Valproic acid doses, concentrations, and clearances in elderly nursing home residents

Angela K Birnbaum, Nancy A. Hardie, Jeannine M Conway, Sandra E. Bowers, Thomas E. Lackner, Nina M. Graves, Ilo E Leppik

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21 Scopus citations


VPA daily dose and total VPA concentrations for 146 elderly (≥65 years) nursing home residents collected from June 1998 to December 2000 in homes located throughout the United States are presented. Average age was 78.5 ± 8.0 years old. The mean VPA daily dose was 16.2 ± 11.2 mg/kg and mean total VPA concentration was 48.5 ± 24.8 mg/L. The majority (56.2%) of the VPA residents are being maintained at total VPA levels <50 mg/L. Mean daily dose (19.4 ± 11.4, 16.3 ± 12.1, and 11.3 ± 7.6 mg/kg/day; p = 0.003) and total VPA concentration (56.4 ± 25.8, 47.7 ± 22.6, and 38.7 ± 23.1 mg/kg/day; p = 0.003) decreased by age groups (65-74, 75-84, and ≥85 years). Daily dose and total VPA concentration were not different in residents receiving inhibitory or inducing co-medications, between men and women, or by albumin level. Total VPA clearance was similar between men and women, among age groups, or according to inducing or inhibiting co-medications.

Original languageEnglish (US)
Pages (from-to)157-162
Number of pages6
JournalEpilepsy Research
Issue number2-3
StatePublished - Dec 2004

Bibliographical note

Funding Information:
This work was supported by NIH NINDS P50-NS16308. The authors thank PharMerica pharmacists and Beverly Enterprises Inc., for their contributions to the study.


  • AED
  • Elderly
  • Epilepsy
  • Nursing home
  • Valproate
  • Valproic acid


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