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Valproate pregnancy prevention — GPhC CRA MCQ

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HardAdverse Drug Reactions and Drug SafetyValproate pregnancy preventionGPhC CRA

A 35-year-old woman with epilepsy presents a repeat prescription for sodium valproate 500mg twice daily. She says she is planning pregnancy within the next year and has not seen her specialist for two years. She is not using contraception. What is the most appropriate action?

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Correct answer: A — Do not stop valproate abruptly and urgently refer to the prescriber or specialist

Valproate is highly teratogenic, but abrupt withdrawal can precipitate seizures and harm the patient. The pharmacist should ensure urgent specialist review and pregnancy prevention counselling while maintaining safe continuity unless a prescriber changes therapy. This combines reproductive safety with seizure-control risk.

Reference: MHRA; BNF