Dr C P Ravikumar

ZONISAMIDE

Parent or patient Information Leaflet

Dr. C. P. Ravi Kumar

Consultant Paediatric Neurologist
MRCPCH, CCT in Paediatrics (U.K.)
Fellow in Paediatric Epilepsy &
Neurology (London)

Brand names :
Tablet : Zonisep, Zonimid

“Generic Vs Branded Drugs”

Zonisamide is a medicine used in epilepsy to control both generalized and focal epilepsy.

Why is it important for my child to take this medicine?

It is important that your child takes Zonisamide regularly so that they have no Seizures or fewer seizures.

Do not stop giving Zonisamide suddenly, as your child may have more seizures.

What is Zonisamide available as?

Zonisamide is available in the preparation of Capsules and Tablets in the market.

When should I give Zonisamide?

Twice a day; morning and evening. Ideally, 10-12 hours apart.

For example, anytime between 7 to 8 am and right after 12 hours between 7 to 8 pm. You can adjust the time slot according to your schedule.

However, there are some exceptions when your doctor may advise to give it thrice a day. Please follow your doctor’s instructions in such case.

It should ideally be given at the samE time every day to establish a routine as it minimizes the chances of missing a dose.

What if I miss a dose?

Tablets & Capsules:The missed dosage can be given, if you remember to give it within a lapse of 6 hours. If you fail to give the missed dose within 6 hours, then might as well leave it. It is advisable to wait until the time of next routine dose.

Never give a double dose of Zonisamide.

If your child vomits within 30 minutes of taking a dose of the medicine then give the dose again; if your child vomits after 30 minutes of taking the dose, then do not give it again.

How much of the drug should be given?

Your doctor will work out the amount of Zonisamide (the dose) that is right for your child. The dose will be Written in your prescription.

When you first start giving Zonisamide to your child, you will give them a small amount and then increase the dose bit by bit over a few days or weeks. This helps your child to get used to the medicine. Your doctor will explain what to do.

It is important that you follow your doctor’s instructions about how much to give.

Ultimately, when your child is free of seizures or convulsions (fits) and has no obvious side effects, you will know that the dosage is just correct.

How should I give it? “Giving Medicines”

Tablets: These must be swallowed whole with a glass of water, juice or milk. They can be crushed and administered in water or juice or small amount of yogurt / Curd.

Capsules: They can be mixed in water or juice or small amount of yogurt / Curd.

Could this medication have any side effects on my child? Side effects

Although medicines are given to make children feel better, sometimes, they may cause some unwanted side effects.

Side-effects that you must do something about – Common

1. Loss of appetite and weight loss secondary to decreased intake.

2. Fever, but NOT due to infection.

3. Abnormal gait (Ataxia)

4. Decreased sweating

Liver disease: It is mandatory to monitor liver enzymes regularly. If your doctor catches any evidence of liver dysfunction, it must be taken care of immediately. If your child’s health deteriorates and falls sick every few hours, suffers from stomachache, skin and eyes are pale yellow in color, feels lethargic and sleepy or increased number of seizures take them to your doctor straight away.

Other side-effects you need to know about

Your child may get these side-effects when they first start taking Zonisamide. They will be able to settle down within a course of week or so as their body gets used to the medicine. Continue to give Zonisamide to your child as your doctor has directed you to.

Your child may be unusually sleepy, or their behaviour may change.

Your child may feel less hungry (lose their appetite) and feel sick (nausea) or be sick (vomit). These problems may be avoided by starting with a small dose with food and gradually increasing the dosage given.

Dizziness

Rarely, it can also cause renal (Kidney) stones, please ensure your child is well hydrated by making them drink adequate water.

Mental disturbances, especially in adults who are already known to have mental health issues.

If your child starts developing skin Rash, Stop Medications right there and SEEK IMMEDIATE MEDICAL ADVICE from your DOCTOR

Sometimes your child may experience other side-effects that are not listed above. If you notice any abnormalities with your child’s body or behavior, do not hesitate and immediately contact your doctor.

Despite this long list of side effects, Zonisamide is a very effective anti-epileptic (anticonvulsant) medicine and has very little effect on the child’s alertness levels, usual behaviour and learning abilities.

Can other common medicines be given at the same time as Zonisamide?

Medications like ibuprofen, paracetamol, antibiotics or any of the other over the counter medicines can be given when necessary, except the ones your doctor has prohibited you from.

Consult with your doctor before giving any other medicines to your child. This includes herbal or complementary medicines.

Some other medicines used to treat epilepsy may affect how well Cannabidiol works or may cause side effects. If your child is experiencing more fits or seizures, or any other side effects after using other medications, talk to your doctor immediately.

Some other medicines used to treat epilepsy may affect how well Zonisamide works or may cause side effects.

If your child is experiencing more fits or seizures, or any other side effects after using other medications, talk to your doctor immediately.

Zonisamide and pregnancy

Zonisamide may harm an unborn baby.

The oral contraceptive pill can be USED SAFELY in women or girls who are taking Zonisamide.

Where should I keep this medicine?

Keep the medicine in a cupboard, secured away from heat and direct sunlight. It is not a must to keep the medicine in the refrigerator though.

Make sure the medicine is out of your child’s reach.

Store the medication in the same box it was packed in.

For more information please refer to the manufacturer’s information leaflet.

References :

1. IAP Drug Formulary Web Update 2020(3) Edition 58, https://www.iapdrugformulary.com/Home
2. Consumer Medicines Information (CMI), https://www.tga.gov.au/consumer-medicines-information-cmi
3. British National Formulary for Children (BNFC)
4. Food and Drug Administration, USA https://www.fda.gov

Dr C P Ravikumar

Dr C P Ravikumar

CONSULTANT – PEDIATRIC NEUROLOGY
Aster CMI Hospital, Bangalore