.

Results

Continuous infusion valproic acid led to a concentration within the desired range (50–100 μg/ml) in 83.4 % of patients, a rate that was higher in pediatric patients. The clinical response rate was also higher in pediatric patients with seizures or migraines and appeared to be better when the concentration was >75 μg/ml. Analysis of safety parameters suggests similar safety considerations to valproic acid when administered via intermittent infusion.

Conclusions

Continuous infusion valproic acid appears to be a safe, effective, and predictable manner by which to administer valproic acid to pediatric and adult patients admitted to the hospital.

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Acknowledgments

The authors would like to thank Courtney Bowlin and Cassidy Harmon for their efforts with data collection.

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Affiliations

  1. Pharmacy Services, UK Healthcare, 800 Rose St. H110, Lexington, KY, 40536, USA

    Aaron M. Cook

  2. Department of Neurology, College of Medicine, University of Kentucky, Lexington, KY, USA

    Muhammad S. Zafar, Sally Mathias, Alejandra M. Stewart, Ana C. Albuja, Meriem Bensalem-Owen, Siddharth Kapoor & Robert J. Baumann

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  1. Aaron M. Cook
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  2. Muhammad S. Zafar
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  3. Sally Mathias
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  4. Alejandra M. Stewart
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  5. Ana C. Albuja
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  6. Meriem Bensalem-Owen
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  7. Siddharth Kapoor
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  8. Robert J. Baumann
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Corresponding author

Correspondence to Aaron M. Cook.

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Funding

This study was not directly funded. The use of REDCap was supported by the National Institutes of Health (NIH) Grant NIH CTSA UL1TR000117.

Conflict of interest

Aaron M. Cook, Muhammad S. Zafar, Sally Mathias, Alejandra M. Stewart, Ana C. Albuja, Meriem Bensalem-Owen, Siddharth Kapoor, and Robert J. Baumann report no conflicts of interest related to this manuscript.

Ethical approval

This study and a waiver of informed consent was approved by our local Institutional Review Board via expedited review. All data was de-identified.

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Cook, A.M., Zafar, M.S., Mathias, S. et al. Pharmacokinetics and Clinical Utility of Valproic Acid Administered via Continuous Infusion. CNS Drugs 30, 71–77 (2016). https://doi.org/10.1007/s40263-015-0304-5

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  • DOI: https://doi.org/10.1007/s40263-015-0304-5

Keywords

  • Migraine
  • Valproic Acid
  • Continuous Infusion
  • Status Epilepticus
  • Intermittent Infusion