Zonegran

Pronunciation

Generic Name: zonisamide (zoe NIS a mide)
Brand Name: Zonegran

What is zonisamide?

Zonisamide is a sulfa drug with anti-convulsant effects.

Zonisamide is used together with other anti-convulsant medications to treat partial seizures in adults with epilepsy.

Zonisamide may also be used for purposes not listed in this medication guide.

What is the most important information I should know about zonisamide?

You should not use this medication if you are allergic to zonisamide, or to other sulfa drugs such as sulfamethoxazole (Gantanol), sulfisoxazole (Gantrisin), or sulfamethoxazole-trimethoprim (Bactrim, Septra, Sulfatrim, SMX-TMP, and others). A sulfa drug allergic reaction can be fatal.

You may have thoughts about suicide while taking this medication. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

Slideshow: Flashback: FDA Drug Approvals 2013

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Do not stop using zonisamide without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using zonisamide suddenly. You may need to use less and less before you stop the medication completely.

If you need surgery, tell the surgeon ahead of time that you are using zonisamide. You may need to stop using the medicine for a short time.

Wear a medical alert tag or carry an ID card stating that you take zonisamide. Any medical care provider who treats you should know that you take seizure medication.

What should I discuss with my healthcare provider before taking zonisamide?

You should not use this medication if you are allergic to zonisamide, or to other sulfa drugs such as sulfamethoxazole (Gantanol), sulfisoxazole (Gantrisin), or sulfamethoxazole-trimethoprim (Bactrim, Septra, Sulfatrim, SMX-TMP, and others). A sulfa drug allergic reaction can be fatal.

To make sure you can safely take zonisamide, tell your doctor if you have any of these other conditions:

  • liver disease;

  • kidney disease;

  • stomach flu or illness causing diarrhea;

  • a growth disorder;

  • a bone disorder that causes soft or weak bones or low bone mineral density;

  • asthma or other breathing problems;

  • a history of suicidal thoughts or actions; or

  • if you have been on a high-protein, low-carb diet.

You may have thoughts about suicide while taking this medication. Tell your doctor if you have new or worsening depression or suicidal thoughts during the first several months of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

FDA pregnancy category C. Zonisamide can cause metabolic acidosis, which could harm an unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment.

In animal studies, zonisamide caused birth defects and infant death. It is not known whether these effects would occur in people using doses recommended for human use. Ask your doctor about your personal risk.

Zonisamide can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using zonisamide.

Do not give this medication to a child younger than 16 years old without the advice of a doctor.

How should I take zonisamide?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Take zonisamide with a full glass of water. Drink 6 to 8 glasses of water each day to prevent kidney stones while you are taking zonisamide.

Zonisamide can be taken with or without food.

Swallow the zonisamide capsule whole. Do not crush, chew, open, or break it.

While using zonisamide, you may need blood tests at your doctor's office. Visit your doctor regularly.

Seizures are often treated with a combination of drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice.

If you need surgery, tell the surgeon ahead of time that you are using zonisamide. You may need to stop using the medicine for a short time.

Do not stop taking zonisamide without first talking to your doctor, even if you feel fine. Stopping zonisamide suddenly may cause you to have seizures. You may need to use less and less before you stop the medication completely.

If you do stop taking zonisamide for any reason, talk with your doctor before restarting the medication. You may need to restart at a lower dose.

Wear a medical alert tag or carry an ID card stating that you take zonisamide. Any medical care provider who treats you should know that you take seizure medication.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include slow heart rate, feeling light-headed, fainting, and slow or shallow breathing.

What should I avoid while taking zonisamide?

This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how zonisamide will affect you.

Avoid drinking alcohol. It can increase some of the side effects of zonisamide.

Zonisamide side effects

Get emergency medical help if you have any of these signs of an allergic reaction: any form of skin rash; hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have a serious side effect such as:

  • increased or worsening seizures;

  • pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;

  • fever, chills, body aches, flu symptoms, sores in your mouth and throat;

  • severe pain in your lower back, blood in your urine;

  • loss of appetite, tired feeling, problems with thinking or speech, trouble concentrating;

  • feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin without sweating;

  • the first sign of any skin rash, no matter how mild; or

  • severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious side effects may include:

  • drowsiness;

  • dizziness; or

  • loss of balance or coordination.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect zonisamide?

Before using zonisamide, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for depression or anxiety). They can add to sleepiness caused by zonisamide.

Tell your doctor about all other seizure medications you use, especially:

  • carbamazepine (Carbatrol, Equetro, Tegretol);

  • phenobarbital (Solfoton);

  • phenytoin (Dilantin);

  • topiramate (Topamax); or

  • cold or allergy medicine that contains an antihistamine.

This list is not complete and other drugs may interact with zonisamide. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about zonisamide.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 10.01. Revision Date: 2012-03-09, 10:37:32 AM.

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