Safety of Rapid Intravenous Valproate Infusion in Pediatric Patients

In order to investigate the safety of rapidly infused intravenous valproate in children with seizures, the drug was administered to 18 patients (age range, 1-16 years) at doses ranging from 7.5 to 41.5 mg/kg and rates of 1.5 to 11 mg/kg per minute. Forty-eight intravenous valproate doses were administered during 19 hospital admissions (range, 1-16 doses per admission). Only one adverse event was reported; a 9-year-old male experienced burning at the infusion site while receiving 660 mg intravenous valproate at 6 mg/kg per minute. The patient tolerated three subsequent infusions (one of 330 mg and two of 165 mg) at the same rate with no further discomfort. Electrocardiogram results, available for 18 admissions, revealed no arrhythmias, bradycardias, or hypotensive episodes. No abnormal laboratory results were reported. Rapid intravenous valproate infusion appears to be safe in pediatric patients.