Take special care with Epilim Syrup
A small number of people being treated with anti-epileptics such as sodium valproate have had thoughts of harming or killing themselves. If at any time you have these thoughts, immediately contact your doctor.
Children and adolescents
Children and adolescents under 18 years of age:
Epilim Syrup should not be used in children and adolescents under 18 years of age for the treatment of mania.
Taking with food and drink
Alcohol intake is not recommended during treatment.
Check with your doctor or pharmacist before taking this medicine if:
- You have diabetes. This medicine may affect the results of urine tests
- You have kidney problems. Your doctor may give you a lower dose
- You have fits (epilepsy), brain disease or a metabolic condition affecting your brain
- You have a ‘urea cycle disorder’ where too much ammonia builds up in the body
- You have an illness called “systemic lupus erythematosus (SLE)” - a disease of the immune system which affects skin, bones, joints and internal organs
If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking Epilim Syrup.
Taking Epilim Syrup may make you put on weight. Talk to your doctor about how this will affect you.
Your doctor may wish to do blood tests before you start taking Epilim Syrup and during your treatment.
Taking Epilim Syrup with other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines. This includes medicines you buy without a prescription, including herbal medicines. This is because Epilim Syrup can affect the way some other medicines work.
Also some medicines can affect the way Epilim Syrup works.
The following medicines can increase the chance of you getting side effects, when taken with Epilim Syrup:
- Some medicines used for pain and inflammation (salicylates) such as aspirin.
- Some other medicines used to treat fits (epilepsy) – see section 3, “Patients taking other medicines for ‘fits’’’. This includes medicines such as phenobarbital, primidone, phenytoin, carbamazepine, topiramate, lamotrigine and felbamate
Epilim Syrup may increase the effect of the following medicines:
- Medicines used for thinning the blood (such as warfarin)
- Zidovudine used to treat HIV infection
- Medicines for depression
- Monoamine oxidase inhibitors (MAOI) such as moclobemide, selegiline, linezolid
- Medicines used to calm emotional and mental conditions such as diazepam and olanzapine
The following medicines can affect the way Epilim Syrup works:
- Some medicines used for the prevention and treatment of malaria such as mefloquine and chloroquine
- Cimetidine used for stomach ulcers
- Colestyramine used to lower blood fat (cholesterol) levels
- Some medicines used for infections (antibiotics) such as rifampicin and erythromycin
- In particular, tell your doctor or nurse if you are taking any of the following medicines:
Carbapenem agents (antibiotic used to treat bacterial infections). The combination of valproic acid and carbapenems should be avoided because it may decrease the effect of sodium valproate
Pregnancy and breast-feeding
You should not take this medicine if you are pregnant or a woman of child-bearing age unless explicitly advised by your doctor. If you are a woman of child-bearing age, you have to use effective contraception during treatment.
Epilim Syrup has no effect on how well the oral contraceptive pill works.
Well before you become pregnant it is important to discuss pregnancy and epilepsy with your doctor and, if you have one, your epilepsy specialist. This is to make sure that you and your doctor agree that you should have Epilim if you become pregnant.
Women taking Epilim during pregnancy have a higher risk than other women of having a child with an abnormality. The chance of abnormalities is increased if you are also taking other medicines for epilepsy at the same time. These abnormalities include:
- Head and face deformities including cleft palate (a gap or depression in the lip)
- Deformities of the bones, including hip dislocation
- Malformations of the arms and legs
- Deformities of the tube from the bladder to the penis, where the opening is formed in a different place
- Heart and blood vessel malformations, including heart defects
- Defects of the lining of the spinal cord
- An abnormality of the spinal cord called ‘Spina bifida’
Women who take Epilim Syrup during pregnancy may be more likely to have a baby with spina bifida. Taking folic acid 5mg each day as soon as you stop contraception may lower the risk of
having a baby with spina bifida.
There is also an increased risk of other birth defects. These other defects can usually be detected in the first 3 months of the pregnancy using routine antenatal screening blood tests and ultrasound scans. Pregnant mothers who take Epilim Syrup may have babies with blood clotting problems (such as blood not clotting or not clotting very well). This may appear as bruising or bleeding which takes a long time to stop.
Some babies born to mothers who took Epilim Syrup during pregnancy may develop less quickly than normal or have autistic disorders. These children may require additional educational support. There have been cases of low blood sugar (hypoglycaemia) reported in infants less than 4 weeks old, whose mothers have taken valproate during the third trimester of pregnancy.
Talk to your doctor before you stop taking Epilim if you want to become pregnant. Do not stop taking Epilim suddenly, as it is likely that your fits will come back.
Women who are planning to get Pregnant
If you become pregnant, think you may be pregnant or plan to become pregnant while taking Epilim Syrup, you must tell your doctor straight away.
- Your doctor will suggest changes to your treatment or dose
- He or she will also want to check your progress while you are pregnant
It is very important that you discuss your treatment with your doctor well before you become pregnant.
Very little Epilim Syrup gets into the breast milk. However, talk to your doctor about whether you should breast-feed your baby.
Ask your doctor or pharmacist for advice before taking any medicine.