Valproate (Epilim, Depakote) medicines must no longer be used in women or girls of childbearing potential unless a pregnancy prevention programme is in place and there is no alternative medicine available. Medicines containing valproate taken in pregnancy cause malformations in 11 per cent of babies and developmental disorders in 30-40 per cent of children after birth. 

Women and girls must be fully informed of the risks and the need to avoid exposure to valproates in pregnancy. GPs should have reviewed patients, ensured they are on effective contraception, provided a patient guide and referred them to a specialist to re-evaluate treatment and ensure the patient has signed a risk acknowledgement form.

Valproate medicines must be dispensed in whole packs whenever possible and, when dispensing to females of childbearing potential, with a warning label on the carton (this can be via a sticker). These risks must be discussed when dispensing valproate medicines, including the need for contraception. The patient should be asked whether they have received a patient guide from their GP.