{"id":59333,"date":"2024-02-28T05:52:45","date_gmt":"2024-02-28T05:52:45","guid":{"rendered":"https:\/\/medsname.com\/torvate\/"},"modified":"2026-04-30T10:23:59","modified_gmt":"2026-04-30T10:23:59","slug":"torvate","status":"publish","type":"product","link":"https:\/\/medsbase.com\/ro\/product\/torvate\/","title":{"rendered":"Torvate"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div class=\"medsbase-tldr-answer\" style=\"background:#fff8d6;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<h3 style=\"margin-top:0;\">\u26a1 R\u0103spuns rapid<\/h3>\n<p style=\"margin-bottom:0;\">Torvate (Valproat de sodiu 200 \/ 300 \/ 500 mg) este un anticonvulsivant \u0219i stabilizator de dispozi\u021bie utilizat pentru epilepsie, manie bipolar\u0103 \u0219i profilaxie migrenei. <strong>Contraindica\u021bie absolut\u0103 \u00een sarcin\u0103 \u0219i la femeile \u00een v\u00e2rst\u0103 fertil\u0103 f\u0103r\u0103 m\u0103suri stricte de prevenire a sarcinii<\/strong> \u2014 risc ridicat de teratogenitate \u0219i afectare a dezvolt\u0103rii neurologice.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Ce beneficii ofer\u0103 MedsBase:<\/strong> Produc\u0103tor certificat WHO-GMP \u00b7 Ambalaj discret \u00b7 Livrare la nivel mondial \u00b7 Peste 1.400 de recenzii verificate <a href=\"https:\/\/medsbase.com\/ro\/reviews\/\">ale clien\u021bilor<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Fiecare comand\u0103 este acoperit\u0103 de politica noastr\u0103 de <a href=\"https:\/\/medsbase.com\/ro\/medsbase-re-shipment-assurance-policy\/\"><strong>Politica noastr\u0103 de Reexpediere Garantat\u0103<\/strong><\/a> \u2014 dac\u0103 coletul dumneavoastr\u0103 nu sose\u0219te \u00een 20 de zile lucr\u0103toare, \u00eel relivr\u0103m.<\/p>\n<h3>De ce s\u0103 comanzi de la MedsBase<\/h3>\n<p>Torvate la MedsBase este furnizat direct de la un produc\u0103tor certificat WHO-GMP \u00een ambalaje discrete \u0219i simple. Fiecare comand\u0103 este acoperit\u0103 de <a href=\"https:\/\/medsbase.com\/ro\/medsbase-re-shipment-assurance-policy\/\">Politica noastr\u0103 de Reexpediere Garantat\u0103<\/a> \u2014 perioad\u0103 de livrare de 20 de zile lucr\u0103toare sau retrimitem f\u0103r\u0103 costuri suplimentare \u2014 \u0219i se calific\u0103 pentru <a href=\"https:\/\/medsbase.com\/ro\/loyalty-points\/\">programul nostru de loialitate pentru clien\u021bi<\/a>. Livr\u0103rile sunt disponibile \u00een majoritatea destina\u021biilor la nivel mondial.<\/p>\n<h2>Ce este Torvate \u0219i cum func\u021bioneaz\u0103<\/h2>\n<p>Torvate este un comprimat de valproat de sodiu furnizat de Torrent. Doze disponibile: <strong>200 \/ 300 \/ 500 mg<\/strong>. Valproatul este un anticonvulsivant cu spectru larg ale c\u0103rui mecanisme anti-criz\u0103 includ blocarea canalelor de sodiu, modularea canalelor de calciu tip T \u0219i cre\u0219terea disponibilit\u0103\u021bii GABA. Mecanismul anti-manic este slab \u00een\u021beles dar bine dovedit \u00een studii.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<strong>Sarcin\u0103 \u2014 contraindica\u021bie absolut\u0103 \u00een afara epilepsiei<\/strong><\/p>\n<p style=\"margin-bottom:0;\"><strong>Valproatul este unul dintre cele mai teratogene medicamente utilizate \u00een mod obi\u0219nuit.