Valproate Annual Risk Acknowledgement Form

Valproate Annual Risk Acknowledgement Form

If you use valproate while you are pregnant, there is a significant risk of serious harm to your child which may be identified at birth or early development. This form confirms that you or your caregiver/parent/responsible person understand the risks of using valproate (contained in medicines such as Epilim, Epilizine, Navalpro, Eprolep, Adco Sodium Valproate, Valeptic, Sandoz Sodium Valproate, Cerepiv and Convulex).

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Document Number: GLF-CEM-PV-S01
Version: 2
Date Updated: 13/05/2025
File Type: pdf
Category: Form
Unit: Pharmacovigilance