II. Indications
- Adjunctive management of Partial Seizures
- Add to primary antiepileptic regimens
- Other potential uses currently being researched
- Myoclonic Seizures
- Infantile Spasm
- Atypical Absence Seizure
- Generalized Tonic Clonic Seizures
III. Pharmacology
- Weak carbonic anhydrase inhibitor
-
Sulfonamide that blocks Sodium and calcium channels
- Increases Dopaminergic transmission
- Increases serotonergic transmission
- Metabolized by CYP3A4
- Half-Life: 60 hours
IV. Drug Interactions
- Increased Zonisamide clearance with CYP3A4 inducers
- Phenytoin
- Carbamazepine
- Phenobarbital
- Concurrent carbonic anhydrase inhibitor (Topamax)
- Increased Nephrolithiasis risk
V. Adverse effects
- Dizziness
- Ataxia
- Somnolence
- Nausea
- Anorexia
- Abdominal Pain
- Insomnia
- Impaired cognition
- Confusion
- Decreased concentration
- Speech problems
- Psychosis
- Nephrolithiasis
- Rash
- Stevens Johnson Syndrome
- Toxic Epidermal Necrolysis
- Childhood Adverse Effects
- Oligohydrosis
- Hyperthermia (and Heat Stroke)
VI. Contraindications
- Sulfonamide Allergy
- Pregnancy (Teratogenic in animals)
VII. Dosing: Adults
- Initial: 100 mg PO qd
- Increase: 100 mg every two weeks as needed
- Maximum: 600 mg/day divided qd-bid
- Caution: Increase more slowly in Renal Insufficiency
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| zonisamide (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| ZONISAMIDE 100 MG CAPSULE | Generic | $0.15 each |
| ZONISAMIDE 25 MG CAPSULE | Generic | $0.11 each |
| ZONISAMIDE 50 MG CAPSULE | Generic | $0.15 each |
| zonegran (on 11/23/2016 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| ZONEGRAN 100 MG CAPSULE | Generic | $0.15 each |
| ZONEGRAN 25 MG CAPSULE | Generic | $0.11 each |
Ontology: zonisamide (C0078844)
| Definition (NCI) | A sulfonamide derivative with an anticonvulsant property. The exact mechanism of action remains to be elucidated. Zonisamide appears to block sodium and calcium channels, thereby stabilizing neuronal membranes and suppressing neuronal hyper-synchronization. Although zonisamide shows affinity for the gamma-aminobutyric acid (GABA)/benzodiazepine receptor ionophore complex, it does not potentiate the synaptic activity of GABA. In addition, this agent also facilitates both dopaminergic and serotonergic neurotransmission. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C022189 |
| SnomedCT | 398762003, 125693002 |
| LNC | LP28438-7, MTHU013979 |
| English | 1,2-benzisoxazole-3-methanesulfonamide, 3-sulfamoylmethyl-1,2-benzisoxazole, 1,2-Benzisoxazole-3-methanesulfonamide, zonisamide (medication), ZONISAMIDE, zonisamide [Chemical/Ingredient], zonisamide, Zonisamide (product), Zonisamide (substance), Zonisamide |
| Spanish | zonisamida (producto), zonisamida (sustancia), zonisamida |
Ontology: Zonegran (C0876224)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C022189 |
| English | Zonegran, zonegran, Elan brand of zonisamide |
