Gastrointestinal tolerance of divalproex sodium

Divalproex sodium (DS), a new enteric-coated preparation of valproate, was administered to 27 patients who had not tolerated valproate because of gastrointestinal symptoms. Twenty-three (85%) tolerated DS and continued therapy. Of 34 patients previously naive to valproate, DS therapy was discontinued in only 4 patients (12%) because of gastrointestinal intolerance. Enteric-coated DS tablets had fewer gastrointestinal effects than VA capsules. Although the absorption of DS was delayed, the bioavailability of VA capsules and DS tablets was equivalent. After oral doses, peak plasma levels occurred within 1 hour with VA and at 3 hours with DS. Seven patients were maintained on a twice-daily schedule of DS.