Before starting valproic acid, you should assess history of which condition?

• A. Hypertension
• B. Liver disorders
• C. Diabetes
• D. Kidney stones

Answer: (B)

Valproic acid carries a notable risk of serious liver toxicity, especially early after starting treatment. The most important factor to assess beforehand is the patient’s liver health. A history of liver disorders signals a higher risk of hepatotoxicity with valproate, so baseline liver function tests and careful consideration of whether this drug is appropriate are essential. If there’s known liver disease or abnormal baseline liver enzymes, valproic acid may be avoided or require rigorous monitoring and alternative therapy. Other conditions like hypertension, diabetes, or kidney stones aren’t the primary red flags for initiating valproate.