Zonisamide

DEA Class;  Rx

Common Brand Names; Zonegran, Zonisade

  • Anticonvulsants, Other

Sulfonamide anticonvulsant
Used for adjunctive treatment of partial seizures
Monitor for suicidal thoughts/behavior or depression

Indicated as adjunctive therapy for partial seizures

Hypersensitivity to zonisamide or sulfonamides

  • Somnolence (17%)
  • Anorexia (13%)
  • Dizziness (13%)
  • Headache (10%)
  • Nausea (9%)
  • Agitation/irritability (9%)
  • Fatigue (8%)
  • Tiredness (7%)
  • Abdominal pain (6%)
  • Ataxia (6%)
  • Confusion (6%)
  • Depression (6%)
  • Diplopia (6%)
  • Insomnia (6%)
  • Difficulty concentrating (6%)
  • Difficulty with memory (6%)
  • Diarrhea (5%)
  • Speech disorder (5%)
  • Flu-like symptoms (4%)
  • Mental slowing (4%)
  • Nystagmus (4%)
  • Paresthesia (4%)
  • Dyspepsia (3%)
  • Weight loss (3%)
  • Anxiety (3%)
  • Rash (3%)
  • Constipation (2%)
  • Rhinitis (2%)
  • Difficulty with verbal expression (2%)
  • Ecchymosis (2%)
  • Xerostomia (2%)
  • Nervousness (2%)
  • Schizophrenic/schizophreniform behavior (2%)
  • Taste perversion (2%)

Rare reports of serious hematologic events (2 confirmed cases of aplastic anemia and 1 confirmed case of agranulocytosis)

As with other antiepileptic drugs, may increase risk of seizure frequency and status epilepticus with abrupt withdrawal

Potential for teratogenic effects; advise females of childbearing potential to use effective contraception

May cause kidney stones; in general, increasing fluid intake and urine output can help reduce risk of stone formation, particularly in those with predisposing risk factors

Increased risk of serum creatinine and BUN

Unclear for clinical trials if increases risk of status epilepticus

Based on findings from animal studies, may cause fetal harm when administered to pregnant females

Zonisamide causes metabolic acidosis in humans

Readily transferred to human milk, with reported milk-to-plasma ratio ranging between 0.7 to 0.9

There are no data of effect on milk production

Adults

600 mg/day PO.

Geriatric

600 mg/day PO.

Adolescents

16 to 17 years: 600 mg/day PO.
1 to 15 years: Safety and efficacy have not been established; 12 mg/kg/day PO has been suggested.

Children

Safety and efficacy have not been established; 12 mg/kg/day PO has been suggested.

Infants

Safety and efficacy have not been established.

Neonates

Safety and efficacy have not been established.

Zonisamide

capsule

  • 25mg (Zonegran; generic)
  • 100mg (Zonegran; generic)

oral suspension

  • 100mg/5mL (Zonisade)

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