Monotherapy for partial seizures w/ or w/o secondary generalisation in adults w/ newly diagnosed epilepsy. Adjunctive therapy for partial seizures in adults w/ epilepsy.
Adult Monotherapy Newly diagnosed patients Titration phase: Wk 1 + 2: 100 mg once daily. Wk 3 + 4: 200 mg once daily. Wk 5 + 6: 300 mg once daily. Maintenance dose: 300 mg once daily, may increase at 2-wkly intervals in increments of 100 mg up to a max of 500 mg. Adjunctive therapy Initially 100 mg once daily, may be increased to 200 mg after 2 wk for 2 wk, then may be further increased to 300 & 400 mg for 2 wk.
Discontinue use in patients who develop unexplained rash (eg, Stevens-Johnson syndrome & toxic epidermal necrolysis); predisposing risk factors of kidney stone formation; acute renal failure or a clinically significant sustained increase in the creatinine/BUN conc. Cases of aplastic anemia & agranulocytosis. Monitor closely for evidence of decreased sweating & increased body temp especially in ped patients; signs of suicidal ideation & behaviours. Concomitant use w/ carbonic anhydrase inhibitors & drugs w/ anticholinergic activity; drugs that either induce or inhibit CYP3A4 may alter serum conc of zonisamide. Abrupt w/drawal may precipitate increased seizure frequency or status epilepticus. Assess markers of muscle damage including serum creatine phosphokinase & aldolase levels; pancreatic lipase & amylase levels. May impair ability to drive, operate machinery or perform hazardous task. Hepatic & renal dysfunction. Use of effective contraception is advised in women of child bearing potential. Pregnancy & lactation. Childn <16 yr. Elderly.
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