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When is the best time to get a valproate level if a patient is taking Depakote DR once daily?
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3 AnswersMednet Member
Psychiatry · RK Psychiatry Associates, LLC
Levels should be obtained at steady state - which is 5 half lives. For ER formulation, figure about 5 days and it should be a trough level (immediately before the next dose).
Mednet Member
Psychiatry · Massachusetts General Hospital
Getting a level just before the next scheduled dose will represent a trough, but may not be practical given lab hours and such. Getting a level 12 hours after the last dose may be more feasible and still useful, but will not reflect a true trough.
Mednet Member
Psychiatry · Komrad Mark S Office
The valproic acid levels are really normed for seizure disorders, not really for psychiatric. As this study shows, if you get a 12-hour post-dose level on Depakote ER, the level will be around 20% higher than IR, so you can just calculate with that correction factor. Or, you can get pretty close to ...