Correct (2): Valproate carries boxed warnings for hepatotoxicity (anorexia, vomiting, jaundice, easy bruising from impaired coagulation) and pancreatitis (severe abdominal pain, vomiting). Both are life-threatening and require immediate evaluation with LFT, lipase, ammonia. (1) Mild gum bleeding can occur from any cause and is not a red flag alone. (3) Some weight gain is expected. (4) Mild drowsiness early in therapy is common and self-limited.
In-depth explanation
Memory Tip Valproate "VALPro" red flags = Vomiting, Anorexia, Liver(jaundice), Pancreatitis(abdominal pain). CPG Baseline LFT, ammonia, platelets; recheck periodically.
For study reference only. Always follow current clinical guidelines and your institution’s protocols.