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Valproate in pregnancy — GPhC CRA MCQ

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HardCNS TherapeuticsValproate in pregnancyGPhC CRA

A 26-year-old woman taking sodium valproate modified-release 500mg twice daily asks for advice after a positive pregnancy test. She says the medicine controls her generalised seizures and she has not seen her specialist for a year. What is the most appropriate action?

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Correct answer: D — Advise urgent specialist review and continue treatment until medically reviewed

Valproate is highly teratogenic and requires urgent specialist review in pregnancy or possible pregnancy. Abrupt cessation can precipitate seizures, which may harm both patient and fetus, so treatment changes should be specialist-led. High-dose folic acid may be used but does not remove valproate risk. Pharmacists should also consider Pregnancy Prevention Programme requirements for patients of childbearing potential.

Reference: BNF; MHRA Drug Safety Update