Pharm
Zonisamide
search
Zonisamide
, Zonegran
Indications
Adjunctive management of
Partial Seizure
s
Add to primary antiepileptic regimens
Carbamazepine
Phenytoin
Valproate
Other potential uses currently being researched
Myoclonic
Seizure
s
Infantile Spasm
Atypical
Absence Seizure
Generalized Tonic Clonic Seizure
s
Pharmacology
Weak carbonic anhydrase inhibitor
Sulfonamide
that blocks
Sodium
and
Calcium
channels
Increases
Dopamine
rgic 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 (
Teratogen
ic 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]
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