<\/strong> Expunerea \u00een primul trimestru produce defecte ale tubului neural (~ 1\u20132% risc absolut), malforma\u021bii cardiace \u0219i scheletice \u0219i o reducere substan\u021bial\u0103 a IQ-ului \u00een copil\u0103rie (\u00een medie cu 7\u201310 puncte mai mic la v\u00e2rsta de 6 ani). UK MHRA, EMA \u0219i FDA cer toate programe stricte de prevenire a sarcinii pentru femeile \u00een v\u00e2rst\u0103 fertil\u0103. \u00cen afara epilepsiei refractare unde nu exist\u0103 alternativ\u0103, <strong>nu ini\u021bia\u021bi sau continua\u021bi valproatul la nicio femeie \u00een v\u00e2rst\u0103 fertil\u0103 f\u0103r\u0103 contracep\u021bie eficient\u0103 \u0219i un program de prevenire a sarcinii<\/strong>. Trece\u021bi la litiu, lamotrigin\u0103 sau un antipsihotic atipic pentru men\u021binerea bipolar\u0103 la femeile premenopauzale.<\/p>\n<\/div>\n<h2>Indica\u021bii \u0219i dozaj<\/h2>\n<table>\n<thead>\n<tr>\n<th>Indica\u021bie<\/th>\n<th>Doza ini\u021bial\u0103<\/th>\n<th>\u021aint\u0103<\/th>\n<th>Nivelul \u021bint\u0103<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>Epilepsie generalizat\u0103<\/td>\n<td>10\u201315 mg\/kg\/zi \u00een 2 doze<\/td>\n<td>20\u201360 mg\/kg\/zi<\/td>\n<td>50\u2013100 \u00b5g\/mL<\/td>\n<\/tr>\n<tr>\n<td>Manie bipolar\u0103 (acut\u0103)<\/td>\n<td>20\u201330 mg\/kg\/zi \u00een 2 doze<\/td>\n<td>20\u201360 mg\/kg\/zi<\/td>\n<td>50\u2013125 \u00b5g\/mL<\/td>\n<\/tr>\n<tr>\n<td>Men\u021binere bipolar\u0103<\/td>\n<td>\u2014<\/td>\n<td>500\u20132500 mg\/zi<\/td>\n<td>50\u2013100 \u00b5g\/mL<\/td>\n<\/tr>\n<tr>\n<td>Profilaxia migrenei<\/td>\n<td>250 mg de 2 ori pe zi<\/td>\n<td>500\u20131500 mg\/zi<\/td>\n<td>\u2014<\/td>\n<\/tr>\n<tr>\n<td>Pacien\u021bi \u00een v\u00e2rst\u0103 \/ probleme hepatice<\/td>\n<td>\u00eenjum\u0103t\u0103\u021bi\u021bi doza<\/td>\n<td>\u2014<\/td>\n<td>\u2014<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2>Considera\u021bii importante de siguran\u021b\u0103<\/h2>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<strong>Hepatotoxicitate<\/strong><\/p>\n<p style=\"margin-bottom:0;\">Hepatita fatal\u0103 idiosincratic\u0103 este o complica\u021bie recunoscut\u0103 a valproatului, cu risc cel mai mare la copiii sub 2 ani \u00een politerapie. Testele hepatice de baz\u0103 sunt obligatorii \u0219i trebuie repetate la 3 luni, 6 luni, apoi anual. Opri\u021bi imediat la apari\u021bia icterului, hepatomegaliei, durerii \u00een cadranul superior drept sau a valorilor AST\/ALT &gt; 3\u00d7 limita superioar\u0103 normal\u0103.<\/p>\n<\/div>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<strong>Pancreatit\u0103 (rar\u0103)<\/strong><\/p>\n<p style=\"margin-bottom:0;\">Pancreatita acut\u0103 hemoragic\u0103 a fost descris\u0103, inclusiv cazuri fatale pediatrici. Opri\u021bi la apari\u021bia dureri abdominale inexplicabile, v\u0103rs\u0103turi sau anorexie.<\/p>\n<\/div>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<strong>Hiperamonemie<\/strong><\/p>\n<p style=\"margin-bottom:0;\">Valproatul inhib\u0103 ciclul ureei; hiperamonemia poate ap\u0103rea chiar \u0219i cu teste hepatice normale \u0219i provoac\u0103 somnolen\u021b\u0103, confuzie \u0219i (rar) encefalopatie. Verifica\u021bi amonemia la pacien\u021bii cu letargie sau modific\u0103ri cognitive noi.