Drug Interaction Report

MONITOR: Coadministration with drugs that are inducers of CYP450 3A4 may decrease the plasma concentrations and pharmacologic effects of zonisamide, which is primarily metabolized by the isoenzyme.

MANAGEMENT: Pharmacologic response to zonisamide should be monitored more closely whenever a CYP450 3A4 inducer is added to or withdrawn from therapy, and the zonisamide dosage adjusted as necessary. Patients should be advised to notify their physician if they experience loss of seizure control.

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.