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ZONISAMIDE 100 MG CAPSULES HARD

Active substance(s): ZONISAMIDE / ZONISAMIDE / ZONISAMIDE

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280 mm
PACKAGE LEAFLET: INFORMATION FOR THE USER
Zonisamide 100 mg, capsules, hard

280 mm

3. How to take Zonisamide

safety of this medicine.

Always take this medicine exactly as your doctor has told you. You should check with your doctor or
pharmacist if you are not sure.

5. How to store Zonisamide

Zonisamide

Keep this medicine out of the sight and reach of children.

The recommended adult dose
Read all of this leaflet carefully before you start taking this medicine because it contains important
information for you.
- Keep this leaflet. You may need to read it again.
- If you have any further questions, ask your doctor or pharmacist.
- This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if
their signs of illness are the same as yours.
- If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not
listed in this leaflet. See section 4.
What is in this leaflet
1. What Zonisamide is and what it is used for
2. What you need to know before you take Zonisamide
3. How to take Zonisamide
4. Possible side effects
5. How to store Zonisamide
6. Contents of the pack and other information
1. What Zonisamide is and what it is used for

Do not use this medicine after the expiry date which is stated on the blister and the carton after EXP. The
expiry date refers to the last day of that month.

When you take Zonisamide on its own:
Ÿ The starting dose is 100 mg taken once a day.
Ÿ This may be increased by up to 100 mg at intervals of two weeks.
Ÿ The recommended dose is 300 mg once a day.

This medicinal product does not require any special storage condition.

When you take Zonisamide with other antiepileptic medicines:
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Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw
away medicines you no longer use. These measures will help to protect the environment.

The starting dose is 50 mg daily taken in two equal doses of 25 mg.
This may be increased by up to 100 mg at intervals of one to two weeks.
The recommended daily dose is between 300 mg and 500 mg.
Some people respond to lower doses. The dose may be increased more slowly if you experience
side effects, are elderly or if you suffer from kidney or liver problems.

6. Contents of the pack and other information
What Zonisamide contains

Use in children (aged 6 to 11 years) and adolescents (aged 12 to 17 years) weighing at least 20 kg:
Ÿ The starting dose is 1 mg per kg of body weight taken once a day.
Ÿ This may be increased by 1 mg per kg of body weight at intervals of one to two weeks.
Ÿ The recommended daily dose is 6 to 8 mg per kg for a child with a body weight of up to 55 kg or 300
to 500 mg for a child with a body weight more than 55 kg (which ever dose is lower) taken once a
day.

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The 100 mg hard capsule shell contains: gelatin, water, titanium dioxide (E171) sunset yellow, (E110),
allura red (E129).

Zonisamide contains the active substance zonisamide, and is used as an antiepileptic medicine.
Zonisamide is used to treat seizures that affect one part of the brain (partial seizure), which may or may not
be followed by a seizure affecting all of the brain (secondary generalisation).
Zonisamide may be used:
Ÿ On its own to treat seizures in adults.
Ÿ With other antiepileptic medicines to treat seizures in adults, adolescents, and children aged 6
years and above.

Example: A child who weighs 25 kg should take 25 mg once a day for the rst week, and then increase the
daily dose by 25 mg at the start of each week until a daily dose between 150 to 200 mg is reached.

What Zonisamide looks like and contents of the pack

If you feel that the effect of Zonisamide is too strong or too weak, talk to your doctor or pharmacist.
Ÿ Zonisamide capsules must be swallowed whole with water.
Ÿ Do not chew the capsules.
Ÿ Zonisamide can be taken once or twice daily, as instructed by your doctor.
Ÿ It you take Zonisamide twice a day, take half the daily dose in the morning and half in the evening.

Zonisamide hard capsules contain 100 mg of zonisamide.
Each 100 mg capsule are Red-White opaque coloured hard gelatin capsules of size “1” imprinted with “I”
on cap and “20” on body with black ink containing white to off white powder.
Capsule size approximately 19.30 mm ± 0.4 mm.

If you take more Zonisamide than you should
2. What you need to know before you take Zonisamide
Do not take Zonisamide
Ÿ if you are allergic to zonisamide or any of the other ingredients of this medicine (listed in section
6),
Ÿ if you are allergic to other sulphonamide medicines. Examples include: sulphonamide antibiotics,
thiazide diuretics, and sulfonylurea antidiabetes medicines.

If you may have taken more Zonisamide than you should, tell a carer (relative or friend), your doctor or
pharmacist immediately, or contact your nearest hospital casualty department, taking your medicine with
you. You may become sleepy and could lose consciousness. You might also feel sick, have a sore stomach,
muscle twitches, eye movement, feel faint, have a slowed heart beat, and reduced breathing and kidney
function. Do not try to drive.

