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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Janelle on June 4, 2003, at 16:36:03
I called a couple of pharmacies (to double check the info) and was told by BOTH that the ONLY version of 125mg of Depakote (in the US) is in SPRINKLE capsule form only and it should NOT be combined with a 250mg ER tablet! Where did you hear that there are 125mg tablets? Perhaps you live outside the US where things are different?
Anyway, my pdoc increased my dose gradually from 250 to 500 to 750! And to ease the side effects I got from taking it all at once, he smartly put me on divided dose - 250 mg/am, 250 mg/dinner, 250mg/bedtime!
Posted by Ritch on June 5, 2003, at 0:28:41
In reply to RITCH: re Depakote 125mg pills:, posted by Janelle on June 4, 2003, at 16:36:03
> I called a couple of pharmacies (to double check the info) and was told by BOTH that the ONLY version of 125mg of Depakote (in the US) is in SPRINKLE capsule form only and it should NOT be combined with a 250mg ER tablet! Where did you hear that there are 125mg tablets? Perhaps you live outside the US where things are different?
>
> Anyway, my pdoc increased my dose gradually from 250 to 500 to 750! And to ease the side effects I got from taking it all at once, he smartly put me on divided dose - 250 mg/am, 250 mg/dinner, 250mg/bedtime!Janelle, I live in the US and I have got a bottle a few feet away from me that reads: "Depakote EC 125mg Take one tablet two times daily". I've tried the Sprinkle version of the 125's-the green and white caps with the white pellets inside? You can't smell the vanilla smell with the 125 Sprinkles or the ER versions. But my 125 EC tabs smell like vanilla like the 250 EC's I have. Whoa! So you are taking Depakote 250mg ER 3x daily right? That's a lurch!
Posted by Snoozy on June 5, 2003, at 1:02:32
In reply to Re: RITCH: re Depakote 125mg pills: » Janelle, posted by Ritch on June 5, 2003, at 0:28:41
Just curious - are your pills made by Abbott Labs? I was mentioning this the other day in relation to how yucky Wellbutrin SR smells, but I've had 2 meds from Abbott that smelled almost like candy - very pleasant. A few months ago I got some Depakote ER samples (Abbott) from my neurologist. I have to say I was disappointed when I opened the first one and went for a sniff and didn't find anything much. I guess it's one of those small pleasures in life :)
And do they have something they actually call "Sprinkle"? With the new Klonopin "Wafers" I sense a trend here! Reminds me of something I watched once - someone was making a drug cocktail "with Percocet jimmies" (it was a comedy). That one still makes me chuckle.
>
> Janelle, I live in the US and I have got a bottle a few feet away from me that reads: "Depakote EC 125mg Take one tablet two times daily". I've tried the Sprinkle version of the 125's-the green and white caps with the white pellets inside? You can't smell the vanilla smell with the 125 Sprinkles or the ER versions. But my 125 EC tabs smell like vanilla like the 250 EC's I have. Whoa! So you are taking Depakote 250mg ER 3x daily right? That's a lurch!
Posted by Ritch on June 5, 2003, at 10:09:04
In reply to Re: RITCH: re Depakote 125mg pills: mmmm..vanilla » Ritch, posted by Snoozy on June 5, 2003, at 1:02:32
Oh yeah, Depakote is a branded name for divalproex sodium made by Abbott. They make the "vanilla tabs" in 125mg, 250mg, and 500mg enteric coated (EC) forms. They also make the "non-vanilla" 125mg green/white "Sprinkle" capsules. These are most commonly used for small children with epilepsy because the capsule is opened and you sprinkle out little white beads and put it on food (so you can give a very small person the correct smaller dose). I was taking a 250mg EC tab at bedtime and half a Sprinkle capsule at midday with lunch for awhile. Those little beads can really bounce!--so make sure you have some food for them to stick to. The new ER versions don't have the vanilla smell. I noticed that right away when I got samples from my pdoc.
> Just curious - are your pills made by Abbott Labs? I was mentioning this the other day in relation to how yucky Wellbutrin SR smells, but I've had 2 meds from Abbott that smelled almost like candy - very pleasant. A few months ago I got some Depakote ER samples (Abbott) from my neurologist. I have to say I was disappointed when I opened the first one and went for a sniff and didn't find anything much. I guess it's one of those small pleasures in life :)
>
> And do they have something they actually call "Sprinkle"? With the new Klonopin "Wafers" I sense a trend here! Reminds me of something I watched once - someone was making a drug cocktail "with Percocet jimmies" (it was a comedy). That one still makes me chuckle.
