Seizure disorders:

Indications for: ZONEGRAN

Adjunct in partial seizures.

Adult Dosage:

Swallow whole. ≥16yrs: initially 100mg once daily; may increase at intervals of at least 2 weeks by 100mg/day in 1 or 2 divided doses. Usual range: 100–400mg/day in 1 or 2 divided doses; usual max 600mg/day.

Children Dosage:

<16yrs: not established.

ZONEGRAN Warnings/Precautions:

Discontinue or monitor closely if serious rash occurs. Evaluate immediately if signs/symptoms of DRESS/multi-organ hypersensitivity develop; discontinue if no alternative etiology. Renal failure: not recommended. Renal or hepatic impairment: titrate more slowly and monitor more frequently. Acute myopia. Secondary angle closure glaucoma. Depression. Suicidal tendencies (monitor). Maintain adequate hydration. Exposure to extreme heat; monitor closely for oligohidrosis and hyperthermia (esp. children). Measure baseline serum bicarbonate and periodically during treatment; consider reducing dose or discontinuing if metabolic acidosis occurs. Avoid abrupt cessation. Advise women of childbearing potential to use effective contraception. Elderly. Labor & delivery. Newborns. Pregnancy. Nursing mothers: not recommended.

ZONEGRAN Classification:

Carbonic anhydrase inhibitor (sulfonamide).

ZONEGRAN Interactions:

Antagonized by CYP3A4 inducers (eg, phenytoin, carbamazepine, phenobarbital); may need to adjust zonisamide dose. Increased severity of metabolic acidosis, risk of kidney stone formation or hyperammonemia with concomitant other carbonic anhydrase inhibitors (eg, topiramate, acetazolamide, dichlorphenamide); monitor. Caution with other drugs that interfere with temperature regulation (eg, anticholinergics, carbonic anhydrase inhibitors). Caution with concomitant alcohol, other CNS depressants, or P-gp substrates (eg, digoxin, quinidine).

Adverse Reactions:

CNS effects (eg, somnolence, anorexia, dizziness, headache, agitation, fatigue, ataxia, confusion, difficulty with memory and/or concentration, depression, insomnia, abnormal vision or speech), GI upset/pain, paresthesia; kidney stones, metabolic acidosis, hyperammonemia, encephalopathy; rarely: Stevens-Johnson syndrome, toxic epidermal necrolysis, DRESS, aplastic anemia, agranulocytosis, oligohidrosis, hyperthermia.


To enroll pregnant patients in the North American Antiepileptic Drug Pregnancy Registry, call (888) 233-2334.

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