Orfiril long
Orfiril long is a medicine used to treat epilepsy and mania, helping to control seizures and mood swings.
Form
depotkapseli, kova
Strength
300 mg
Active Ingredient
Sodium valproate
Manufacturer
Desitin Arzneimittel GmbH
How to Use
Dosage
Your doctor will decide your dose. For epilepsy, adults usually start with 600 mg daily. For mania, the usual starting dose is 750 mg, and the average daily dose ranges from 1000 mg to 2000 mg.
Method
Swallow the capsules whole with water, before, during, or after a meal. You can also open the capsule and mix the contents with soft food, but do not chew it as this can make it less effective.
Important
Your doctor will determine your maximum daily dose based on your condition and response to treatment.
Possible Side Effects
COMMON
- •Increased ammonia levels in your blood
- •Pain, feeling sick (nausea), throwing up (vomiting)
- •Shaking (tremors)
- •Fits (convulsions)
- •Bruising or bleeding
- •Fewer blood platelets, red or white blood cells
- •Increased insulin levels
- •Weight changes (gain or loss), changes in appetite (more or less hungry)
- •Headache, feeling drowsy or sleepy
- •Strange skin sensations (like tingling, prickling, or itching without a clear cause)
- •Reduced awareness or consciousness (feeling very out of it)
- •Stiff muscles, weak movements, muscle twitching
- •Aggression*, restlessness*, trouble concentrating*
- •Confusion, seeing or hearing things that aren't real (hallucinations), loss of appetite
- •Memory problems, uncontrolled eye movements, dizziness
- •Diarrhea
- •Gum problems (like swollen gums), gum inflammation
- •Low sodium levels in your blood
- •Changes in liver test results
- •Lower 'good' cholesterol (HDL) levels
- •Allergic reactions
- •Temporary hair loss, faded hair color, or curly hair
- •Missed periods
- •Nail and nail bed problems
- •Involuntary urination (leaking urine)
RARE
- •Decrease in all types of blood cells
- •Severe liver damage, including liver failure
- •Swelling of hands, feet, ankles, face, mouth, tongue, or other body parts, which can cause breathing problems (angioedema)
- •Inflammation of the pancreas, which can be life-threatening
- •Kidney failure, which may show as decreased urine production
- •Irritability, hyperactivity
- •Worsening seizures
- •Temporary coma (sometimes with more seizures)
- •Unsteady walking (ataxia)
- •Muscle spasms
- •Sluggishness
- •Brain disease (encephalopathy)
- •Parkinson-like symptoms that go away after stopping treatment
- •Syndrome where the body retains fluid and produces less urine (SIADH), with symptoms like weight gain, nausea, vomiting, muscle cramps, confusion, and seizures
- •Inflammation of blood vessels
- •Severe menstrual pain (dysmenorrhea)
- •Increased male hormones (androgens), potentially causing masculinization and increased hair growth in women (hirsutism), acne, or male-pattern hair loss (e.g., receding hairline) in men
- •Low body temperature
- •Rash
- •Severe lack of certain white blood cells (agranulocytosis)
- •Decreased number 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 count (macrocytic anemia)
- •Failure of red blood cell development
- •Low levels of certain proteins in the blood (insulin-like growth factor binding protein I)
- •Swelling of legs and/or arms (edema)
- •Severe muscle breakdown (rhabdomyolysis)
- •Increased saliva production
- •Severe blistering reactions on skin and mucous membranes (Stevens-Johnson syndrome, toxic epidermal necrolysis)
- •Redness of the skin (erythema multiforme)
- •Drug rash with eosinophilia and systemic symptoms (DRESS syndrome) (rash, increased white blood cells, swollen lymph nodes, fever, and possible organ damage)
- •Immune system disorder (lupus erythematosus), causing joint pain, rash, and fever
- •Polycystic ovary syndrome (a condition with various sized cysts in the ovaries)
- •Male infertility, usually reversible after stopping treatment or reducing the dose
- •Hearing loss (can be permanent or temporary)
- •Obesity
- •Brain dysfunction with brain shrinkage (cerebral atrophy) that improves after stopping treatment
- •Impaired understanding, memory, or thinking (cognitive disorder)
- •Double vision, speech problems, coordination problems
- •Abnormal behavior*, learning difficulties*, psychomotor hyperactivity*
- •Difficulty falling asleep
- •Excessive urination and thirst (Fanconi syndrome)
- •Bedwetting
- •Kidney tissue inflammation
- •Decreased levels of at least one clotting factor and changes in clotting tests
- •Decreased vitamin B8 (biotin) levels in the body
- •Underactive thyroid gland
- •Changes in blood counts, such as low white blood cells (neutropenia, lymphopenia), increased white blood cells (eosinophilia), decreased platelet clumping, or low levels of clotting proteins (fibrinogen, factor VIII)
- •Prolonged bleeding time
- •Psychosis, anxiety, depression
- •Abnormal thyroid function test results
- •Ringing in the ears (tinnitus)
Important Warnings
- Orfiril long can seriously harm an unborn baby if taken during pregnancy. If you can get pregnant, use effective birth control throughout treatment. Talk to your doctor if you plan to get pregnant or think you are pregnant. Do not stop taking the medicine without your doctor's advice.
- Do not use this medicine if you are allergic to the active substance or any other ingredient.
- Do not use if you have or have had severe liver or pancreas disease.
- Tell your doctor if a family member has had liver disease or if a sibling died from liver problems while on valproate.
- Do not use if you have porphyria (a rare metabolic disorder).
Show 8 more warnings
- Do not use if you have a hereditary mitochondrial disease, such as Alpers-Huttenlocher syndrome.
- Do not use if you have a urea cycle disorder.
- Do not use if you have untreated carnitine deficiency.
- Contact your doctor immediately if you or your child experience symptoms like vomiting, tiredness, stomach pain, drowsiness, weakness, loss of appetite, or yellow skin, as these can be signs of liver or pancreas problems.
- If you experience balance problems, severe drowsiness, or vomiting, contact your doctor as these can be due to high ammonia levels in your blood.
- If you have thoughts of harming yourself, contact your doctor immediately.
- If your seizures get worse or increase in number, contact your doctor.
- Contact your doctor immediately if you develop severe skin reactions like blistering, peeling skin, or swelling.
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)