Undiluted IV Push Valproic Acid Shows Favorable Safety Across 5500 Doses

This large single-center cohort adds real-world safety data supporting rapid undiluted intravenous push administration of valproic acid across a broad dosing range, relevant to pharmacists managing seizures, status epilepticus, and headache in acute care.

valproic acidvalproateanticonvulsantanti-seizure medicationstatus epilepticusepilepsyheadacheIV pushintravenous administrationretrospective cohortmedication safety Neurology / Neuropharmacology

Background Information

Undiluted IV push valproic acid proves safe for rapid seizure treatment.

Traditional intravenous infusion delays of valproic acid (VPA) can hinder emergent treatment for seizures and headaches. Rapid intravenous push (IVP) administration could mitigate this issue. In 570 patients receiving 5546 doses of undiluted IVP VPA, only three non-probable adverse events occurred, indicating favorable safety and tolerability. This study supports the use of undiluted IVP for VPA in urgent clinical settings, but as a retrospective study, its findings should be corroborated by further prospective trials. Undiluted IVP VPA may be a safe option for rapid administration in time-sensitive situations like seizures.

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Authors: Rollins S, Radosevich JJ, Sammani N, Haller JT

Citation: Rollins S, Radosevich JJ, Sammani N, et al. Rapid administration of undiluted IV push valproic acid. Journal of neurology. 2026;273(8). doi:10.1007/s00415-026-13983-y

Article Links: PubMed · Journal / DOI

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