<\/p>\n<\/div>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<strong>Sindromul ovarelor polichistice \u0219i efectele metabolice<\/strong><\/p>\n<p style=\"margin-bottom:0;\">Administrarea pe termen lung de valproat este asociat\u0103 cu cre\u0219terea \u00een greutate, rezisten\u021ba la insulin\u0103 \u0219i PCOS la femeile tinere \u2014 un alt motiv pentru a prefera alternative la femeile premenopauzale.<\/p>\n<\/div>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<strong>Trombocitopenie \u0219i disfunc\u021bie pla\u021betar\u0103<\/strong><\/p>\n<p style=\"margin-bottom:0;\">Trombocitopenia u\u0219oar\u0103 este frecvent\u0103; verifica\u021bi hemoleucograma la ini\u021biere, dup\u0103 3 luni, 6 luni. Trombocitopenia semnificativ\u0103 este rar\u0103.<\/p>\n<\/div>\n<h2>Efecte secundare frecvente<\/h2>\n<ul>\n<li><strong>GI:<\/strong> gre\u021buri, dureri abdominale, dispepsie \u2014 universale la ini\u021biere; formul\u0103rile XR\/EC ajut\u0103.<\/li>\n<li><strong>Tremur<\/strong> \u2014 frecvente la doze sau niveluri mai mari.<\/li>\n<li><strong>Sedare<\/strong> \u2014 frecvente.<\/li>\n<li><strong>Cre\u0219terea \u00een greutate<\/strong> \u2014 de obicei 4\u20138 kg pe parcursul a 12 luni.<\/li>\n<li><strong>Sub\u021bierea p\u0103rului \/ alopecie<\/strong> \u2014 frecvent\u0103; suplimentarea cu biotin\u0103 este uneori recomandat\u0103.<\/li>\n<li><strong>Hiperamonemie<\/strong> \u2014 asimptomatice sau simptomatice.<\/li>\n<li><strong>Trombocitopenie<\/strong> \u2014 de obicei u\u0219oar\u0103.<\/li>\n<li><strong>\u00cence\u021bo\u0219are cognitiv\u0103<\/strong> \u2014 la doze mai mari.<\/li>\n<\/ul>\n<h2>Interac\u021biuni medicamentoase<\/h2>\n<ul>\n<li><strong>Lamotrigin\u0103<\/strong> \u2014 valproatul inhib\u0103 glucuronidarea lamotriginei; doza ini\u021bial\u0103 de lamotrigin\u0103 trebuie redus\u0103 la jum\u0103tate atunci c\u00e2nd se adaug\u0103 valproat (risc de sindrom Stevens-Johnson).<\/li>\n<li><strong>Carbamazepin\u0103, fenitoin\u0103, fenobarbital<\/strong> \u2014 interac\u021biuni bidirec\u021bionale; modific\u0103ri ale nivelului sunt probabile.<\/li>\n<li><strong>Aspirin\u0103, warfarin<\/strong> \u2014 deplasare a leg\u0103rii proteice; modific\u0103ri ale nivelului\/frac\u021biunii libere.<\/li>\n<li><strong>Antibiotice carbapenemice<\/strong> \u2014 sc\u0103dere dramatic\u0103 a nivelului de valproat; semnificativ din punct de vedere clinic.<\/li>\n<li><strong>Topiramate<\/strong> \u2014 risc crescut de hiperamonemie.<\/li>\n<\/ul>\n<h2>Sarcina, al\u0103ptare, pediatric<\/h2>\n<p>Sarcina: risc ridicat de teratogenitate \u0219i afectare a dezvolt\u0103rii neurologice; contraindica\u021bie absolut\u0103 \u00een afara epilepsiei refractare cu program strict de prevenire a sarcinii. Alaptare: trece \u00een lapte \u00een cantit\u0103\u021bi mici; de obicei compatibil\u0103. Pediatric: autorizat pentru epilepsie de la v\u00e2rsta infantil\u0103; risc crescut de hepatotoxicitate la copiii sub 2 ani \u00een politerapie.<\/p>\n<h2>Depozitare<\/h2>\n<p>P\u0103strare la 15\u201330 \u00b0C \u00een ambalajul original.<\/p>\n<h2 id=\"faqs\">\u00centreb\u0103ri frecvente<\/h2>\n<h3>De ce este valproatul at\u00e2t de restrictiv pentru femei?