This section gives an overview of the commonly used drugs (excluding opioids) to manage symptoms in patients with terminal illnesses. The information includes basic dosage information as well as indications for use and potential side effects. Please note that non-opioid drugs commonly used in palliative care in Singapore are shown here but the list is NOT exhaustive and neither are the side effects nor indications. Doses are for adults only. Please check with pharmacy colleagues for dose adjustments (if any) in renal or liver impairment. Unless otherwise indicated, use water for injection for dilution in continuous subcutaneous infusions.
*For information on opioids, please search and refer to the drugs with their given context.
Sodium Valproate
Route, Dosage and Frequency
ROUTE
|
DOSAGE AND FREQUENCY
|
| PO |
For pain, 100-200mg modified release at bedtime, increase by 100-200mg every 2-3 days as needed (max 2g/day). For seizures, 150-200mg modified release b.d., increase by 150-200mg b.d. every 3 days as needed (max 2.5g/day) |
Other Information
Indications
Neuropathic pain, Seizures.
Side-Effects
Nausea, Hair loss, Drowsiness, Postural tremor, Pancreatitis, Chronic hepatitis, Liver failure (idiosyncratic).
Remarks
Anti-epileptic, adjuvant analgesic. Avoid in liver impairment and pregnancy. Interacts with many drugs. Serum valproate levels may be used to guide treatment. Available in tablet and syrup. CSCI use has been reported in case series.
Reference
- Watson M. Oxford Handbook of Palliative Care. Oxford, NY: Oxford University Press; 2009.