Ethosuximide

What is Ethosuximide?

• Ethosuximide (Zarontin) is an anticonvulsant succinimide used for absence (petit mal) seizures in both adults and children.

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Ethosuximide

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What are the uses of this medicine?

• Ethosuximide (Zarontin) is a prescription medicine used to treat absence (petit mal) seizures.

How does this medicine work?

• Ethosuximide (eth' oh sux" a mide) is a succinimide derivative and potent anticonvulsant that has been used to treat absence (petit mal) seizures for more than 50 years.
• Ethosuximide suppresses the paroxysmal three cycle per second spike and wave activity associated with lapses of consciousness which is common in absence (petit mal) seizures.
• The frequency of epileptiform attacks is reduced, apparently by depression of the motor cortex and elevation of the threshold of the central nervous system to convulsive stimuli.

Who Should Not Use this medicine ?

This medicine cannot be used in patients who:

• are allergic to succinimides (methsuximide or ethosuximide), or any of the ingredients in ethosuximide capsules.

What drug interactions can this medicine cause?

• Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Be sure to mention any of the following:

• antidepressants
• other medications for seizures such as phenytoin (Dilantin) and valproic acid (Depakene, Depakote)
• medications for pain
• sedatives
• sleeping pills
• tranquilizers

Is this medicine FDA approved?

• Ethosuximide was approved for use in epilepsy in 1960 for use alone or in combination with other agents to treat absence seizures.
• Ethosuximide is available as tablets of 250 mg and as syrup for pediatric use in several generic forms and under the brand name of Zarontin.

How should this medicine be used?

Recommended dosage:

• The initial dose for patients 3 to 6 years of age is (250 mg) per day.
• For patients 6 years of age and older, (500 mg) per day.
• The dose thereafter must be individualized according to the patient's response.
• Dosage should be increased by small increments.
• One useful method is to increase the daily dose by 250 mg every four to seven days until control is achieved with minimal side effects.
• Dosages exceeding 1.5 g daily, in divided doses, should be administered only under the strictest supervision of the physician.
• The optimal dose for most pediatric patients is 20 mg/kg/day.
• This dose has given average plasma levels within the accepted therapeutic range of 40 to 100 mcg/mL.

Administration:

• Ethosuximide comes as a capsule and as a syrup to take by mouth.
• It is usually taken one or more times a day.
• Take ethosuximide at around the same time every day.
• Your doctor will probably start you on a low dose of ethosuximide and gradually increase your dose, usually once every 4 to 7 days.
• Ethosuximide may help to control your condition, but will not cure it.
• Continue to take ethosuximide even if you feel well.
• Do not stop taking ethosuximide without talking to your doctor, even if you experience side effects such as unusual changes in behavior or mood.
• If you suddenly stop taking ethosuximide, your seizures may worsen. Your doctor will probably decrease your dose gradually.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As a capsule and as a syrup

This medicine is available in fallowing brand namesː

• Zarontin

What side effects can this medication cause?

The most common side effects of this medicine include:

• nausea or vomiting
• fatigue
• indigestion, stomach pain
• dizziness or lightheadedness
• diarrhea
• unsteadiness when walking
• weight loss
• headache
• loss of appetite
• loss of concentration
• hiccups

Ethosuximide capsules may cause other serious side effects, including:

• Rare but serious blood problems that may be life-threatening
• Drug reactions that may affect different parts of the body such as your liver, kidneys, heart, or blood cells
• Serious allergic reactions
• Changes in thinking, mood, or behavior
• Grand mal seizures

What special precautions should I follow?

