Methsuximide
Pronunciation: (Meth-SUCK-sih-mide)Class: Succinimide
Trade Names:
Celontin
- Capsules 150 mg
- Capsules 300 mg
Pharmacology
Elevates seizure threshold and suppresses paroxysmal spike wave activity associated with lapses of consciousness common in absence (petit mal) seizures.
Pharmacokinetics
Absorption
T max is 1 to 4 h and is readily absorbed.
Elimination
The t ½ is 2.6 to 4 h. Less than 1% recovered unchanged in urine.
Indications and Usage
Control of absence (petit mal) seizures that are refractory to other drugs.
Contraindications
Hypersensitivity to succinimides.
Dosage and Administration
Adults and Children Initial dosePO 300 mg/day for the first week. Dosage may be increased at weekly intervals by 300 mg/day (max, 1,200 mg/day).
Storage/Stability
Store capsules at controlled room temperature (59° to 86°F). Protect from moisture and light.
Drug Interactions
Hydantoins (eg, phenytoin), phenobarbitalPlasma concentrations may be elevated by methsuximide, increasing the risk of side effects.
LamotriginePlasma concentrations may be reduced by methsuximide, decreasing the therapeutic effects.
Laboratory Test Interactions
None well documented.
Adverse Reactions
Cardiovascular
Hyperemia.
CNS
Drowsiness; ataxia; dizziness; irritability; nervousness; headache; insomnia; confusion; instability; mental slowness; depression; hypochondriacal behavior; auditory hallucinations; aggressiveness.
Dermatologic
Urticaria; Stevens-Johnson syndrome; pruritic erythematous rash.
EENT
Periorbital edema; blurred vision.
GI
Nausea; vomiting; anorexia; diarrhea; weight loss; epigastric and abdominal pain; constipation; hiccups.
Genitourinary
Proteinuria; microscopic hematuria.
Hematologic
Eosinophilia; leukopenia; monocytosis; pancytopenia (with and without bone marrow suppression).
Miscellaneous
Photophobia.
Precautions
Pregnancy
Category C . Anticonvulsant drugs have been associated with an increase in the incidence of birth defects.
Lactation
Undetermined.
Renal Function
Use with caution.
Hepatic Function
Use with caution.
Dosage adjustment
Proceed slowly when increasing or decreasing the dose; do not withdraw drug abruptly as this may precipitate absence (petit mal) seizures.
Hematologic
Blood dyscrasias, including fatal cases, have occurred.
Systemic lupus
Systemic lupus has occurred.
Overdosage
Symptoms
Nausea, vomiting, CNS depression (including coma with respiratory depression).
Patient Information
- Instruct patient to take exactly as prescribed and to not change the dose or stop taking unless advised by health care provider.
- Advise patient that dose may be gradually increased no more often than every week until max benefit is achieved.
- Advise patient to swallow capsule whole and to not chew or break the capsule.
- Advise patient that each dose may be taken without regard to meals but to take with food if GI upset occurs.
- Advise patient that if a dose is missed to take it as soon as possible. Caution patient that if several hours have passed or it is nearing time for the next dose not to double the dose in an effort to catch up and to take the next dose as scheduled.
- Advise patient that if medication needs to be discontinued it will be slowly withdrawn over a period of several weeks unless safety concerns (eg, rash) require a more rapid withdrawal.
- Caution patient that drug may cause drowsiness, dizziness, or blurred vision and to use caution while driving or performing other tasks requiring mental alertness until tolerance is determined.
- Instruct patient to contact health care provider immediately if any of the following occur: rash; joint pain; fever, sore throat, or other signs of infection; unusual bruising or bleeding; depression; aggressive behavior or other behavioral changes.
- Instruct patient to inform health care provider if seizures get worse of if new types of seizures occur.
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More Methsuximide resources
methsuximide Drug Interactions
methsuximide - Includes detailed dosage instructions.
