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Ropakin®

Patient Details

Ropakin®

Ropakin® 200 (Sodium Valproate) is a medication acting on the nervous system and used to treat a wide range of disorders. It enhances or mimics the action of GABA (gamma-aminobutyric acid), an inhibitory neurotransmitter, and also inhibits voltage-dependent sodium channels on the neuronal membrane. By suppressing rapid and repetitive neuronal firing, it reduces the excitability of brain cells.

Indications

  • Various types of epilepsy (partial and generalized)
  • Bipolar disorder
  • Prevention of migraine

Dosage Form

Each Ropakin® 200 tablet contains 200 mg sodium valproate.

How to Use and Dosage of Ropakin® 200

  • Take the medication exactly as prescribed by your doctor. If unsure, consult your physician or pharmacist.
  • Ropakin® 200 is preferably taken with food. Do not chew or crush the tablets.
  • The dose is determined by the physician based on age, weight, therapeutic response, and serum drug levels.
  • Treatment with Ropakin® 200 requires regular and close medical monitoring. Do not change the dose or discontinue the medication without medical advice.

If You Miss a Dose

  • Take the missed dose as soon as you remember.
  • If it is nearly time for the next dose, skip the missed dose.
  • Do not double the dose.

Overdose of Ropakin® 200

Overdose may cause drowsiness, respiratory depression, low blood pressure, increased heart rate, or coma.
If more than the prescribed dose is taken accidentally, immediately contact emergency services and your doctor.

Monitoring Requirements During Ropakin® 200 Use

Before and during treatment, your doctor may request the following tests at appropriate intervals:

  • Blood tests
  • Coagulation studies
  • Liver enzyme levels
  • Serum valproate levels
  • Bone density assessment
  • Blood and urine tests for glucose and electrolytes

Contraindications of Ropakin® 200

Do not use if:

  • Hypersensitivity to valproic acid or its derivatives, or to any excipient in the formulation
  • Severe hepatic impairment
  • Urea cycle disorders
  • Suspected POLG-related disorder in children under two years of age
  • Known mitochondrial disorders caused by mutations in mitochondrial DNA polymerase γ (POLG)
  • Pregnancy, unless no suitable alternative
  • Women of childbearing potential, unless the requirements of the Pregnancy Prevention Program are fulfilled
  • Porphyria
  • Primary carnitine deficiency

Warnings and Precautions

  • Ropakin® 200 may cause drowsiness. Avoid driving or operating machinery if affected.
  • A small number of patients may experience suicidal thoughts; if this occurs, contact your doctor immediately.
  • Seek medical attention if symptoms of liver injury appear: nausea, vomiting, abdominal pain, loss of appetite, or jaundice.
  • Contact your doctor if you experience vomiting, reduced alertness, or mental status changes during treatment.
  • Since the medication may affect blood clotting, inform healthcare providers or dentists before procedures.
  • Long-term use may require calcium and vitamin D supplementation, especially in patients with low physical activity or insufficient sunlight exposure; consult your doctor.
  • If you develop fever, rash, or swollen lymph nodes, seek medical advice.
  • Do not abruptly discontinue the medication, as sudden withdrawal of antiepileptic drugs increases seizure risk.

Use of Ropakin® 200 During Pregnancy and Breastfeeding

  • Women of childbearing age must use a reliable contraceptive method during treatment.
  • Estrogen-containing contraceptives (e.g., LD, Yaz, Rokin, etc.) can lower sodium valproate levels and increase seizure risk—consult your doctor for the best contraceptive option.
  • If you plan to become pregnant, consult your doctor first.
  • If pregnancy occurs, do not stop Ropakin® 200 abruptly; seek medical guidance.
  • Use during pregnancy increases the risk of neural tube defects. It should only be used if no better alternative exists.
  • If used during pregnancy, discuss folic acid supplementation with your doctor, as it can reduce the risk of neural tube defects and early miscarriage.
  • Sodium valproate is excreted into breast milk in small amounts; consult your doctor before breastfeeding.

Side Effects of Ropakin® 200

Not everyone experiences side effects. Possible adverse reactions include:

  • Allergic reactions (rash with joint pain, fever, breathing or swallowing problems, swelling of lips, throat, tongue) and Stevens-Johnson syndrome
  • Weight gain, nausea, vomiting, severe fatigue, drowsiness, upper abdominal pain, jaundice, loss of appetite, edema, gum swelling, mouth ulcers
  • Thrombocytopenia (low platelets), coagulation disorders, unexplained bleeding
  • Mood changes, headache, restlessness, aggression, confusion, hallucinations, learning difficulties, hyperactivity, memory loss, poor concentration, loss of consciousness
  • Hypothyroidism
  • Balance and coordination problems, weakness, lethargy, tremor
  • Temporary hair loss or changes in hair color/texture
  • Elevated androgen levels
  • Menstrual irregularities and increased facial/body hair in women
  • Kidney problems, frequent urination, urinary incontinence

Drug Interactions

Consult your doctor or pharmacist before using Ropakin® 200 with any other medications or supplements.

Packaging

Each bottle contains 30 enteric-coated tablets.

Storage Conditions

  • Keep out of reach and sight of children.
  • Store below 30°C, away from light and moisture.
  • Use until the end of the month indicated on the expiry date.
  • Do not use expired medication.
  • Keep the medicine in its original packaging.

References

  1. Electronic Medicines Compendium (emc)

  2. Valproate: Drug Information, UpToDate 2023

Ropakin®
Prescribing Information