Zonisamide
CLINICAL USE
Anti-epileptic
DOSE IN NORMAL RENAL FUNCTION
Initially: 25 mg twice daily, increasing to maintenance dose of 300–500 mg daily in 1 or 2 divided doses
PHARMACOKINETICS
Molecular weight                           : 212.2 %Protein binding                           : 40–60 %Excreted unchanged in urine     : 15–35 Volume of distribution (L/kg)       : 0.8–1.6 half-life – normal/ESRD (hrs)      : 60–63/Increased DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
20 to 50     : Dose as in normal renal function 10 to 20     : Dose as in normal renal function, titrate slowly. <10           : Dose as in normal renal function, titrate slowly. DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                : Dialysed. Dose as in GFR <10 mL/min HD                     : Dialysed. Dose as in GFR <10 mL/min HDF/high flux   : Dialysed. Dose as in GFR <10 mL/min CAV/VVHD      : Probably dialysed. Dose as in GFR 10 to 20 mL/min IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs Antidepressants: anticonvulsant effect antagonised by MAOIs, SSRIs and tricyclics Antimalarials: possibly increased risk of convulsions with chloroquine and hydroxychloroquine; anticonvulsant effect antagonised by mefloquine ADMINISTRATION
Reconstition
– Route
Oral Rate of Administration
– Comments
– OTHER INFORMATION
AUC is increased by 35% in patients with a GFR<20 mL/min Increase dose at 2 weekly intervals in people with renal impairment and monitor more frequently .
See how to identify renal failure stages according to GFR calculation
See how to diagnose irreversible renal disease
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