Zonisade Generic Name & Formulations
Zonisamide 100mg/5mL; oral susp; strawberry flavor.
Carbonic anhydrase inhibitor (sulfonamide).
As adjunct therapy for partial-onset seizures.
Zonisade Dosage and Administration
Shake well. Use an accurate measuring device. ≥16yrs: initially 100mg once daily; may increase at intervals of at least 2 weeks by 100mg/day in 1 or 2 divided doses. Usual range: 100–400mg/day in 1 or 2 divided doses; usual max 600mg/day.
<16yrs: not established.
Hypersensitivity to sulfonamides.
Zonisade Boxed Warnings
Discontinue immediately if hypersensitivity or other serious reactions occur (including severe rash). Evaluate immediately if signs/symptoms of DRESS/multi-organ hypersensitivity develop; discontinue if no alternative etiology. Acute myopia. Secondary angle closure glaucoma. Depression. Suicidal tendencies (monitor). Maintain adequate hydration. Exposure to extreme heat; monitor closely for oligohidrosis and hyperthermia (esp. children). Measure baseline serum bicarbonate and periodically during treatment; consider reducing dose or discontinuing if metabolic acidosis occurs. Measure serum ammonia if signs/symptoms of encephalopathy occur. Avoid abrupt cessation. Avoid in those with renal failure (eGFR <50mL/min). Discontinue if acute renal failure or a clinically significant sustained increase in the creatinine/BUN concentration develops. Renal impairment: titrate more slowly and monitor more frequently. Elderly. Newborns: monitor for metabolic acidosis. Pregnancy: may cause fetal harm. Advise females of reproductive potential to use effective contraception during and for 1 month after discontinuation. Nursing mothers: monitor infants.
Increased severity of metabolic acidosis, risk of kidney stone formation, or hyperammonemia with concomitant other carbonic anhydrase inhibitors (eg, topiramate, acetazolamide, dichlorphenamide); monitor. Antagonized by CYP3A4 inducers (eg, phenytoin, carbamazepine, phenobarbital); monitor closely and may need to adjust the zonisamide dose and other CYP3A4 substrates. Caution with other drugs that interfere with temperature regulation (eg, anticholinergics, carbonic anhydrase inhibitors). Caution with concomitant alcohol, other CNS depressants.
Zonisade Adverse Reactions
Somnolence, anorexia, dizziness, ataxia, agitation/irritability, difficulty with memory and/or concentration; kidney stones, metabolic acidosis, hyperammonemia, encephalopathy, Stevens-Johnson syndrome, toxic epidermal necrolysis, DRESS, aplastic anemia, agranulocytosis, oligohidrosis, hyperthermia, cognitive/neuropsychiatric reactions.
Zonisade Clinical Trials
Zonisade Patient Counseling