Posted by Janelle on June 5, 2003, at 16:42:53
In reply to Re: RITCH: re Depakote 125mg pills: » Janelle, posted by Ritch on June 5, 2003, at 0:28:41
This could be the difference - you kept referring to your 125mg pills as "EC" and I don't know what that means. I have "ER" which is Extended Release and CANNOT be combined with ANY other form of Depakote. But now you've got me wondering what on earth is Depakote EC???? Thanks!
Posted by Ritch on June 6, 2003, at 1:07:01
In reply to RITCH: what does Depakote EC mean versus ER? » Ritch, posted by Janelle on June 5, 2003, at 16:42:53
> This could be the difference - you kept referring to your 125mg pills as "EC" and I don't know what that means. I have "ER" which is Extended Release and CANNOT be combined with ANY other form of Depakote. But now you've got me wondering what on earth is Depakote EC???? Thanks!
"EC" means enteric coated
"ER" means extended releaseEC pills are peachy-salmon-lavendar and smell like vanilla
ER pills do not smell like vanilla. My 250mg ER
tabs are white.:)
Posted by Janelle on June 6, 2003, at 18:53:44
In reply to Re: RITCH: what does Depakote EC mean versus ER? » Janelle, posted by Ritch on June 6, 2003, at 1:07:01
Okay, I've checked into the matter(!) and have come up with the fact that EC (Enteric Coated) for easier digestion/absorption are DIFFERENT formulation than ER, Extended (slow) Release and that one should NOT take a 125mg EC with a 250mg ER to get a total of 375 mg.
My pdoc bumped me up from ONE 250 mg ER (the white boring ones, not smelling like vanilla) to THREE of these three times a day for a total of 750 mg.
Even with the divided doses which he said should help with the side effects I was getting with taking it all at once, I'm STILL getting side effects (typical for me; I'm extremely sensitive to meds almost to the point of becoming treatment resistant I fear).
Anyway, what dose (total) of Depakote are you on, and I hope you are NOT combining the EC with the ER??? Just wondering ...
Thanks.
Posted by Ritch on June 7, 2003, at 0:33:53
In reply to RITCH: the TWO Depakotes ... » Ritch, posted by Janelle on June 6, 2003, at 18:53:44
> Okay, I've checked into the matter(!) and have come up with the fact that EC (Enteric Coated) for easier digestion/absorption are DIFFERENT formulation than ER, Extended (slow) Release and that one should NOT take a 125mg EC with a 250mg ER to get a total of 375 mg.
>
> My pdoc bumped me up from ONE 250 mg ER (the white boring ones, not smelling like vanilla) to THREE of these three times a day for a total of 750 mg.
>
> Even with the divided doses which he said should help with the side effects I was getting with taking it all at once, I'm STILL getting side effects (typical for me; I'm extremely sensitive to meds almost to the point of becoming treatment resistant I fear).
>
> Anyway, what dose (total) of Depakote are you on, and I hope you are NOT combining the EC with the ER??? Just wondering ...
>
> Thanks.
I guess our pdocs are of two different opinions. Mine says divalproex sodium is divalproex sodium no matter how you cover it up with whatever coatings. I think your pdoc doesn't want to jack around with little titration steps and wants you on PLENTY of Depakote-just a hunch :) ! I'm just taking ONE of those white boring pills every day (250mg). Just an FYI, but in the prescribing info for Depakote ER it says you can take two 500mg ER tabs together at one time per day.
Posted by Janelle on June 7, 2003, at 16:30:39
In reply to Re: RITCH: the TWO Depakotes ... » Janelle, posted by Ritch on June 7, 2003, at 0:33:53
Hi,
I am GUESSING from what you wrote that YOUR pdoc says it is OKAY to combine the two DIFFERENT formulations of Depakote, that is, it is OKAY to take let's say 125 EC with 250 ER, to get at total of 375?
Interesting, cuz my pdoc says NO, NO, NO as did two different pharmacists I spoke to!
Also, to address what you said about taking TWO 250mg ER tablets at the SAME TIME, I do know that this is permissible (in fact some people take like 1000 to 1500 all at once).
The ONLY reason my pdoc had me DIVIDE the doses and NOT take two 250's at the same time to equal 500 is because I had sustained side effects when I tried taking 500mg all at once!
