ETHOSUXIMIDE:
It is antiseizure drug used to treat the patients with Epilepsy.
What is Ethosuximide used for?
Absence seizure.
How is Ethosuximide available?
Syrup/ oral solution.
Capsule. (Not available in India)
How does Ethosuximide act?
It acts by interfering with the transmission of nerve signals in the brain thereby reducing the episodes of seizure. (Mechanism of action = stabilizes T type calcium channels)
Why is Ethosuximide important for you/your child’s treatment?
It is important that your child takes Ethosuximide regularly so that you/your child doesn’t suffer from Seizures or have fewer seizures episodes.
ETHOSUXIMIDE controls seizures but doesn’t cure epilepsy and works only while you keep taking it. So do not stop giving Ethosuximide suddenly, as it may result in having more seizures.
When should Ethosuximide be taken?
Ethosuximide can be taken before or after food but follow the same on each day.
If taking twice a day, leave a gap of 10-12 hours between the doses.
It is recommended to take the medication at the same time each day to help establish a routine and minimize the risk of forgetting a dose.
What if I miss a dose?
If you miss the dose, it can be taken as soon as you remember within the lapse of 6 hours. Do not take the missed dose if it is close to the next one; just take the next dose as normal. If you miss two or more doses; discuss it with your doctor.
Avoid giving a double dose of ethosuximide under any circumstances.
If your child vomits out the content within 30 minutes of taking the medicine dosage then you can give the dose again; but if your child vomits after 30 minutes of taking the dose, then just leave it be and do not give it again.
How much of the drug should be given?
It is mandatory to follow the instructions given by your doctor about the dosage of medication.
Your doctor may start you on a low dose of ethosuximide and gradually increase your dose, not more often than once every 2 weeks.
How should I give the medicine?
Tablets: A whole tablet must be swallowed with a glass of water, juice or milk. You may give it by crushing and mixing it in water/ juice or small serving of yogurt / Curd. Liquid or syrup: Use an oral syringe or a medicine spoon to measure the adequate amount. You can easily get these from any pharmacy nearby. Do not use a kitchen teaspoon as it will not give the accurate amount of the drug.Could this medication have any side effects on my child?
Every medication has both positive and potential negative effects. Fortunately, adverse effects are not common for everyone, but it’s essential to be aware of them. Understanding possible side effects allows us to act quickly and effectively if they occur, ensuring that we can address any concerns promptly while continuing to benefit from the intended effects of medications.
Even though it may be rare, few people sometimes may have serious side effects when taking a drug. Consult your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect.
Side effects of Ethosuximide:
Skin: Itchy red rashes, hives, or rare serious skin reactions like Stevens-Johnson syndrome or Toxic epidermal necrolysis. Hormonal and Metabolic: Increased body hair and weight loss. Digestive System: Stomach pain or cramps, loss of appetite, diarrhoea, upper stomach pain, indigestion, swollen gums, hiccups, nausea, or vomiting. Urinary and Reproductive: Blood in urine or unexpected vaginal bleeding. Blood: Higher levels of white blood cells or low blood cell counts. Allergic Reactions: Rashes with other symptoms, severe allergic reactions, or swelling of the tongue. Brain and Mood: Aggressive behavior, clumsiness, paranoia, depression, dizziness, extreme tiredness, feeling overly happy or energetic, headaches, irritability, difficulty focusing, night terrors, trouble sleeping, or fatigue. Eyes: Difficulty seeing far (near-sightedness).PREGNANCY AND LACTATION:
During pregnancy, it is considered risky because there isn’t enough information to say for sure whether it is completely safe for the baby.
If you’re pregnant, it is crucial to discuss with your doctor whether taking this medicine is safe for you. Sometimes, controlling seizures may be more important than the risks, but only a doctor can help decide what’s best for you.
Breastfeeding Considerations
Avoid unless no other drugs are effective and after considering the potential risks and benefits of the medicine and discussion with the concerned doctor.
Can I stop taking Ethosuximide?
Drug should not be discontinued abruptly because the possibility of increasing seizure frequency; therapy should be withdrawn gradually to minimize the potential of increased seizure frequency.
Monitoring parameters of Ethosuximide
LFTs, CBC with differential, urinalysis, platelets, signs of rash, trough serum concentration
How to cope with side effects:
- Drowsiness or Fatigue: Take the medication at night or adjust the timing of the dose (as per your doctor’s recommendation). Try to ensure you’re getting enough rest and avoid activities requiring high concentration until you know how ethosuximide affects you.
- Nausea and Vomiting: Take ethosuximide after food to reduce stomach irritation. Drinking plenty of fluids and eating small, frequent meals can also help.
- Loss of Appetite: Try to eat smaller, more frequent meals. Ensure to take adequate nutrition if you’re not feeling hungry.
- Headaches: Staying hydrated and ensuring good sleep might help.
- Dizziness or Light-headedness: Standing up slowly to prevent dizziness. Sit down immediately if you feel light-headed and avoid sudden movements.
Serious Side Effects of Ethosuximide:
While less common, ethosuximide can cause more serious side effects that may require medical attention.
- Skin Rash or Allergic Reactions: If you develop a rash or other signs of an allergic reaction (such as difficulty breathing, swelling of the face or throat), seek immediate medical attention. Discontinue use and consult your doctor.
- Mood Changes or Behavioural Symptoms (e.g., depression, agitation, suicidal thoughts): If you notice any mood changes, increased irritability, or other unusual behaviours, talk to your doctor immediately. These symptoms may require a change in medication or additional support.
GENERAL ADVICE:
Stay Hydrated and Maintain a Healthy Diet Dehydration and poor nutrition can exacerbate side effects like dizziness, fatigue, or nausea. Make sure to drink plenty of water and eat a balanced diet.- If side effects persist or worsen, talk to your doctor. Your doctor may adjust your treatment plan, consider switching medications, or recommend other treatments to address the side effects.
- Never stop taking the medication suddenly without consulting your healthcare provider, as this can increase the risk of seizures.
In Summary
Ethosuximide is an important medicine for controlling absence seizures. By following your doctor’s instructions and maintaining a routine, you can help ensure its effectiveness while minimizing side effects. Regular monitoring and open communication with your healthcare provider will help keep you or your child safe and healthy while on this medication.
Author:
- Dr. Ramya. R, Pharm D, Clinical pharmacologist, Aster Hospitals, Bengaluru
- Dr Praveen Kumar, B. Pharm, Pharm D(PB), Head Clinical Pharmacologist, Aster Hospitals, Bengaluru
- Dr C P Ravi Kumar, Consultant Paediatric Neurologist, Aster CMI Hospital.