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Zonisamide Dosage

This dosage information may not include all the information needed to use Zonisamide safely and effectively. See additional information for Zonisamide.

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Seizures

For use as adjunctive therapy in the treatment of partial seizures:

Initial Dose: 100 mg once a day. After two weeks, the dose may be increased to 200 mg/day as either a single or divided dose (100 mg BID) for at least two weeks. It can then be increased to 300 mg/day, then 400 mg/day either as a single daily dose or divided into two daily doses, with the dose stable for at least two weeks to achieve steady state at each level.

Although this regimen is one that has been shown to be tolerated, the prescriber may wish to prolong the duration of treatment at the lower doses in order to fully assess the effects of zonisamide at steady state (noting that many of the side effects of zonisamide are more frequent at doses of 300 mg per day and above). Although there is some evidence of greater response at doses above 100 to 200 mg/day, the increase appears small and formal dose-response studies have not been conducted.

A chart review of 77 patients treated with zonisamide as monotherapy for 6 to 180 months concluded that long-term zonisamide monotherapy was efficacious in a wide range of patients with epilepsy. The authors of the article on this chart review further noted that zonisamide did not seem to exhibit a reduction in efficacy during long term use of up to 180 months.

Evidence from controlled trials suggests that zonisamide doses of 100 to 600 mg/day are effective, but there is no suggestion of increasing response above 400 mg/day.

Usual Pediatric Dose for Seizures

Safety and efficacy in pediatric patients below the age of 16 have not been established.

>=16 years: For use as adjunctive therapy in the treatment of partial seizures:

Initial Dose: 100 mg once a day. After two weeks, the dose may be increased to 200 mg/day as either a single or divided dose (100 mg BID) for at least two weeks. It can then be increased to 300 mg/day, then 400 mg/day either as a single daily dose or divided into two daily doses, with the dose stable for at least two weeks to achieve steady state at each level.

Although this regimen is one that has been shown to be tolerated, the prescriber may wish to prolong the duration of treatment at the lower doses in order to fully assess the effects of zonisamide at steady state (noting that many of the side effects of zonisamide are more frequent at doses of 300 mg per day and above). Although there is some evidence of greater response at doses above 100-200 mg/day, the increase appears small and formal dose-response studies have not been conducted.

Evidence from controlled trials suggests that zonisamide doses of 100-600 mg/day are effective, but there is no suggestion of increasing response above 400 mg/day.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

The prescriber should be aware that, because of the long half-life of zonisamide, up to two weeks may be required to achieve steady state levels upon reaching a stable dose or following dosage adjustment.

If metabolic acidosis develops and persists, consideration should be given to reducing the dose of zonisamide, or to discontinuing zonisamide using dose tapering and modifying the treatment as appropriate. If the decision is made to continue patients with persistent acidosis on zonisamide, then alkali treatment should be considered.

Precautions

Zonisamide is contraindicated in patients who have demonstrated hypersensitivity to sulfonamides.

Dialysis

Data not available

Other Comments

Zonisamide is given orally and can be taken with or without food. Capsules should be swallowed whole.

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