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Zonegran
Zonegran (zonisamide) is an anticonvulsant medication used to treat partial seizures in adults with epilepsy. It is often prescribed as an adjunct (add-on) therapy to help control seizures that are not adequately managed by other medications. Zonegran works by stabilizing electrical activity in the brain, helping to reduce the frequency of seizures. In addition to its use in epilepsy, Zonegran is sometimes used off-label for other neurological conditions.
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Frequently Asked Questions
How long does it take for Zonegran to start working?
It may take several weeks to reach the full therapeutic effect of Zonegran. Your doctor will gradually increase the dose to find the optimal level that controls your seizures.
Can Zonegran be used for children?
Zonegran is not typically recommended for children under the age of 16 due to the increased risk of hyperthermia and other side effects. Always consult your healthcare provider for pediatric use.
Does Zonegran cause weight loss?
Yes, weight loss is a potential side effect of Zonegran, especially in patients with prolonged use. If you experience significant or unwanted weight loss, notify your healthcare provider.
What should I do if I miss a dose of Zonegran?
If you miss a dose, take it as soon as you remember, unless it’s almost time for your next dose. Do not take two doses at once to make up for a missed dose.
Can I drink alcohol while taking Zonegran?
It is best to avoid alcohol while taking Zonegran, as it can increase the sedative effects of the medication and may lower the seizure threshold, increasing the risk of seizures.
Comprehensive Drug Guide
How Does Zonegran Work?
Zonegran works by blocking sodium and calcium channels in the brain, which helps reduce abnormal electrical activity that leads to seizures. It also enhances the actions of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter that calms nerve activity. Additionally, Zonegran has weak carbonic anhydrase inhibitory effects, which may contribute to its anticonvulsant properties.
Common Dosages
- 25 mg capsules
- 50 mg capsules
- 100 mg capsules
Typical Dosing
- For partial seizures, the starting dose of Zonegran is usually 100 mg once daily, with increases of 100 mg every two weeks, depending on response and tolerability.
- The typical maintenance dose ranges from 300 mg to 400 mg per day, taken either once daily or divided into two doses.
Typical Dosing
FDA Approved Indications
- Partial seizures in adults with epilepsy
Who Shouldn't Take Zonegran?
- A known hypersensitivity to zonisamide or sulfonamides (sulfa drugs), as it is chemically related to sulfonamides.
- Severe kidney disease.
Advice From The Pharmacist
- Zonegran can be taken with or without food, but try to take it at the same time every day to maintain consistent levels of the medication in your body.
- Stay well-hydrated while taking Zonegran, as it may increase the risk of kidney stones.
- Do not stop taking Zonegran suddenly, as this can increase the risk of seizures. If discontinuation is needed, your doctor will gradually reduce the dose to prevent withdrawal seizures.
- Zonegran may cause drowsiness or dizziness, so avoid driving or operating heavy machinery until you know how it affects you.
Side Effects of Zonegran
Common Side Effects
- Drowsiness or sedation
- Dizziness
- Loss of appetite
- Nausea
- Weight loss
- Headache
Uncommon/Severe Side Effects
- Kidney stones
- Metabolic acidosis (an imbalance of acid in the body)
- Skin reactions (Stevens-Johnson syndrome or toxic epidermal necrolysis)
- Suicidal thoughts or mood changes
- Hyperthermia (overheating), especially in children
Risks and Warnings of Zonegran
- Metabolic Acidosis: Zonegran may cause a buildup of acid in the blood, leading to metabolic acidosis. Symptoms include rapid breathing, fatigue, and confusion. Regular monitoring of bicarbonate levels is recommended, especially in high-risk patients.
- Kidney Stones: Zonegran may increase the risk of kidney stones, particularly in patients who do not drink enough fluids. Staying well-hydrated can help reduce this risk.
- Hyperthermia: Zonegran can impair the body’s ability to regulate temperature, particularly in children. Avoid excessive heat or strenuous activity that can lead to overheating.
- Serious Skin Reactions: Rare but serious skin reactions such as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) may occur. Discontinue the medication and seek immediate medical attention if you experience any signs of a severe rash.
Interactions with Zonegran
Common Drug Interactions
- Carbonic anhydrase inhibitors: Taking Zonegran with other medications that inhibit carbonic anhydrase, such as topiramate or acetazolamide, can increase the risk of metabolic acidosis and kidney stones.
- CNS depressants: Zonegran can increase the sedative effects of other central nervous system depressants, such as benzodiazepines, opioids, and alcohol.
- Oral contraceptives: Zonegran may reduce the effectiveness of hormonal contraceptives. Consider using a backup form of contraception if you are taking Zonegran.
Alternatives to Zonegran
- Lamotrigine (Lamictal): Another anticonvulsant used for partial seizures and mood stabilization in bipolar disorder.
- Levetiracetam (Keppra): An anticonvulsant used to treat partial seizures in epilepsy with a favorable side effect profile.
- Topiramate (Topamax): A similar anticonvulsant used for seizures and migraine prevention.
