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Zonegran is an antiepileptic drug, used to treat cases of partial seizures alone or in combination. To understand more about the ingredients, uses and how to use Zonegran, please refer to the article below.1. What does Zonegran do?
Zonegran medicine has the main ingredient is Zonisamide 100mg, prepared in tablet form. Zonisamide is a Benzisoxazole derivative with antiepileptic activity with weak carbonic anhydrase activity.
The main mechanism of action of Zonisamide has not been fully studied. Zonisamide can disrupt the synchronous activation of neurons, reduce the propagation of seizures, and thereby prevent further seizures. Zonisamide also has the other effect of inhibiting GABA-mediated neurons.
2. Indications and contraindications of the drug Zonegran
Indications:
Zonegran can be used as monotherapy or as adjunctive therapy in the treatment of partial onset seizures (partial seizures) in adults, adolescents and children from 6 years and older. Do not use Zonegran for the following cases:
Hypersensitivity to the main active ingredient Zonisamide, sulphonamide group substances or to any of the excipients of the drug. Do not use if you are allergic to peanuts or soy.
3. How to use and dose Zonegran
Focal (partial) onset epilepsy:
Initial oral dose is 100mg/day. Dosage may be increased to 200 mg/day 2 weeks after initiation. Subsequent doses may be increased to 300 and 400 mg/day thereafter. Dose adjustments can be made with a minimum of 2 weeks between titrations, in order to reach steady state at each dose level. How to stop treatment with Zonisamide:
In long-term therapy, when stopping the drug should be tapered to minimize the possibility of increased seizure frequency (in patients with epilepsy) and reduce withdrawal symptoms (dysphagia, hallucinations, headache, insomnia, tremor). For seizure disorders, some experts recommend reducing the dose of antiepileptic drugs over one to several months.
4. Side effects of the drug Zonegran
When taking the drug you may experience side effects including:
Central nervous system: Drowsiness, dizziness, headache, agitation, irritability, fatigue, confusion, depression, insomnia, lack of exercise psychosis, memory impairment, speech disorder, ataxia, reduced mental vision, anxiety, nervousness, schizophrenia, convulsions, hypertonia, convulsions, status epilepticus , lower blood pressure, increased body temperature; Gastrointestinal: Anorexia, nausea, abdominal pain, diarrhea, dyspepsia, weight loss, constipation, xerostomia, vomiting; Cardiovascular: Edema in the face; Dermatology: Skin rash, bruising, pruritus, hypohidrosis seen in children, Stevens-Johnson syndrome, toxic epidermal necrolysis. Other: Metabolic acidosis, leukopenia, aplastic anemia, paresthesia, abnormal gait, tremor, weakness, presbyopia, nystagmus, amblyopia, tinnitus, kidney stones, increased urea nitrogen blood, rhinitis, cough, pharyngitis, flu-like syndrome. During the course of taking the medicine, if you experience any side effects, you should tell your doctor or see a doctor if the side effects are serious.
5. Things to keep in mind when using Zonegran
Serious rashes have been reported in association with Zonegran therapy, including cases of Stevens-Johnson syndrome. Discontinuation of Zonegran should be considered in patients with an unexplained rash. All patients who develop a rash while taking Zonegran should be closely monitored. Glaucoma can cause a syndrome including acute myopia in both adults and children taking Zonegran. Symptoms of angle-closure glaucoma can occur hours to weeks after starting treatment, with symptoms including acute onset of decreased vision or eye pain. The drug should be stopped and examined immediately, as this condition can cause permanent vision loss in the long run. According to current clinical practice studies, discontinuation of Zonegran in patients with epilepsy should be accomplished by gradual dose reduction, to reduce the likelihood of seizures occurring upon discontinuation. Taking Zonegran may cause weight loss. An adequate dietary supplement or increased food intake may need to be taken if the patient loses or is underweight while taking this medicine. If significant unwanted weight loss occurs, Zonegran should be discontinued. Weight loss may be more severe in children. Patients receiving Zonegran who develop clinical signs of pancreatitis should have their pancreatic lipase and amylase levels monitored. If pancreatitis is identified in the absence of another obvious cause, Zonegran should be discontinued and appropriate therapy initiated for the pancreatitis. Rhabdomyolysis: For people taking Zonegran, if signs such as severe muscle pain or weakness develop, with or without fever, should be evaluated for signs of muscle damage, including creatine levels. phosphokinase and aldolase in serum. If the indices are elevated, in the absence of other causes such as trauma or major epileptic seizures, it is recommended that Zonegran be discontinued and appropriate therapy initiated. Closely monitor the patient's suicidal behavior, especially children and adolescents need supervision to detect self-harm behavior early. Taking medication can increase the risk of kidney stones, so you need to use more water to prevent this risk. Because the drug has a negative effect on pregnancy and lactation, it is recommended not to use it, only use it when absolutely necessary and stop breastfeeding during use. For women of childbearing potential, it is necessary to ensure effective contraception during and 1 month after taking the pill.
6. Drug interactions
Interactions of Zonegran with other drugs reported include:
Caution when co-administering Zonisamide with carbonic anhydrase inhibitors including Topiramate, Acetazolamide in adults and the combination of these two drugs should not be used. in pediatric patients. Caution should be exercised when treating Zonegran in patients taking drugs that are P-gp substrates such as Digoxin, quinidine If it is necessary to co-administer Zonegran with inducers of CYP3A4 enzymes such as Phenytoin, Carbamazepine, Phenobarbitone, the patient should be closely monitored and dose adjusted as necessary. Zonegran is used under a doctor's prescription, so you should not use it yourself. During the course of taking the drug, it is necessary to conduct re-examination and monitor the body's signs regularly.
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