Orfiril long
Orfiril long is a medicine used to treat epilepsy and mania, a condition often linked to bipolar disorder.
Form
depotkapseli, kova
Strength
150 mg
Active Ingredient
Sodium valproate
Manufacturer
Desitin Arzneimittel GmbH
How to Use
Dosage
Your doctor will tell you how much to take. The usual starting dose for adults with epilepsy is 600 mg daily, and for mania, it's typically 750 mg, with an average daily dose between 1000-2000 mg.
Method
Swallow the capsules whole with water, before, during, or after a meal. You can also open the capsules and mix the contents with soft food, but do not chew them.
Important
Your doctor will determine your maximum daily dose. Follow their instructions carefully.
Possible Side Effects
COMMON
- •Increased blood ammonia levels
- •Pain, nausea, and vomiting, especially at the start of treatment
- •Tremor (shaking)
- •Convulsions
- •Bruising or bleeding
- •Decreased platelets, red blood cells, or white blood cells
- •Increased insulin levels
- •Weight gain or loss, increased or decreased appetite (can be a risk factor for polycystic ovary syndrome)
- •Headache, lethargy, drowsiness
- •Skin sensations like burning, tingling, itching, or numbness
- •Reduced consciousness (stupor)
- •Muscle stiffness, weakness, and tremor (extrapyramidal disorders)
- •Aggression, agitation, and difficulty concentrating
- •Confusion, hallucinations, and loss of appetite
- •Memory impairment, involuntary eye movements, and dizziness
- •Diarrhea
- •Gum disorder (mainly gum overgrowth) and gingivitis
- •Low blood sodium levels
- •Changes in liver enzyme values
- •Decreased HDL cholesterol levels
- •Hypersensitivity
- •Temporary hair loss, hair color changes, and hair curling
- •Absence of menstruation (amenorrhea)
- •Nail and nail bed disorders
- •Involuntary urination (urinary incontinence)
RARE
- •Decrease in all blood cell counts (pancytopenia)
- •Severe liver damage, including liver failure
- •Swelling of hands, feet, ankles, face, mouth, tongue, or other body parts, which can cause breathing difficulties (angioedema)
- •Pancreas damage (pancreatitis), which can be fatal
- •Kidney failure, with symptoms such as reduced urine output
- •Irritability, hyperactivity
- •Worsening or increased seizures
- •Temporary coma (in some cases associated with increased seizures)
- •Unsteady gait (ataxia)
- •Muscle spasms
- •Sleepiness
- •Organic brain disorder (encephalopathy)
- •Parkinsonism-like symptoms, which resolve after stopping treatment
- •Syndrome with fluid retention in the blood and reduced urine output (SIADH), with symptoms such as weight gain, nausea, vomiting, muscle cramps, confusion, and seizures
- •Vasculitis (inflammation of blood vessels)
- •Severe menstrual pain (dysmenorrhea)
- •Increased male hormone (androgen) levels, leading to male secondary sexual characteristics and increased male pattern hair growth in women (hirsutism), acne, or male pattern hair loss (such as a receding hairline)
- •Low body temperature
- •Rash
- •Severe lack of certain blood cells (agranulocytosis)
- •Decrease in quantity and quality of blood-forming cells in the bone marrow (myelodysplastic syndrome)
- •Bone marrow dysfunction
- •Enlarged red blood cells with normal count (macrocytosis) or decreased (macrocytic anemia)
- •Inhibition of red blood cell development
- •Low blood levels of a hormone (insulin-like growth factor-binding protein I)
- •Swelling of legs and/or arms (edema)
- •Severe muscle breakdown (rhabdomyolysis)
- •Increased salivation
- •Severe blistering skin and mucous membrane reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis)
- •Skin redness (erythema multiforme)
- •Syndrome with drug rash, increased white blood cells (eosinophilia), enlarged lymph nodes, fever, and organ dysfunction (DRESS syndrome)
- •Immune system disorder causing joint pain, rash, and fever (lupus erythematosus)
- •Polycystic ovary syndrome, which causes ovarian cysts of various sizes
- •Male infertility (usually reversible after stopping treatment or dose reduction; do not stop without doctor's consultation)
- •Hearing loss (reversible or permanent)
- •Obesity
- •Brain dysfunction with reversible brain shrinkage (atrophy) after stopping treatment
- •Impaired understanding, memory, or thinking (cognitive disorder)
- •Double vision, speech disorder, and coordination disorders
- •Abnormal behavior, learning difficulties, and psychomotor hyperactivity
- •Difficulty falling asleep
- •Excessive urination and thirst (Fanconi syndrome)
- •Nocturnal enuresis (bedwetting)
- •Kidney tissue inflammation
- •Decreased levels of at least one clotting factor and changes in clotting tests
- •Decreased vitamin B8 levels (biotin deficiency)
- •Underactive thyroid
Important Warnings
- This medicine can seriously harm an unborn baby if taken during pregnancy. If you are a woman who can get pregnant, you must use effective birth control throughout your treatment.
- Do not stop taking Orfiril long without your doctor's advice, as your condition might worsen.
- Contact your doctor immediately if you or your child develop severe tiredness, repeated vomiting, stomach pain, yellow skin/eyes, swollen legs, or if your epilepsy worsens, as these could be signs of serious liver or pancreas problems.
- Seek medical help if you or your child experience balance or coordination issues, severe drowsiness, reduced alertness, and vomiting, as these could be due to high ammonia levels in the blood.
- Contact your doctor immediately if you have thoughts of harming yourself or suicide at any time.
Show 5 more warnings
- Inform your doctor if your seizures get worse or become more frequent.
- Seek urgent medical help if you develop severe skin reactions with blistering or rash, as these can be life-threatening.
- Tell your doctor if you bruise easily, bleed unusually, or have a reduced number of platelets in your blood.
- Do not drink alcohol while taking Orfiril long, as it may increase the risk of liver damage.
- You will need regular blood tests to check your blood cell count, liver, and pancreas function, especially at the beginning of treatment.
Use in Elderly Patients
Category C
Suitable for older adults, with specific precautions. Low serum albumin levels increase the response. Consider potential adverse effects, such as hyponatraemia och hematological changes. Monitor liver function. (updated 10.11.2025)