Update on valproate

Children born to women who take valproate during pregnancy are at significant risk of birth defects and persistent developmental disorders. As such, it is vital that women and girls are dispensed valproate safely. The GPhC is reminding all pharmacy professionals of what they must do to ensure women and girls receive the right information about valproate and the risk of birth defects. 

This reminder coincides with a letter being sent by NHS England to all women and girls aged 12-55 who are currently prescribed valproate which includes important reminders of safety considerations, including around contraception, pregnancy and regular prescribing reviews. The GPhC have shared this letter with pharmacy professionals so they aware and are prepared to support patients taking valproate who may have questions.

The GPhC has sent the following important reminders to all pharmacy professionals: 

Medicines in Pregnancy Registry 

NHS Digital and the Medicines and Healthcare products Regulatory Agency (MHRA) have developed a valproate registry. Work is underway to extend the valproate registry to include Scotland and Wales. Data collected in England between April 2018 and September 2020 shows: 

  • 47,532 females (ages 0-54) were prescribed one or more prescriptions for valproate in one or more months within the reporting period
  • 180 females were prescribed valproate while pregnant 
  • 238 females stopped receiving prescriptions of valproate prior to their pregnancy

Supplying valproate safely to women and girls

Pharmacy professionals have a key role in supplying valproate safely. Valproate must not be used in any woman or girl able to have children unless there is a pregnancy prevention programme (PPP) in place

For women and girls, when they are dispensed valproate, they should expect:

  • to be provided with a Patient Card every time valproate is dispensed
  • for valproate to be dispensed with a copy of the patient information leaflet, and if repackaged, with a warning on the container supplied
  • to be reminded of the risks in pregnancy and the need for highly effective contraception, and a reminder of the need for annual specialist review
  • to be asked if they have received the Patient Guide

You must make sure that the patient label is not placed over the warning labels or warning sticker on the box. Women taking valproate have shared with us examples of where this has happened. 

When patients are visiting pharmacies for pregnancy tests or emergency hormonal contraception remember to ask them about any medications they are taking so you can provide further advice if their medicines are teratogenic.

Find out more about what you need to do in our Focus on supplying medicines safely: sodium valproate

Watch our film where we speak to two women whose children were affected by exposure to sodium valproate during their pregnancies, to find out why it’s so important to make sure that women are made aware of the risks when dispensing sodium valproate.

Valproate case study 

This in-depth case study explores patient Millie’s interactions with the different healthcare professionals she meets. It explores how to approach difficult conversations and highlights the important role all healthcare professionals have in prescribing and dispensing valproate safely. 

How pharmacies can support women and girls taking valproate 

Find out more in this example of notable practice on supporting people taking valproate from our Knowledge Hub. 

Our inspectors check the pharmacy team are following the requirements of the Pregnancy Prevention Programme during inspections.