Methsuximide

Trade Names:
Celontin
- Capsules 150 mg
- Capsules 300 mg

Pharmacology

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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

PO 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

Plasma concentrations may be elevated by methsuximide, increasing the risk of side effects.

Plasma 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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