Zonegran (Zonisamide)

Description

Zonegran, or Zonisamide, is a medication used to help control epilepsy, a condition that causes seizures. It belongs to a group of drugs known as sulfonamides and has a unique way of working compared to other seizure medications. Zonisamide helps stabilize the nerve cells in the brain and reduces abnormal electrical activity that can lead to seizures. It is typically prescribed to people who have partial-onset seizures, providing another option for those who need additional treatment alongside other medications.

Directions

Zonegran is typically taken once or twice every day. The capsules should be swallowed whole and can be taken with or without food. Most people start with a Zonegran dosage of 100 mg per day, but this amount can be increased based on how well the person responds and how well they tolerate it. The usual maintenance dose is between 300 to 400 mg per day, taken in one or two doses. It’s important not to stop taking Zonegran suddenly, as this can lead to serious problems, including seizures. Always take this medication with guidance from a doctor or healthcare provider.

Ingredients

The active ingredient in Zonegran is Zonisamide.

Contraindications

Avoid taking or using this medication if you have a known hypersensitivity to sulfonamides or Zonisamide itself, as this may lead to severe allergic reactions.

Cautions

• Before taking Zonegran, tell your healthcare provider about the following:
• Any existing health conditions
• Any allergies
• A list of all medications you are currently taking
• Whether you are pregnant or breastfeeding
• Fatal reactions have occurred with sulfonamides, including Zonegran. These include severe skin reactions, liver failure, and blood disorders. If you develop a rash or signs of hypersensitivity, stop taking Zonegran immediately and seek medical attention.
• Severe skin reactions like Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) have been reported with Zonegran. These can be life-threatening. If you develop a rash, discontinue Zonegran unless directed otherwise by your doctor.
• Some patients taking Zonegran have developed serious blood disorders, including aplastic anemia and agranulocytosis. If you experience unexplained bruising, fatigue, or infections, contact your doctor immediately.
• A rare but serious condition called Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) has occurred with Zonegran. It can cause fever, rash, swollen lymph nodes, and organ inflammation. If you develop these symptoms, stop taking Zonegran and seek medical help.
• Zonegran can cause reduced sweating and overheating, especially in children. This can lead to heat stroke, requiring hospitalization. Be cautious in hot weather and monitor for signs of decreased sweating or high body temperature.
• Acute myopia (sudden nearsightedness) and secondary angle-closure glaucoma have been reported with Zonegran. Symptoms include blurred vision, eye pain, and redness. If these occur, stop Zonegran and seek emergency eye care.
• Antiepileptic drugs like Zonegran may increase the risk of suicidal thoughts and behaviors. Monitor for changes in mood, depression, or suicidal thoughts, and report any concerns to a healthcare provider immediately.
• Stopping Zonegran suddenly can increase the risk of seizures or status epilepticus, a life-threatening seizure condition. Always taper off the medication under medical supervision.
• Zonegran has been linked to birth defects in animal studies. Women who are pregnant or planning to become pregnant should discuss the risks with their doctor before taking this medication.
• Zonegran may cause hyperammonemia, a condition that leads to high levels of ammonia in the blood. This can cause confusion, vomiting, and fatigue. If symptoms develop, medical evaluation is necessary.
• Zonegran is not recommended for patients with severe kidney disease, as it may worsen kidney function. Patients with existing kidney problems should be closely monitored while taking this medication.
• Some people taking Zonegran have developed status epilepticus, a serious seizure condition. If seizures become more frequent or last longer than usual, seek medical attention immediately.

Side Effects

The most common side effects of Zonegran include drowsiness, loss of appetite, dizziness, and difficulty with memory or concentration. Some patients also reported coordination issues, irritability, and trouble sleeping. Digestive symptoms such as nausea, dry mouth, and constipation were also noted. These side effects were generally mild to moderate and often improved over time.

Zonegran may cause more severe reactions, including severe skin rashes, kidney stones, or metabolic acidosis, which can lead to symptoms like rapid breathing, confusion, and irregular heartbeat. Some patients experienced mood changes, depression, or suicidal thoughts. Rare but serious cases of heat intolerance and decreased sweating have been reported, particularly in children. If you develop signs of a severe allergic reaction, significant behavioral changes, or unexplained fatigue, contact your healthcare provider immediately.

References

1. Zonegran (Zonisamide) Product Monograph. Dublin, Ireland: Amdipharm Limited; 2020.
2. Zonegran (Zonisamide) Drug Label Information. Bannockburn, IL: Advanz Pharma (US) Corp.; 2023.

About Dr. Gerardo Sison (Page Author)

An honors graduate of the University of Florida, Dr. Sison started his pharmacy career in a community setting, extending his services to hospitals and clinics over time. He has also worked in medication therapy management, advising patients on proper medication use for their chronic health conditions. Read More....