Valproate medicines are used in the treatment of epilepsy, bipolar disorder and occasionally to prevent migraine headaches.
If taken during pregnancy, there is a significant risk that babies may be born with birth defects. Women and girls using valproate medicines must now be protected by a Pregnancy Prevention Programme, which brings valproate in line with other medicines which are dangerous during pregnancy, such as isotretinoin and thalidomide.
Valproate also interacts with a number of medicines including antiepileptic medicines, antipsychotics and antibiotics.
To support the prescribing and dispensing of valproate, NICE have produced a resource to summarise guidance and safety advice relating to the use of valproate in adults, young people and children.
A joint resource has also been developed to support pharmacy teams in helping women and girls who have been prescribed valproate medicines. The resource includes a decision pathway and key points for consideration to prompt conversations between the pharmacy team and their patients.
It has been developed by the Community Pharmacy Patient Safety Group and Royal Pharmaceutical Society in partnership with the pharmacy organisations represented on the MHRA’s Valproate Stakeholder Network, including Community Pharmacy Northern Ireland, Community Pharmacy Scotland, Community Pharmacy Wales, the Pharmacy Forum of Northern Ireland and the Pharmaceutical Services Negotiating Committee.
The resource builds on the MHRA’s national toolkit for all healthcare professionals and enables pharmacists to understand where they can advise and help patients.
Valproate clinical audit
Nearly 6,500 community pharmacies took part in a two-part audit to explore the contribution of pharmacy teams in supporting women and girls prescribed valproate medicines.
The audit, which took place between July and October 2018 and February and March 2019, found that:
- Pharmacy teams’ awareness about the risks associated with valproate medicines and pregnancy improved over the audit period
- There was an increase in the proportion of valproate prescriptions, which indicated that a Pregnancy Prevention Programme (PPP) was in place for the patient, and
- One in five pharmacies indicated that they would appoint a valproate champion in their pharmacy.
Janice Perkins, Chair of the Patient Safety Group said “the audit’s findings demonstrate the significant role that pharmacy teams play in raising awareness and understanding about high-risk medicines among patients and their families and carers. Supporting women and girls prescribed valproate is a key priority across the whole health sector.”