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Zarontin (ethosuximide) Disease Interactions

There are 5 disease interactions with Zarontin (ethosuximide):

Major

Succinimides (Includes Zarontin) ↔ Blood Dyscrasias

Severe Potential Hazard, Low plausibility

Applies to: Bone Marrow Depression/Low Blood Counts

Hematologic toxicities, some with fatal outcome, have been associated with the use of succinimide anticonvulsants. Leukopenia, agranulocytosis, aplastic anemia, thrombocytopenia, pancytopenia, and eosinophilia have been reported. Therapy with succinimide anticonvulsants should be administered cautiously in patients with preexisting blood dyscrasias and/or bone marrow suppression. Complete blood counts, including platelets, should be performed prior to initiating therapy and periodically during therapy. Marked depression of blood counts may be indication for withdrawal of succinimide therapy.

References

  1. "Product Information. Celontin Kapseals (methsuximide)." Parke-Davis, Morris Plains, NJ.
  2. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  3. "Product Information. Milontin (phensuximide)." Parke-Davis, Morris Plains, NJ.
View all 6 references
Major

Succinimides (Includes Zarontin) ↔ Renal/Liver Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease, Renal Dysfunction

Succinimide anticonvulsants have produced morphological and functional changes in the liver of animals. In humans, abnormalities in liver and renal function studies have been reported. Therapy with succinimide anticonvulsants should be administered with extreme caution in patients with known hepatic or renal diseases. Periodic urinalysis and liver function tests are recommended for all patients treated with these drugs.

References

  1. "Product Information. Milontin (phensuximide)." Parke-Davis, Morris Plains, NJ.
  2. "Product Information. Zarontin (ethosuximide)." Parke-Davis, Morris Plains, NJ.
  3. Korinthenberg R, Wehrle L, Zimmerhackl LB "Renal tubular dysfunction following treatment with anti-epileptic drugs." Eur J Pediatr 153 (1994): 855-8
View all 6 references
Major

Succinimides (Includes Zarontin) ↔ Sle

Severe Potential Hazard, Moderate plausibility

Applies to: Lupus Erythematosus

Cases of systemic lupus erythematosus (SLE) have been reported in association with the use of succinimide anticonvulsants, primarily ethosuximide. Some of the patients recovered promptly following discontinuation of the drug, while others continued to have active disease long after. Therapy with succinimide anticonvulsants should be administered cautiously in patients with a history of SLE.

References

  1. Singsen BH, Fishman L, Hanson V "Antinuclear antibodies and lupus-like syndromes in children receiving anticonvulsants." Pediatrics 57 (1976): 529-34
  2. Livingston S, Rodriguez H, Greene CA, Pauli LL "Systemic lupus erythematosus. Occurrence in association with ethosuximide therapy." JAMA 203 (1968): 731-2
  3. Teoh PC, Chan HL "Lupus-scleroderma syndrome induced by ethosuximide." Arch Dis Child 50 (1975): 658-61
View all 9 references
Moderate

Antiepileptics (Includes Zarontin) ↔ Suicidal Tendency

Moderate Potential Hazard, Moderate plausibility

Applies to: Depression, Psychosis

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs across multiple indications in either monotherapy or adjunctive therapy for a median treatment duration of 12 weeks (up to a maximum of 24 weeks) showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. The estimated rate of suicidal behavior or ideation among 27,863 AED-treated patients was 0.43%, compared to 0.24% for 16,029 placebo-treated patients, representing an increase of approximately one case for every 530 patients treated. There were four suicides in AED-treated patients and none in placebo-treated patients, although the number is too small to establish any causal relationship. The increased risk of suicidal thoughts or behavior was observed as early as one week after starting AEDs and persisted for the duration of treatment assessed. The risk did not vary substantially by age (5 to 100 years) in the clinical trials analyzed. Therapy with AEDs should be administered cautiously in patients with depression or other psychiatric disorders. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. For clinically significant or persistent symptoms, a dosage reduction or treatment withdrawal should be considered. If patients have symptoms of suicidal ideation or behavior, treatment should be discontinued.

Moderate

Ethosuximide (Includes Zarontin) ↔ Dialysis

Moderate Potential Hazard, High plausibility

Applies to: hemodialysis

Ethosuximide has been shown to be removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis.

References

  1. Marbury TC, Lee CSC, Perchalski RJ, Wilder BJ "Hemodialysis clearance of ethosuximide in patients with chronic renal disease." Am J Hosp Pharm 38 (1981): 1757-60

Zarontin (ethosuximide) drug Interactions

There are 611 drug interactions with Zarontin (ethosuximide)

Zarontin (ethosuximide) alcohol/food Interactions

There is 1 alcohol/food interaction with Zarontin (ethosuximide)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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