Zonisamide

From Anvita Health Wiki

Contents 1 Introduction 2 Indications 3 Contraindications 4 Dosage 5 Pharmacokinetics 6 Monitor 7 Adverse-effects 8 Drug-interactions 9 More General Terms 10 Additional Terms 11 Internet Database 12 References

Introduction

• Tradename: Zonegran.

Indications

• adjunctive therapy for partial seizures
• adjunctive therapy for Parkinson's diease

Contraindications

• allergy to sulfonamides
  

Dosage

• 25-100 mg QD

• Take with copious fluids to reduce risk of nephrolithiasis

Pharmacokinetics

• metabolized in the liver by cyt P450 3A4
  

• elimination via liver

Monitor

• renal function periodically [7]
• serum bicarbonate baseline & periodically (may cause metabolic acidosis) [7]
  
• monitor with anticonvulsants

Adverse-effects

• allergy to sulfa

• toxic skin reactions
• agranulocytosis

• rash [6]
• fatigue [2]
• sedation [6]
• paresthesias [2]
• cognitive impairment [2]
• visual impairment [2], visual field defect [6]
• metabolic acidosis [5]
• nephrolithiasis
• anorexia [6]
  
• drug adverse effects of anticonvulsants
• drug adverse effects of sulfonamides

Drug-interactions

• any drug that inhibits cyt P450 3A4 may increase levels of zonisamide
• any drug that induces cyt P450 3A4 may diminish levels of zonisamide
  
• drug interaction(s) of antibiotics with warfarin

More General Terms

• sulfonamide
• anticonvulsant

Additional Terms

• cytochrome P450 3A4 (cytochrome P450 C3, nifedipine oxidase, P450-PCN1, NF-25, CYP3A4)
• seizure; epileptic seizure

Internet Database

PubChem: 5734

References

1. Prescriber's Letter 7(5):28, May 2000
2. Prescriber's Letter 13(3): 2006 Cytochrome P450 drug interactions Detail-Document#: [1] (subscription needed) [2]
3. Prescriber's Letter 10(6):32 2003
4. Murata M, Hasegawa K, Kanazawa I; The Japan Zonisamide on PD Study Group. Zonisamide improves motor function in Parkinson disease: a randomized, double-blind study. Neurology. 2007 Jan 2;68(1):45-50. PMID: [3]
5. FDA Medwatch [4]
6. Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009
7. Prescriber's Letter 17(7): 2010 Recommended Lab Monitoring for Common Medications Detail-Document#: [5] (subscription needed) [6]

zonisamide (Zonegran)