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Zonegran (zonisamide) 

Indications 

• Zonegran is prescribed to treat epilepsy by reducing the frequency and severity of seizures. 
• It is used as an adjunctive therapy for partial seizures in adults with epilepsy. 
• Zonegran may also be used to manage seizures associated with Lennox-Gastaut syndrome, a severe form of childhood epilepsy. 
• Additionally, it is sometimes prescribed off-label to prevent migraine headaches. 

Dosage and Administration 

• Take Zonegran exactly as prescribed by your doctor. 
• Swallow the capsule whole with a full glass of water. 
• Maintain a consistent schedule for taking Zonegran to optimize its effectiveness. If you miss a dose, take it as soon as you remember, but do not double the dose to catch up. 
• Inform your doctor if you experience any changes in your seizure pattern or if you have new types of seizures.
• Do not crush, chew, or open the capsules, as this may alter the drug’s release mechanism. 
• Avoid suddenly stopping Zonegran without consulting your doctor, as this could lead to increased seizure activity. 
• Do not consume alcohol while taking Zonegran, as it may increase the risk of side effects. 
• Do not drive or operate heavy machinery until you know how Zonegran affects you, as it may cause dizziness or drowsiness. 

Mechanism of Action 

Zonisamide, the active ingredient in Zonegran, works by stabilizing the electrical activity in the brain, which helps prevent seizures. It does this by blocking sodium and calcium channels, thereby reducing the abnormal electrical activity that can lead to seizures. 

Contraindications 

• Do not take Zonegran if you are allergic to zonisamide or any components of the capsules. 
• Avoid Zonegran if you have a history of sulfa allergy, as zonisamide contains a sulfonamide moiety. 
• Do not use Zonegran if you have a history of kidney stones or kidney problems without consulting your doctor. 
• Avoid Zonegran if you are pregnant or planning to become pregnant, as it may harm the fetus. 
• Inform your doctor if you have liver disease or any other medical conditions before starting Zonegran. 

Side Effects 

Common Side Effects 

• Dizziness 
• Drowsiness 
• Loss of appetite 
• Nausea 
• Diarrhea 
• Fatigue 

Serious Side Effects 

• Suicidal thoughts or behaviors 
• Skin rash or allergic reactions 
• Fever or flu-like symptoms 
• Changes in mood or behavior 
• Difficulty breathing or swallowing 
• Persistent headache or vision changes 

Precautions 

• Monitor for signs of suicidal thoughts or behaviors, especially when starting or changing the dose of Zonegran. 
• Inform your doctor if you have a history of depression or mood disorders. 
• Stay hydrated and drink plenty of fluids to reduce the risk of kidney stones while taking Zonegran. 
• Report any unusual symptoms or side effects to your healthcare provider promptly. 
• Use effective contraception if you are of childbearing age and sexually active. 

Storage Instructions 

• Store Zonegran capsules at room temperature, below 30°C (86°F). 
• Keep the capsules in their original container, tightly closed, and away from moisture and light. 
• Keep out of reach of children and pets. 
• Do not use Zonegran if it has expired or if the capsules appear damaged or discolored. 
• Dispose of any unused or expired medication properly, following local regulations. 

References 

https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/020789s034lbl.pdf