I think I mentioned that unfortunately, I am VERY sensitive to meds and must either be on low doses of many (ugh!) or take small doses throughout the day in order to avoid side effects.
Sometimes I fear I'm treatment resistant - perish the thought!
Anyway, I would appreciate your clarifying if I am RIGHT in my impression that YOUR pdoc says it's OKAY to combine the two formulations of Depakote? Thanks!
Posted by Ritch on June 7, 2003, at 16:59:58
In reply to RITCH : new Depakote CONFUSION here, please HELP! » Ritch, posted by Janelle on June 7, 2003, at 16:30:39
...
> The ONLY reason my pdoc had me DIVIDE the doses and NOT take two 250's at the same time to equal 500 is because I had sustained side effects when I tried taking 500mg all at once!
>
> I think I mentioned that unfortunately, I am VERY sensitive to meds and must either be on low doses of many (ugh!) or take small doses throughout the day in order to avoid side effects.
>
> Sometimes I fear I'm treatment resistant - perish the thought!
>
> Anyway, I would appreciate your clarifying if I am RIGHT in my impression that YOUR pdoc says it's OKAY to combine the two formulations of Depakote? Thanks!Janelle, med-sensitivity = cheaper meds, that's one positive way to look at it-you don't have to take so much medication. Geez, #30 20mg Celexa tablets would last me a year! Oh, as far as the Depakote thing goes: I was taking 250mg ER at bedtime and then midday the next day was taking half of a 125mg Sprinkle capsule with food-just a little extra. I think the "don't mix the different types of Depakote" thing is just how it is being released. From what I remember the ER version doesn't start to peak in your blood for 7 or 8 hrs on up to about 14 hrs or so. So, it is a lot smoother. The insert I read said that the resulting blood level was more even (with a single 250mg ER tab once daily), than taking 125mg tabs every twelve hours. If you are taking more than 375mg of Depakote, it doesn't make any sense to try to mix the types anyways. The only time it would come up is if you are doing what I was doing (taking more than 250mg but less than 500mg)-so it was "OK", it was spelled out that way-it just happened that way and I didn't think it made any difference and I didn't ask.
Posted by Janelle on June 7, 2003, at 17:55:36
In reply to Re: RITCH : new Depakote CONFUSION here, please HELP! » Janelle, posted by Ritch on June 7, 2003, at 16:59:58
Okay, I now get that at the time you DID combine two different forms of Depakote (the Sprinkles which are EC and a small dose of ER).
However, you also said that you took HALF the sprinkles - so did you open up the capsule and sprinkle out what you considered to be half?
And are you on any Depakote now? If so, how much?
As for med sensitivity = cheaper meds, NOPE, it is the OPPOSITE - the lower doses cost MORE than the higher ones! The way around it if they can be cut (Depakote tabs are too frigging big; they're like horse pills) is to get the pdoc to prescribe a higher dose, then cut them in half or quarters if possible.
Posted by Ritch on June 8, 2003, at 10:12:32
In reply to Sorry RITCH, one more follow-up here: » Ritch, posted by Janelle on June 7, 2003, at 17:55:36
> Okay, I now get that at the time you DID combine two different forms of Depakote (the Sprinkles which are EC and a small dose of ER).
>
> However, you also said that you took HALF the sprinkles - so did you open up the capsule and sprinkle out what you considered to be half?
Oh yeah, I just eye-balled the capsule and dumped roughly half on a spoon of cottage cheese and washed it down quickly. That made a total daily dose of approx. 312.5mg (nominal).
> And are you on any Depakote now? If so, how much?Just a single 250mg ER tab. I'm winding down now-energywise-which is typical of my seasonal pattern.
> As for med sensitivity = cheaper meds, NOPE, it is the OPPOSITE - the lower doses cost MORE than the higher ones! The way around it if they can be cut (Depakote tabs are too frigging big; they're like horse pills) is to get the pdoc to prescribe a higher dose, then cut them in half or quarters if possible.I was talking about antidepressants, not Depakote. I've been taking tiny doses of Effexor XR from a few boxes of samples my pdoc gave me months ago and their cost is $0. You can't chop on Depakote tabs-that would defeat their purpose (of coating them). One thing I found that was kind of nice and a little surprising was that the Depakote 250mg ER tablets cost *slightly less* than twice as many 125mg EC tabs.
This is the end of the thread.
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