<\/h3>\n<p>Expunerea la valproat \u00een primul trimestru provoac\u0103 defecte ale tubului neural, malforma\u021bii cardiace, malforma\u021bii scheletice \u0219i o reducere substan\u021bial\u0103 a IQ-ului \u00een copil\u0103rie (cu 7\u201310 puncte mai mic \u00een medie la v\u00e2rsta de 6 ani). Riscurile sunt printre cele mai mari dintre orice medicament utilizat \u00een mod obi\u0219nuit. MHRA din Marea Britanie, EMA \u0219i FDA impun programe stricte de prevenire a sarcinii pentru femeile \u00een v\u00e2rst\u0103 fertil\u0103. \u00cen tulburarea bipolar\u0103, ar trebui utilizate alternative (litiu, lamotrigin\u0103, antipsihotice atipice) la femeile premenopauzale.<\/p>\n<h3>De ce necesit\u0103 valproatul monitorizarea nivelului sanguin?<\/h3>\n<p>Nivelurile terapeutice pentru mania bipolar\u0103 (50\u2013125 \u00b5g\/mL) \u0219i epilepsie (50\u2013100 \u00b5g\/mL) definesc fereastra de r\u0103spuns. Sub acest interval, tratamentul e\u0219ueaz\u0103; peste el, efectele secundare cresc f\u0103r\u0103 beneficii propor\u021bionale. Nivelurile minime (la 12 ore dup\u0103 administrare) \u00een stare stabil\u0103 ghideaz\u0103 dozarea.<\/p>\n<h3>C\u00e2t dureaz\u0103 p\u00e2n\u0103 ac\u021bioneaz\u0103 valproatul?<\/h3>\n<p>Mania acut\u0103: r\u0103spuns \u00een 1\u20132 s\u0103pt\u0103m\u00e2ni de la atingerea nivelului terapeutic. \u00centre\u021binere: 4\u20136 s\u0103pt\u0103m\u00e2ni pentru efect complet. Profilaxia migrenei: 4\u20138 s\u0103pt\u0103m\u00e2ni.<\/p>\n<h3>Valproatul poate provoca cre\u0219terea \u00een greutate?<\/h3>\n<p>Da \u2014 de obicei 4\u20138 kg \u00een 12 luni. Mai pu\u021bin dec\u00e2t olanzapina, mai mult dec\u00e2t litiul. Managementul activ al greut\u0103\u021bii este recomandat de la \u00eenceput.<\/p>\n<h3>Valproatul poate provoca leziuni hepatice?<\/h3>\n<p>Hepatita fatal\u0103 idiosincratic\u0103 este recunoscut\u0103, \u00een special la copiii  3\u00d7 ULN.<\/p>\n<h3>De ce provoac\u0103 valproatul c\u0103derea p\u0103rului?<\/h3>\n<p>Valproatul provoac\u0103 un tip de efluvium telogen la aproximativ 5\u201310% dintre utilizatori \u2014 sub\u021biere difuz\u0103, uneori semnificativ\u0103. Majoritatea se regenereaz\u0103 la reducerea dozei sau dup\u0103 \u00eentrerupere. Unii clinicieni recomand\u0103 suplimente de zinc \u0219i biotin\u0103; dovezile sunt limitate, dar suplimentele au risc sc\u0103zut.<\/p>\n<h3>Pot consuma alcool sub tratament cu valproat?<\/h3>\n<p>Consumul intens de alcool este contraindicat din cauza hepatotoxicit\u0103\u021bii aditive. Consumul moderat este de obicei tolerat; consumul excesiv este periculos.<\/p>\n<h3>Se poate \u00eentrerupe brusc valproatul?<\/h3>\n<p>\u00cen epilepsie, \u00eentreruperea brusc\u0103 poate precipita status epilepticus \u2014 reducere treptat\u0103 pe s\u0103pt\u0103m\u00e2ni. \u00cen tulburarea bipolar\u0103, \u00eentreruperea brusc\u0103 cre\u0219te semnificativ riscul de recidiv\u0103; reducere treptat\u0103 pe 2\u20134 s\u0103pt\u0103m\u00e2ni.<\/p>\n<h3>De ce necesit\u0103 combinarea valproatului cu lamotrigina un protocol special?