Zonisamide

Pronunciation: zoe-NIS-a-mide
Generic Name: Zonisamide
Brand Name: Zonegran

Zonisamide is used for:

Treating certain types of seizures (partial seizures) in patients with epilepsy. It is used along with other medicines. It may also be used for other conditions as determined by your doctor.

Zonisamide is an anticonvulsant. Exactly how Zonisamide works is not known.

Do NOT use Zonisamide if:

• you are allergic to any ingredient in Zonisamide or to a sulfonamide medicine, such as acetazolamide, celecoxib, certain diuretics (eg, hydrochlorothiazide), glyburide, probenecid, sulfamethoxazole, or valdecoxib


• you have kidney failure

Contact your doctor or health care provider right away if any of these apply to you.

Before using Zonisamide:

Some medical conditions may interact with Zonisamide. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding


• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement


• if you have allergies to medicines, foods, or other substances (including tartrazine)


• if you are allergic to aspirin


• if you have a history of status epilepticus (eg, long periods of continuous seizure activity or a series of seizures without a full return to consciousness)


• if you have a history of liver or kidney problems, kidney stones, lung or breathing problems, mental or mood problems (eg, depression), or suicidal thoughts or actions


• if you have a skin rash


• if you have diarrhea, will be having surgery, or are on a ketogenic diet

Some MEDICINES MAY INTERACT with Zonisamide. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Anticholinergics (eg, benztropine) or carbonic anhydrase inhibitors (eg, acetazolamide) because the risk of heatstroke or high blood acid levels may be increased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Zonisamide may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Zonisamide:

Use Zonisamide as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Zonisamide comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Zonisamide refilled.


• Take Zonisamide by mouth with or without food.


• Swallow Zonisamide whole. Do not break, crush, or chew before swallowing.


• Drink plenty of liquids (6 to 8 glasses of water per day) while taking Zonisamide to help prevent kidney stones.


• Do not suddenly stop taking Zonisamide. Suddenly stopping Zonisamide may cause seizures to occur more often. If you need to stop Zonisamide, your doctor will gradually lower your dose.


• If you miss a dose of Zonisamide, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Zonisamide.

Important safety information:

• Zonisamide may cause dizziness, drowsiness, or vision changes. These effects may be worse if you take it with alcohol or certain medicines. Use Zonisamide with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


• Zonisamide may reduce sweating, which could increase the risk of heat stroke, especially in children. The risk is greater in hot weather and/or during vigorous exercise. Drink plenty of fluids. Dress lightly while in hot climates or when exercising. Check carefully for signs of decreased sweating. If this occurs, promptly seek cooler or air-conditioned shelter and/or stop exercising. Seek medical attention right away if you have an unexplained fever, mental or mood changes, headache, or dizziness.


• Zonisamide may cause high blood acid levels (metabolic acidosis). The risk may be greater in children and in patients with kidney problems, status epilepticus, severe breathing problems, or diarrhea. It may also be greater in patients who are taking certain other medicines (eg, acetazolamide), will be having surgery, or are on a ketogenic diet. Over a period of time, metabolic acidosis may cause kidney problems, bone problems, or decreased growth in children. Contact your doctor immediately if you experience fast breathing, unusual weakness or fatigue, sluggishness, fainting, persistent loss of appetite, or irregular heartbeat.


• Patients who take Zonisamide may be at increased risk of suicidal thoughts or actions. The risk may be greater in patients who have had suicidal thoughts or actions in the past. Watch patients who take Zonisamide closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.


• Contact your doctor right away if your seizures worsen or if you develop a skin rash.


• Tell your doctor or dentist that you take Zonisamide before you receive any medical or dental care, emergency care, or surgery.


• Carry an ID card at all times that says you take Zonisamide.


• This product may contain tartrazine dye (FD&C Yellow No. 5). This may cause an allergic reaction in some patients. If you have ever had an allergic reaction to tartrazine, ask your pharmacist if your product has tartrazine in it.


• Women who take Zonisamide should use effective birth control while using Zonisamide.


• Lab tests, including kidney function or blood bicarbonate levels, may be performed while you use Zonisamide. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Use Zonisamide with caution in the ELDERLY; they may be more sensitive to its effects.


• Zonisamide should be used with extreme caution in CHILDREN younger than 16 years old; safety and effectiveness in these children have not been confirmed. CHILDREN may be at a higher risk of heatstroke, kidney stones, decreased growth, and metabolic acidosis.


• PREGNANCY AND BREAST-FEEDING: Zonisamide may cause harm to the fetus. Do not become pregnant while you are using it. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Zonisamide while you are pregnant. It is not known if Zonisamide is found in breast milk. If you are or will be breast-feeding while you use Zonisamide, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Zonisamide:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Abnormal skin sensations; diarrhea; dizziness; drowsiness; flu-like symptoms; headache; irritability; loss of appetite; nausea; stomach upset; tiredness; trouble sleeping; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bone pain; change in the amount of urine produced; confusion; dark or bloody urine; decreased sweating; double vision or other vision problems; fainting; fast breathing; fast, slow, or irregular heartbeat; fever, chills, cough, or sore throat; loss of coordination; memory problems; mouth sores; new or worsening mental or mood changes (eg, depression, agitation, anxiety, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, inability to sit still); new or worsening seizures; painful urination; persistent loss of appetite; red, swollen, blistered, or peeling skin; severe muscle pain or weakness; severe or persistent drowsiness; sluggishness; sudden stomach or back pain; suicidal thoughts or actions; swelling of the hands, ankles, or feet; tremor; trouble speaking or other speech problems; trouble thinking or concentrating; unusual bruising or bleeding; unusual eye movements; unusual or disturbing thoughts; unusual tiredness or weakness.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Zonisamide side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include difficult, slow, or shallow breathing; severe or persistent dizziness; slow heartbeat; weakness.

Proper storage of Zonisamide:

Store Zonisamide at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Zonisamide out of the reach of children and away from pets.

General information:

• If you have any questions about Zonisamide, please talk with your doctor, pharmacist, or other health care provider.


• Zonisamide is to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Zonisamide. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Zonisamide resources

• Zonisamide Side Effects (in more detail)
• Zonisamide Use in Pregnancy & Breastfeeding
• Drug Images
• Zonisamide Drug Interactions
• Zonisamide Support Group
• 20 Reviews for Zonisamide - Add your own review/rating

• Zonisamide Professional Patient Advice (Wolters Kluwer)


• Zonisamide Monograph (AHFS DI)


• zonisamide Advanced Consumer (Micromedex) - Includes Dosage Information


• Zonegran Prescribing Information (FDA)


• Zonegran Consumer Overview

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