Neurology Book

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Zonisamide

Aka: Zonisamide, Zonegran
  1. Indications
    1. Adjunctive management of Partial Seizures
    2. Add to primary antiepileptic regimens
      1. Carbamazepine
      2. Phenytoin
      3. Valproate
    3. Other potential uses currently being researched
      1. Myoclonic Seizures
      2. Infantile Spasm
      3. Atypical Absence Seizure
      4. Generalized Tonic Clonic Seizures
  2. Pharmacology
    1. Weak carbonic anhydrase inhibitor
    2. Sulfonamide that blocks Sodium and calcium channels
      1. Increases Dopaminergic transmission
      2. Increases serotonergic transmission
    3. Metabolized by CYP3A4
    4. Half-Life: 60 hours
  3. Drug Interactions
    1. Increased Zonisamide clearance with CYP3A4 inducers
      1. Phenytoin
      2. Carbamazepine
      3. Phenobarbital
    2. Concurrent carbonic anhydrase inhibitor (Topamax)
      1. Increased Nephrolithiasis risk
  4. Adverse effects
    1. Dizziness
    2. Ataxia
    3. Somnolence
    4. Nausea
    5. Anorexia
    6. Abdominal Pain
    7. Insomnia
    8. Impaired cognition
      1. Confusion
      2. Decreased concentration
      3. Speech problems
    9. Psychosis
    10. Nephrolithiasis
    11. Rash
    12. Stevens Johnson Syndrome
    13. Toxic Epidermal Necrolysis
    14. Childhood Adverse Effects
      1. Oligohydrosis
      2. Hyperthermia (and Heat Stroke)
  5. Contraindications
    1. Sulfonamide Allergy
    2. Pregnancy (Teratogenic in animals)
  6. Dosing: Adults
    1. Initial: 100 mg PO qd
    2. Increase: 100 mg every two weeks as needed
    3. Maximum: 600 mg/day divided qd-bid
    4. Caution: Increase more slowly in Renal Insufficiency
  7. References
    1. Padgett (1997) Epilepsia 38(suppl 8):107 [PubMed]
    2. Schmidt (1993) Epilepsy Res 15:67 [PubMed]
    3. Wallace (1998) Epilepsy Res 29:147 [PubMed]
    4. Yagi (2000) Neurology 54(Suppl 3):A195 [PubMed]
    5. Yanai (1999) Brain Dev 21:157 [PubMed]
    6. (2000) Med Lett Drugs Ther 42(1089):93-4 [PubMed]
Medication Costs
zonisamide (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing)
ZONISAMIDE 100 MG CAPSULE Generic $0.15 each
ZONISAMIDE 25 MG CAPSULE Generic $0.11 each
ZONISAMIDE 50 MG CAPSULE Generic $0.15 each
zonegran (on 11/23/2016 at Medicaid.Gov Pharmacy Drug pricing)
ZONEGRAN 100 MG CAPSULE Generic $0.15 each
ZONEGRAN 25 MG CAPSULE Generic $0.11 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

zonisamide (C0078844)

Definition (NCI) A sulfonamide derivative with an anticonvulsant property. The exact mechanism of action remains to be elucidated. Zonisamide appears to block sodium and calcium channels, thereby stabilizing neuronal membranes and suppressing neuronal hyper-synchronization. Although zonisamide shows affinity for the gamma-aminobutyric acid (GABA)/benzodiazepine receptor ionophore complex, it does not potentiate the synaptic activity of GABA. In addition, this agent also facilitates both dopaminergic and serotonergic neurotransmission.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C022189
SnomedCT 398762003, 125693002
LNC LP28438-7, MTHU013979
English 1,2-benzisoxazole-3-methanesulfonamide, 3-sulfamoylmethyl-1,2-benzisoxazole, 1,2-Benzisoxazole-3-methanesulfonamide, zonisamide (medication), ZONISAMIDE, zonisamide [Chemical/Ingredient], zonisamide, Zonisamide (product), Zonisamide (substance), Zonisamide
Spanish zonisamida (producto), zonisamida (sustancia), zonisamida
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Zonegran (C0876224)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C022189
English Zonegran, zonegran, Elan brand of zonisamide
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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