<\/h3>\n<p>Valproatul inhib\u0103 glucuronidarea lamotriginei, cresc\u00e2nd nivelurile lamotriginei de 2 ori. Dozele ini\u021biale de lamotrigin\u0103 trebuie \u00eenjum\u0103t\u0103\u021bite la ad\u0103ugarea la valproat, iar titrarea trebuie s\u0103 fie lent\u0103 \u2014 titrarea rapid\u0103 cu valproat cre\u0219te semnificativ riscul de sindrom Stevens-Johnson.<\/p>\n<h3>Ce spune\u021bi despre condusul sub tratament cu valproat?<\/h3>\n<p>Sedarea poate afecta timpul de reac\u021bie, \u00een special \u00een primele 1-2 s\u0103pt\u0103m\u00e2ni \u0219i la doze mai mari. Majoritatea pacien\u021bilor la doze stabile conduc normal.<\/p>\n<h2>Alte Medicamente pentru S\u0103n\u0103tatea Mintal\u0103<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/ro\/licab\/\">Licab (Carbonat de litiu \u2014 standardul de aur)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/qutan-sr-400\/\">Qutan SR 400 (Quetiapin\u0103 \u2014 \u00eentre\u021binere tulburare bipolar\u0103)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/olanzap\/\">Olanzap (Olanzapin\u0103)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/aripicon\/\">Aripicon (Aripiprazol)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/atlura\/\">Atlura (Lurasidon \u2014 depresie bipolar\u0103)<\/a><\/li>\n<\/ul>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:18px 0;border-radius:4px;font-size:0.9em;\">\n<strong>Not\u0103 medical\u0103.<\/strong> Aceast\u0103 pagin\u0103 are scop educa\u021bional \u0219i nu \u00eenlocuie\u0219te sfatul medical personalizat. Farmacoterapia pentru s\u0103n\u0103tatea mintal\u0103 ar trebui ini\u021biat\u0103, monitorizat\u0103 \u0219i ajustat\u0103 de c\u0103tre un clinician calificat. Dac\u0103 tu sau cineva cunoscut se afl\u0103 \u00eentr-o criz\u0103 suicidal\u0103, contacteaz\u0103 imediat serviciile de urgen\u021b\u0103 locale sau sun\u0103 la linia de preven\u021bie a suicidului din \u021bara ta (SUA\/Canada: 988; UK: Samaritans 116 123; list\u0103 interna\u021bional\u0103: <a href=\"https:\/\/findahelpline.com\/\" rel=\"nofollow noopener\" target=\"_blank\">findahelpline.com<\/a>).\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Torvate (Valproat de sodiu 200\/300\/500 mg) \u2014 stabilizator de dispozi\u021bie \u0219i anticonvulsivant pentru epilepsie, manie bipolar\u0103, profilaxie migrenei. Contraindicat \u00een sarcin\u0103 \u0219i la femeile \u00een v\u00e2rst\u0103 fertil\u0103.<\/p>","protected":false},"featured_media":59334,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3342,3906],"product_tag":[4677,4678],"class_list":{"0":"post-59333","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-general-health","8":"product_cat-mental-health-and-psychiatric-medications","9":"product_tag-sodium-valproate","10":"product_tag-torvate","12":"first","13":"instock","14":"shipping-taxable","15":"purchasable","16":"product-type-variable","17":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product\/59333","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/comments?post=59333"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media\/59334"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media?parent=59333"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_brand?post=59333"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_cat?post=59333"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_tag?post=59333"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}