Zonegran (zonisamide) Disease Interactions

There are 5 disease interactions with Zonegran (zonisamide):

The use of sulfonamides has been associated with hematologic toxicity, including methemoglobinemia, sulfhemoglobinemia, leukopenia, granulocytopenia, eosinophilia, hemolytic anemia, aplastic anemia, purpura, clotting disorder, thrombocytopenia, hypofibrinogenemia, and hypoprothrombinemia. Acute dose-related hemolytic anemia may occur during the first week of therapy due to sensitization or glucose-6-phosphate dehydrogenase (G-6-PD) deficiency, while chronic hemolytic anemia may occur with prolonged use. Therapy with sulfonamides should be administered cautiously in patients with preexisting blood dyscrasias or bone marrow suppression. Complete blood counts should be obtained regularly, especially during prolonged therapy (>2 weeks), and patients should be instructed to immediately report any signs or symptoms suggestive of blood dyscrasia such as fever, sore throat, local infection, bleeding, pallor, dizziness, or jaundice.

The use of sulfonamides is associated with large increases in the risk of Stevens-Johnson syndrome, toxic epidermal necrolysis and other serious dermatologic reactions, although these phenomena are rare as a whole. Hepatitis, pneumonitis, and interstitial nephritis have also occurred in association with sulfonamide hypersensitivity. Therapy with sulfonamides should be administered cautiously in patients with severe allergies, bronchial asthma or AIDS, since these patients may be at increased risk for potentially severe hypersensitivity reactions. Patients should be instructed to promptly report signs and symptoms that may precede the onset of cutaneous manifestations of the Stevens-Johnson syndrome, such as high fever, severe headache, stomatitis, conjunctivitis, rhinitis, urethritis, and balantitis. Sulfonamide therapy should be stopped at once if a rash develops.

Oligohydrosis has been reported in pediatric patients (ages 1.6 to 17 years) treated with zonisamide at a rate of 12 per million patient-years of exposure. Temperatures in reported cases ranged from 37 to 42 C. Because decreased sweating may be accompanied by elevated body temperature, especially in the summer, body temperature should be carefully monitored. Therapy with zonisamide should be administered with extreme caution if prescribed to pediatric patients with a fever. Zonisamide is not approved for use in pediatric patients in the U.S.

Zonisamide is converted by the liver to inactive metabolites and subsequently eliminated by the kidney. Approximately 35% of a dose is excreted in the urine as unchanged drug. The plasma clearance of zonisamide may be decreased and the half-life prolonged in patients with impaired renal and/or hepatic function. However, clinical data are lacking in the latter. Therapy with zonisamide should be administered cautiously in patients with renal and/or hepatic disease. Dosage reductions and slower titration may be appropriate in those with significant impairment.

The use of zonisamide may infrequently be associated with the development of nephrolithiasis. The reported incidence for clinically possible or confirmed kidney stones was 4.0% (40 of 991 patients) during premarketing use, representing a rate of 34 per 1000 patient-years of exposure (40 patients with 1168 years of exposure). Therapy with zonisamide should be administered cautiously with adequate hydration in patients with a history of nephrolithiasis. Patients who are dehydrated may be at increased risk for the development of nephrolithiasis and should be encouraged to consume additional amounts of liquid during zonisamide therapy.

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Zonegran (zonisamide) drug Interactions

There are 553 drug interactions with Zonegran (zonisamide)

Zonegran (zonisamide) food/lifestyle Interactions

There is 1 food/lifestyle interaction with Zonegran (zonisamide)

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