Methsuximide

What is Methsuximide?

• Methsuximide (Celontin) is a succinimide-based anticonvulsant similar to ethosuximide that is used for absence (petit mal) seizures in both adults and children.
• It is also called as mesuximide, methosuximide.

Mesuximide

Mesuximid-Enantiomere Strukturformel

What are the uses of this medicine?

• Methsuximide (Celontin) is a prescription medicine used to treat absence (petit mal) seizures that have not gotten better with other seizure medicines.

How does this medicine work?

• Methsuximide (meth sux’ i mide: also called mesuximide) is a succinimide derivative and anticonvulsant that is used to treat absence (petit mal) seizures.
• Methsuximide 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:

• with a history of hypersensitivity to succinimides.

What drug interactions can this medicine cause?

• Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.

Be sure to mention any of the following:

• antidepressants
• other medications for seizures such as phenobarbital and phenytoin (Dilantin)
• medications for pain
• sedatives
• sleeping pills
• tranquilizers

Is this medicine FDA approved?

• Methsuximide was first approved in 1957 for use alone or in combination with other agents to treat absence seizures.
• Methsuximide is no longer in common use, having been replaced by ethosuximide, the most active of the succinimide anticonvulsants and first line therapy for petit mal epilepsy.
• Nevertheless, methsuximide is still available, generically and under the brand name Celontin as capsules of 150 and 300 mg.

How should this medicine be used?

Recommended dosage:

• A suggested dosage schedule is 300 mg per day for the first week.
• If required, dosage may be increased thereafter at weekly intervals by 300 mg per day for the three weeks following to a daily dosage of 1.2 g.
• Celontin may be administered in combination with other anticonvulsants when other forms of epilepsy coexist with absence (petit mal).

Administration:

• Methsuximide comes as a capsule to take by mouth.
• It is usually taken one or more times a day.
• Take methsuximide at around the same times every day.
• Your doctor will probably start you on a low dose of methsuximide and gradually increase your dose, not more often than once a week.
• Methsuximide may help control your condition but will not cure it.
• Continue to take methsuximide even if you feel well.
• Do not stop taking methsuximide without talking to your doctor, even if you experience side effects such as unusual changes in behavior or mood.
• If you suddenly stop taking methsuximide, 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 Celontin capsule contains 300 mg methsuximide

This medicine is available in fallowing brand namesː

• Celontin

What side effects can this medication cause?

The most common side effects of this medicine include:

• drowsiness
• dizziness
• headache
• blurred vision
• nausea or vomiting
• constipation
• diarrhea
• weight loss
• problems with walking and coordination (unsteadiness)
• stomach pain
• loss of appetite

Celontin may cause other serious side effects, including:

• Grand mal seizures can happen more often or become worse
• Rare but serious blood problems that may be life-threatening
• Systemic Lupus Erythematosus
• suicidal thoughts or actions

What special precautions should I follow?

• Blood dyscrasias, including some with fatal outcome, have been reported to be associated with the use of succinimides; therefore, periodic blood counts should be performed.
• Do not drink alcohol or take other medicines that make you sleepy or dizzy while taking Celontin without first discussing this with your healthcare provider. Celontin 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 Celontin affects you. Celontin can slow your thinking and motor skills.
• Methsuximide was associated with hepatic injury in experimental animals, but has not been linked to serum enzyme elevations during treatment or to cases of clinically apparent liver injury with jaundice.
• Cases of systemic lupus erythematosus have been reported with the use of succinimides. The physician should be alert to this possibility.
• Antiepileptic drugs (AEDs), including Celontin, 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.
• It is recommended that the physician withdraw the drug slowly on the appearance of unusual depression, aggressiveness, or other behavioral alterations.
• Patients should be instructed to promptly contact their physician if they develop signs and/or symptoms suggesting an infection (eg, sore throat, fever).
• Since methsuximide has a relatively low melting temperature (124° F), storage conditions which may promote high temperatures (closed cars, delivery vans, or storage near steam pipes) should be avoided. Do not dispense or use capsules that are not full or in which contents have melted. Effectiveness may be reduced. Protect from excessive heat (104° F).
• It is not known if Celontin can pass into breast milk. You and your healthcare provider should decide how you will feed your baby while you take Celontin.

What to do in case of emergency/overdose?

Symptoms of overdosage may include:

• nausea, vomiting, and CNS depression including coma with respiratory depression.
• Methsuximide poisoning may follow a biphasic course. Following an initial comatose state, patients have awakened and then relapsed into a coma within 24 hours.
• It is believed that an active metabolite of methsuximide, N-desmethylmethsuximide, is responsible for this biphasic profile.

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 or gastric lavage, activated charcoal, cathartics, and general supportive measures. Charcoal hemoperfusion may be useful in removing the N-desmethyl metabolite of methsuximide.
• Forced diuresis and exchange transfusions are ineffective.

Can this medicine be used in pregnancy?

• It is not known if Celontin can harm your unborn baby.
• Tell your healthcare provider right away if you become pregnant while taking Celontin.
• You and your healthcare provider will decide if you should take Celontin while you are pregnant.
• If you become pregnant while taking Celontin, 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?

• Methsuximide is a succinimide-based anticonvulsant similar to ethosuximide that is used for absence (petit mal) seizures in both adults and children.

What are the active and inactive ingredients in this medicine?

• Active ingredient: methsuximide
• Inactive ingredients: starch, colloidal silicon dioxide NF, D&C yellow No. 10, FD&C yellow No.6, gelatin NF, and sodium lauryl sulfate NF.

Who manufactures and distributes this medicine?

Distributed by:

• Parke-Davis
• A division of pfizer Inc.
• NY

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

• Store Celontin at room temperature, between 59°F to 86°F (15°C to 30°C).
• Keep Celontin capsules in a dry place.
• Keep Celontin out of the light.
• Protect Celontin from heat.
• Do not use Celontin capsules that if they do not look full or if the contents have melted.

• Dailymed label info on Methsuximide
• FDA Methsuximide

Methsuximide Resources
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