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Children with primary carnitine insufficiency who experience acute episodes of hypoglycemia are rapidly treated with intravenous ten percent dextrose, therapy of any concomitant metabolic abnormalities (such as acid-base abnormalities), and urgent carnitine supplementation

Valproate should not be administered to a woman of childbearing potential unless other medications have failed to provide adequate symptom control or are otherwise unacceptable [see WARNINGS AND PRECAUTIONS , Use In Specific Populations , and Patient Counseling Information ]

Concomitant topiramate may increase the risk of hyperammonemia and encephalopathy

H.GunaratnamB.FeyginY.WrightS

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