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Zonisamide
Aka: Zonisamide, Zonegran
- Indications
- Adjunctive management of Partial Seizures
- Add to primary antiepileptic regimens
- Carbamazepine
- Phenytoin
- Valproate
- Other potential uses currently being researched
- Myoclonic Seizures
- Infantile Spasm
- Atypical Absence Seizure
- Generalized Tonic Clonic Seizures
- 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
-
Drug Interactions
- Increased Zonisamide clearance with CYP3A4 inducers
- Phenytoin
- Carbamazepine
- Phenobarbital
- Concurrent carbonic anhydrase inhibitor (Topamax)
- Increased Nephrolithiasis risk
- 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)
- Contraindications
- Sulfonamide Allergy
- Pregnancy (Teratogenic in animals)
- 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
- References
- Padgett (1997) Epilepsia 38(suppl 8):107 [PubMed]
- Schmidt (1993) Epilepsy Res 15:67 [PubMed]
- Wallace (1998) Epilepsy Res 29:147 [PubMed]
- Yagi (2000) Neurology 54(Suppl 3):A195 [PubMed]
- Yanai (1999) Brain Dev 21:157 [PubMed]
- (2000) Med Lett Drugs Ther 42(1089):93-4 [PubMed]