Zonisamide 100 mg: Clear PVC /PVdC/ Aluminum blister pack of 14, 28, 56, 84, 98 and 196 hard capsules.
Not all pack sizes may be available.
Marketing Authorisation Holder and Manufacturer

If you forget to take Zonisamide
Warnings and precautions
Zonisamide belongs to a group of medicines (sulphonamides) which can cause severe allergic reactions,
severe skin rashes, and blood disorders, which very rarely can be fatal (see section 4. Possible Side Effects).

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The Marketing Authorisation Holder
WARREN GENERICS s.r.o.
U Staré tvrze 285/21,
196 00 Praha 9,
Czech Republic

If you forget to take a dose, don't worry: take the next dose when it is due.
Do not take double the dose to make up for the forgotten dose.

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If your doctor advises you to stop taking Zonisamide your dose will be reduced gradually to lower
the risk of more seizures.

Like all medicines, Zonisamide can cause side effects, although not everybody gets them.
Zonisamide belongs to a group of medicines (sulphonamides) that can cause severe allergic reactions,
severe skin rashes, and blood disorders, which very rarely can be fatal.

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Talk to your doctor about the following risks:
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have difficulty breathing, a swollen face, lips or tongue, or a severe skin rash as these symptoms
may indicate that you are having a severe allergic reaction.
have signs of overheating - high body temperature but little or no sweating, rapid heartbeat and
breathing, muscle cramps, and confusion.
have thoughts of harming or killing yourself. A small number of people being treated with antiepileptics such as Zonisamide have had thoughts of harming or killing themselves.
have pain in your muscles or a feeling of weakness, as this may be a sign of abnormal muscle
breakdown which can lead to kidney problems.
get a sudden pain in your back or stomach, have pain on urinating (passing water) or notice blood
in your urine, as this may be a sign of kidney stones.

When your child is taking Zonisamide:
Ÿ Keep your child cool especially in hot weather
Ÿ Your child must avoid heavy exercise especially when the weather is hot
Ÿ Give your child plenty of cold water to drink
Ÿ Your child must not take these medicines:
carbonic anhydrase inhibitors (like topiramate and acetazolamide), and anticholinergic agents
(like clomipramine, hydroxyzine, diphenhydramine, haloperidol, imipramine and oxybutynin).

Contact your doctor as soon as possible if you:

If your child's skin feels very hot with little or no sweating, becomes confused, has muscle cramps, or your
child's heartbeat or breathing becomes rapid:
Ÿ Take your child to a cool, shaded place
Ÿ Sponge your child's skin with cool (not cold) water
Ÿ Give your child cold water to drink
Ÿ Seek urgent medical assistance.
Ÿ Body weight: You should monitor your child's weight every month and see your doctor as soon as
possible if your child is not gaining enough weight. Zonisamide is not recommended for children
who are underweight or have a small appetite, and should be used with caution in those below 20
kg.

Your doctor may decide that you should stop using Zonisamide.

Other medicines and Zonisamide
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines,
including medicines obtained without a prescription.
Ÿ Zonisamide should be used carefully in adults when taken with medicines that can cause kidney
stones, like topiramate or acetazolamide. In children, this combination is not recommended
Ÿ Zonisamide could possibly increase your blood levels of medicines like digoxin and quinidine,
and so a reduction in their dose may be required.
Ÿ Other medicines like phenytoin, carbamazepine, phenobarbitone and rifampicin can decrease
your blood levels of Zonisamide, which may require an adjustment of your dose of Zonisamide.
Zonisamide with food and drink
Zonisamide can be taken with or without food.
Pregnancy, breast-feeding and fertility
If you are a woman of childbearing age you must use adequate contraception while taking and for one
month after stopping Zonisamide.
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your
doctor for advice before taking this medicine.>
You must only take Zonisamide during your pregnancy if your doctor tells you to. Research has shown an
increased risk of birth defects in children of women taking anti-epileptic medicines.

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Very common side effects: may affect more than 1 in 10 people
Ÿ agitation, irritability, confusion, depression
Ÿ poor muscle coordination, dizziness, poor memory, sleepiness, double vision
Ÿ loss of appetite, decreased blood levels of bicarbonate (a substance that prevents your blood from
becoming acidic)
Common side effects: may affect up to 1 in 10 people

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difficulty sleeping, strange or unusual thoughts, feeling anxious or emotional.
slowed thoughts, loss of concentration, speech abnormalities, abnormal skin sensation (pins and
needles), tremor, involuntary movement of the eyes.
kidney stones.
skin rashes, itching, allergic reactions, fever, tiredness, flu-like symptoms, hair loss.
ecchymosis (a small bruise caused by blood leaking from broken blood vessels in the skin).

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loss of weight, nausea, indigestion, stomach pains, diarrhoea (loose stools), constipation.
swelling of the feet and legs.

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Uncommon side effects: may affect up to 1 in 100 people
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anger, aggression, thoughts of suicide, suicide attempt.
vomiting.
gall bladder inflammation, gallstones.
urinary stones.
lung infection / inflammation, urinary tract infections.
low blood potassium levels, convulsions/seizures.

