Zonegran 25 mg capsule

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Medication name

Generic name:
Zonisamide - oral

Pronunciation
(zoh-NISS-uh-mide)

Brand name(s)
Zonegran , Zonisade

Uses

Zonisamide is used with other medications to prevent and control seizures (epilepsy). Zonisamide is a sulfonamide anticonvulsant and a carbonic anhydrase inhibitor. It is unknown how zonisamide works to prevent seizures.

How to use

Read the Medication Guide provided by your pharmacist before you start taking zonisamide and each time you get a refill. If you have any questions, consult your doctor or pharmacist.

Take this medication by mouth with or without food as directed by your doctor, usually 1 to 2 times a day. To prevent kidney stones from forming, drink plenty of liquids while taking this medication unless your doctor instructs you otherwise.

If you are using the capsule form of this medication, swallow the capsules whole.

If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. Shake the bottle well before each dose.

Dosage is based on your medical condition and response to treatment. It is very important to follow your doctor's dosing instructions exactly. Your doctor will start you on a low dose and slowly increase your dose. It may take several weeks or months to reach the best dose for you and to get the full benefit from this medication.

Use this medication regularly to get the most benefit from it. This drug works best when the amount of medicine in your body is kept at a constant level. To help you remember and to keep a constant level, take zonisamide at the same time(s) each day.

Do not stop taking this medication without consulting your doctor. Some conditions may become worse when the drug is suddenly stopped. Your dose may need to be gradually decreased.

Tell your doctor if your condition does not improve or if it worsens.

Side effects

Dizziness, drowsiness, trouble sleeping, lack of coordination, lightheadedness, loss of appetite, diarrhea, or double vision may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including:

  • mental/mood problems (such as confusion, difficulty concentrating, memory problems, agitation, irritability)
  • speech problems
  • decreased sweating
  • sudden back/side/abdominal pain
  • painful urination

A small number of people who take anticonvulsants for any condition (such as seizure, bipolar disorder, pain) may experience depression, suicidal thoughts/attempts, or other mental/mood problems. Tell your doctor right away if you or your family/caregiver notice any unusual/sudden changes in your mood, thoughts, or behavior including signs of depression, suicidal thoughts/attempts, thoughts about harming yourself.

This medication may cause a serious metabolic problem (metabolic acidosis). Get medical help right away if you have any of the following symptoms:

  • bone pain
  • rapid breathing
  • fast/irregular heartbeat
  • sudden/unexplained tiredness
  • severe drowsiness/difficulty staying awake

Get medical help right away if you have any very serious side effects, such as:

  • easy bruising/bleeding
  • eye pain/redness
  • vision changes (such as decreased vision, blurred vision)
  • signs of kidney problems (such as change in the amount of urine, pink/bloody urine)
  • signs of liver problems (such as nausea/vomiting that doesn't stop, loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark urine)

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

  • fever
  • swollen lymph nodes
  • rash
  • itching/swelling (especially of the face/tongue/throat)
  • severe dizziness
  • trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking zonisamide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

  • liver disease
  • kidney disease (such as kidney stones)
  • lung/breathing problems
  • long-term diarrhea
  • metabolic imbalance (metabolic acidosis)
  • a special diet (ketogenic diet)
  • mental/mood problems (such as depression, psychosis)

This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This medication may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest. Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness.

Older adults may be more sensitive to the side effects of this drug, especially dizziness, lightheadedness, or lack of coordination. These side effects can increase the risk of falling.

Children may be more sensitive to the side effects of the drug, especially decreased sweating, heat stroke, or metabolic imbalance.

During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Ask about reliable forms of birth control while using this medication and for 1 month after the last dose. Since untreated seizures are a serious condition that can harm both a pregnant woman and her unborn baby, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, talk to your doctor right away about the benefits and risks of using this medication during pregnancy.

This medication passes into breast milk. Consult your doctor before breastfeeding.

Drug interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include:

  • carbonic anhydrase inhibitors (such as acetazolamide)
  • orlistat

Other medications can affect the removal of zonisamide from your body, which may affect how zonisamide works. Examples include other medications to treat seizures (such as phenobarbital, primidone), rifamycins (such as rifabutin), St. John's wort, among others. Your doctor may need to adjust your dose of zonisamide if you are on these medications.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669. Symptoms of overdose may include: slow/shallow breathing, severe dizziness, loss of consciousness.

Notes

Do not share this medication with others.

Lab and/or medical tests (such as kidney function, bicarbonate level, complete blood count) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

Missed dose

It is important to take each dose at the scheduled time. If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Storage

Store at room temperature away from light and moisture. Do not store in the bathroom. For the liquid form, once the bottle is opened, the medication expires after 30 days. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Medical alert

Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

Important note

HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Information last revised September 2024.

Selected from NATIONAL DRUG DATA FILE (NDDF) data included with permission and copyrighted by First Databank, Inc., 2019. This copyrighted material has been downloaded from a licensed data provider.

The above information is intended to supplement, not substitute for, the expertise and judgment of your health care professional. You should consult your health care professional before taking any drug, changing your diet, or commencing or discontinuing any course of treatment.