• Do not drink alcohol or take other medicines that make you sleepy or dizzy while taking ethosuximide capsules without first talking to your healthcare provider. Ethosuximide capsules taken with alcohol or medicines that cause sleepiness or dizziness may make your sleepiness or dizziness worse.
• Do not drive, operate heavy machinery, or do other dangerous activities until you know how ethosuximide capsules affects you. Ethosuximide capsules can slow your thinking and motor skills.
• Blood dyscrasias, including some with fatal outcome, have been reported to be associated with the use of ethosuximide; therefore, periodic blood counts should be performed.
• Drug-induced immune thrombocytopenia (DITP) has been reported with ethosuximide. If possible, assess the presence of drug-dependent antiplatelet antibodies. Avoid future use of ethosuximide in patients with history of ethosuximide-induced DITP.
• Ethosuximide has been associated with rare instances of serum enzyme elevations during treatment, but has not been linked to cases of clinically apparent liver injury with jaundice.
• Cases of systemic lupus erythematosus have been reported with the use of ethosuximide. The physician should be alert to this possibility.
• Antiepileptic drugs (AEDs), including ethosuximide, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Patients treated with any AED for any indication should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior.
• Serious dermatologic reactions, including Stevens-Johnson syndrome (SJS), have been reported with ethosuximide treatment. If signs or symptoms suggest SJS, use of this drug should not be resumed and alternative therapy should be considered.
• Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), also known as multi organ hypersensitivity, has occurred with Ethosuximide. Ethosuximide should be discontinued if an alternative etiology for the signs or symptoms cannot be established.
• Ethosuximide is excreted in human breast milk. Because the effects of ethosuximide on the nursing infant are unknown, caution should be exercised when ethosuximide is administered to a nursing mother. Ethosuximide should be used in nursing mothers only if the benefits clearly outweigh the risks.
• Ethosuximide, when used alone in mixed types of epilepsy, may increase the frequency of grand mal seizures in some patients.
• Prior to initiation of treatment with ethosuximide, the patient should be instructed that a rash may herald a serious medical event and that the patient should report any such occurrence to a physician immediately.
• If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking ethosuximide.

What to do in case of emergency/overdose?

Symptoms of overdosage may include:

• nausea, vomiting, and CNS depression including coma with respiratory depression.

Management of overdosage:

• In case of overdose, call the poison control helpline of your country. In the United States, call 1-800-222-1222.

• Overdose related information is also available online at poisonhelp.org/help.
• In the event that the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services. In the United States, call 911.
• Treatment should include emesis (unless the patient is or could rapidly become obtunded, comatose, or convulsing) or gastric lavage, activated charcoal, cathartics and general supportive measures.
• Hemodialysis may be useful to treat ethosuximide overdose.
• Forced diuresis and exchange transfusions are ineffective.

Can this medicine be used in pregnancy?

• It is not known if ethosuximide capsules can harm your unborn baby. Tell your healthcare provider right away if you become pregnant while taking ethosuximide capsules. You and your healthcare provider should decide if you should take ethosuximide capsules while you are pregnant.
• If you become pregnant while taking ethosuximide capsules, talk to your healthcare provider about registering with the North American Antiepileptic Drug (NAAED) Pregnancy Registry.
• The purpose of this registry is to collect information about the safety of antiepileptic drugs during pregnancy.
• You can enroll in this registry by calling 1-888-233-2334.

Can this medicine be used in children?

• Safety and effectiveness in pediatric patients below the age of 3 years have not been established.

What are the active and inactive ingredients in this medicine?

• Active ingredient: ethosuximide
• Inactive ingredients: Polyethylene glycol 400, NF; FD&C yellow No. 6; FD&C red No.3; gelatin, NF; glycerin, USP; and sorbitol.

Who manufactures and distributes this medicine?

Manufactured by:

• Swiss Caps AG, Kirchberg, Switzerland

Distributed by:

• Akorn
• Lake Forest, IL

What should I know about storage and disposal of this medication?

• Store ethosuximide capsules at room temperature, between 20º-25ºC (68º-77ºF).

• Dailymed label info on Ethosuximide
• FDA Ethosuximide

Ethosuximide Resources
Latest articles Most recent articles Ongoing trials	Wikipedia

• Dailymed label info on Ethosuximide
• FDA Ethosuximide

Ethosuximide Resources
Latest articles Most recent articles Ongoing trials	Wikipedia