Very rare side effects: may affect up to 1 in 10,000 people
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Do not breastfeed whilst taking, or for one month after stopping Zonisamide.
There are no clinical data available on the effects of zonisamide on human fertility. Studies in animals have
shown changes in fertility parameters.

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Zonisamide may affect your concentration, ability to react/respond, and may make you feel sleepy,
particularly at the beginning of your treatment or after your dose is increased. Be especially careful while
driving or operating machinery, if Zonisamide affects you in this way.

have an unexplained skin rash, as this could develop into a more severe skin rash or skin peeling.
feel unusually tired or feverish, have a sore throat, swollen glands, or find that you bruise more
easily, as this may mean you have a blood disorder.
have signs of increased acid level in the blood- headaches, drowsiness, shortness of breath and loss
of appetite. Your doctor may need to monitor or treat this.

The most common side effects of Zonisamide are mild. They occur during the first month of treatment and
usually decrease with continued treatment. In children ages 6 – 17 years old, side effects were consistent
with those described below with the following exceptions: pneumonia, dehydration, sweating decreased
(common) and abnormal liver enzymes (uncommon).

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Driving and using machines

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hallucinations, memory loss, coma, neuroleptic malignant syndrome (inability to move, sweating,
fever, incontinence), status epilepticus (prolonged or repeated seizures).
breathing disorders, shortness of breath, inflammation of the lungs.
inflammations of the pancreas (severe pain in the stomach or back)
liver problems, kidney failure, increased blood levels of creatinine (a waste product that your
kidneys should normally remove). .
severe rashes or skin peeling (at the same time you may feel unwell or develop a fever).
abnormal muscle breakdown (you may feel pain or weakness in your muscles) which can lead to
kidney problems.
swollen glands, blood disorders (reduction in the number of blood cells, which can make infection
more likely and can make you look pale, feel tired and feverish, and bruise more easily).
decreased sweating, overheating.

Reporting of side effects
Zonisamide contains sunset yellow (E110) and allura red (E129)
Zonisamide 100 mg hard capsules contain a yellow color called sunset yellow (E110) and a red color allura
red (E129), which may cause allergic reactions

This leaflet was last revised in September 2016

Contact your doctor immediately if you:

Children and adolescents

Increased acid level in the blood and kidney stones: Reduce these risks by ensuring that your child
drinks enough water and is not taking any other medicine which could cause kidney stones (see
Other medicines). Your doctor will monitor your child's blood bicarbonate levels and kidneys (see
also section 4).
Do not give this medicine to children below the age of 6 years because it is not known for this age group
whether the potential benefits are greater than the risks.

Wessling Hungary Kft.
Fóti út 56,
1047, Budapest,
Hungary

4. Possible side effects

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Manufacturer
IMUNA PHARM, a.s.
Jarková 269/17,
082 22, Šarišské Michaľany,
Slovak Republic

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

If any of these applies to you, tell your doctor before you take Zonisamide.

Preventing overheating and dehydration in children
Zonisamide can cause your child to sweat less and overheat and if your child is not treated this can lead to
brain damage and death. Children are most at risk especially in hot weather.

Zonisamide is meant to be taken as a long-term medicine. Do not reduce your dose or stop your
medicine unless your doctor tells you to.

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not
listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme, website
www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the

470 mm

470 mm

If you stop taking Zonisamide
Serious rashes occur in association with Zonisamide therapy, including cases of Stevens-Johnson
syndrome.
Talk to your doctor or pharmacist before taking Zonisamide capsules:
Ÿ if you are younger than 12 years old, as you may be at greater risk of decreased sweating, heat
stroke, pneumonia and liver problems. If you are younger than 6 years old, Zonisamide is not
recommended for you.
Ÿ if you are elderly, as your dose of Zonisamide may need adjusting, and you may be more likely to
develop an allergic reaction, severe skin rash, swelling of the feet and legs, and itchiness when
taking Zonisamide (see section 4 Possible Side Effects).
Ÿ if you suffer from liver problems, as your dose of Zonisamide may need adjusting.
Ÿ if you suffer from kidney problems as your dose of Zonisamide may need adjusting.
Ÿ if you have previously suffered from kidney stones, as you may be at increased risk of developing
more kidney stones. Reduce the risk of kidney stones by drinking sufficient water.
Ÿ if you live in a place or are on holiday in a place where the weather is warm. Zonisamide can make
you perspire less, which can cause your body temperature to increase. Reduce the risk of
overheating by drinking sufficient water and keeping cool.
Ÿ if you are underweight, or have lost a lot of weight as Zonisamide can cause you to lose more
weight. Tell your doctor as this may need to be monitored.

The active substance is zonisamide. Each hard capsule contains 100 mg zonisamide.
The other ingredients are present in the capsule contents are: cellulose microcrystalline,
hydrogenated vegetable oil, sodium laurilsulfate and silica colloidal anhydrous.

Expand Transcript

Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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