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Valproic acid blood test: therapeutic drug monitoring

The valproic acid test monitors blood levels of this anticonvulsant and mood stabilizer, as prescribed by your doctor. As part of comprehensive health monitoring, this test helps ensure medication levels remain effective while minimizing the risk of side effects.

Doctor's Assessment Included

When is this value abnormal?

Decision limits per result, in mg/l
Result Value (mg/l)
Subtherapeutic < 50
Therapeutic 50–100
Above therapeutic range ≥ 100

Range for epilepsy; as a mood stabiliser 60–80 mg/l (maintenance) to 80–120 mg/l (acute phase). Toxic: > 120 mg/l.

Source: UMC Utrecht

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

Valproic Acid: what this test measures

This test measures the blood concentration of valproic acid, as prescribed by your doctor. Monitoring helps your healthcare provider assess whether your current dose is producing levels within the desired therapeutic range.

Valproic Acid: why this value matters

Maintaining valproic acid within the therapeutic range is important for effective seizure control or mood stabilization. Levels outside this range may be associated with reduced effectiveness or an increased risk of side effects, including liver-related complications.

Valproic Acid: how the blood test works

Referral
No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw
A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Which test
on its own €49,-
Where
650+ draw sites run by independent laboratories across the Netherlands. Draw sites

Valproic Acid: how to prepare

  1. Draw just before your next dose

    Required

    A drug level is measured just before your next dose. If you take it at a fixed time each day, have the blood drawn just before then. For lithium, at least 12 hours after the last dose.

  • Water is always fine. Drink as usual beforehand, it makes the draw easier.
  • Take your usual medication, unless your own doctor told you otherwise.

Valproic Acid: when is testing worthwhile?

Testing is recommended when starting valproic acid therapy, after dose adjustments, during pregnancy planning, or when symptoms suggest subtherapeutic or toxic levels. Your healthcare provider will advise on the appropriate monitoring frequency.

Valproic Acid: symptoms of a high or low value

Low Levels

Low valproic acid levels may indicate subtherapeutic dosing, which can be associated with breakthrough seizures or inadequate mood stabilization. Consult your healthcare professional for interpretation of results.

High Levels

High valproic acid levels may indicate a risk of toxicity, which can be associated with nausea, vomiting, tremor, drowsiness, and in serious cases, liver damage or pancreatitis. Contact your healthcare provider promptly if you experience these symptoms.

Valproic Acid: lifestyle and this value

Take valproic acid exactly as prescribed by your doctor and do not adjust your dose without medical guidance. Attend all scheduled blood monitoring appointments, including liver function tests. Inform your doctor if you are planning pregnancy.

Valproic Acid: frequently asked questions

Why does my doctor also check liver function with valproic acid?

Valproic acid can occasionally affect liver function, especially in the early months of treatment. Regular liver function monitoring helps detect any issues early, allowing your healthcare provider to take appropriate action.

Can valproic acid interact with other medications?

Yes, valproic acid can interact with many medications, including other anticonvulsants, aspirin, and certain antibiotics. Always inform your healthcare provider about all medications and supplements you are taking.

Is valproic acid safe during pregnancy?

Valproic acid is associated with significant risks during pregnancy and is generally avoided when possible. If you are of childbearing age, discuss contraception and pregnancy planning with your healthcare provider.

Valproic Acid: sources

  1. UMC Utrecht, Divisie Laboratoria en Apotheek. Bepalingenwijzer: therapeutische geneesmiddelspiegels (amitriptyline, nortriptyline, carbamazepine, valproïnezuur, fenytoïne, digoxine, lamotrigine). Geraadpleegd 14 juli 2026. (retrieved 2026) umcutrecht.nl

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Medical policy
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Valproic Acid

€49,-