Hyperammonemia (valproate-induced)
- Stop/reduce valproate when clinically significant
- Check ammonia with encephalopathy—not routinely
- L-carnitine is used for severe toxicity/overdose
- Treat contributing infection, fasting or urea-cycle risk
- Normal LFTs do not exclude valproate hyperammonemia
- Severe encephalopathy may require dialysis
Use at a glance
- Stop/reduce valproate when clinically significant
Practical pearls
- Severe encephalopathy may require dialysis
Other practical pearls
- Check ammonia with encephalopathy—not routinely
- L-carnitine is used for severe toxicity/overdose
Safety / pitfalls
- Treat contributing infection, fasting or urea-cycle risk
- Normal LFTs do not exclude valproate hyperammonemia
Self-check
- When is ammonia checked during valproate treatment?
With encephalopathy—not routinely. - Do normal LFTs exclude valproate hyperammonemia?
No.
Drugs used for this (1)
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