Zonegran (Zonisamide)

Before taking ZONEGRAN, tell your doctor if you have, or have ever had:

• Liver disease
• Kidney problems or kidney stones
• Lung or breathing difficulties
• High blood acid levels
• A mental illness, such as depression
• A history of status epilepticus (long periods of continuous seizures, or a series of seizures without a return to consciousness)
• Allergies to medications

Also, let your doctor know if you're on a high-fat, low-carbohydrate diet (ketogenic diet) to control your seizures.

ZONEGRAN can make it harder for your body to cool down when it gets hot. Avoid exposure to extreme heat, and tell your doctor immediately if you have a fever or aren't sweating as you usually do.

Let your healthcare provider know if you have diarrhea any time before or during your treatment.

Your mental health may change in unexpected ways while taking ZONEGRAN. In clinical studies, a small number of people who took anticonvulsants such as ZONEGRAN became suicidal.

Tell your doctor right away if you experience any of the following symptoms:

• New or worsening depression, anxiety, or irritability
• Violent, aggressive, or angry behavior
• Thoughts of harming yourself
• Agitation or restlessness
• Panic attacks
• Difficulty falling asleep or staying asleep
• An abnormally excited mood
• Withdrawal from family and friends
• A preoccupation with death
• Any other changes in behavior or mood

Your doctor will probably tell you to drink six to eight glasses of water every day while taking ZONEGRAN. Follow these instructions carefully.

Some people who take medicines like ZONEGRAN develop a severe, and sometimes fatal, reaction. Tell your doctor right away if you experience:

• Fever, chills, cough, or sore throat
• Rash
• Swollen, blistered, or peeling skin
• Red or irritated eyes
• Sores in the mouth, throat, nose, or eyes
• Unusual bleeding or bruising
• Extreme fatigue
• Pale skin
• Severe stomach pain
• Loss of appetite
• Dark-colored urine or pale-colored stools

Be sure to tell your healthcare provider you're taking this medicine before having any type of surgery, including a dental procedure.

ZONEGRAN may cause a condition called metabolic acidosis (high blood acid levels). Talk to your doctor about this risk.

This medicine shouldn't be taken by children younger than 16. Children may be at higher risk for side effects such as kidney stones, heatstroke, reduced growth, and metabolic acidosis.

Continue to take ZONEGRAN even if you feel well. Don't stop taking this drug without first talking to your doctor.

If you stop taking this medicine suddenly, your seizures may worsen. Your doctor will probably tell you to stop taking ZONEGRAN gradually if the drug is no longer helpful or needed.

Your doctor will want to order frequent tests to check your body's response to ZONEGRAN. Keep all appointments with your doctor's office and laboratory.

Pregnancy and ZONEGRAN

ZONEGRAN can harm a fetus, so don't take it if you're pregnant. Contact your doctor right away if you become pregnant while taking this medicine.

Use an effective form of birth control while taking ZONEGRAN.

ZONEGRAN passes into breast milk. Don't breastfeed while taking this medicine.

Common Side Effects of ZONEGRAN

Tell your doctor if any of the following side effects become severe or don't go away:

• Nausea or vomiting
• Heartburn
• Constipation
• Weight loss
• Changes in taste
• Dry mouth
• Dizziness or drowsiness
• Headache

Serious Side Effects of ZONEGRAN

Tell your doctor if you experience any of the symptoms listed in the ZONEGRAN Warnings section above, or any of the following serious side effects:

• Worsening or longer-lasting seizures
• Sudden back pain
• Bone pain
• Painful urination
• Difficulty thinking of words, or trouble speaking
• Confusion or memory problems
• Difficulty concentrating
• Lack of coordination
• Difficulty walking
• Severe weakness or muscle pain
• Shallow, fast breathing
• Irregular heartbeat
• Loss of consciousness
• Pain, burning, numbness, or tingling in the hands or feet
• Uncontrollable eye movements or double vision

Tell your doctor about all prescription, non-prescription, illegal, recreational, herbal, nutritional, or dietary drugs you're taking, especially:

• Cordarone or Pacerone (amiodarone)
• Antifungals, such as Sporanox (itraconazole) or Nizoral (ketoconazole)
• Carbonic anhydrase inhibitors, such as Diamox (acetazolamide) or Neptazane (methazolamide)
• Biaxin (clarithromycin) or Prevpac (lansoprazole, amoxicillin, and clarithromycin)
• Cardizem, Dilacor, or Tiazac (diltiazem)
• E.E.S., E-Mycin, or Erythrocin (erythromycin)
• Luvox (fluvoxamine)
• HIV protease inhibitors, such as Crixivan (indinavir), Viracept (nelfinavir), Norvir (ritonavir), or Kaletra (lopinavir and ritonavir)
• Medications for irritable bowel disease, motion sickness, Parkinson's disease, ulcers, or urinary problems
• Other medications for seizures, such as Carbatrol, Epitol, or Tegretol (carbamazepine), Luminal or Solfoton (phenobarbital), Dilantin or Phenytek (phenytoin), or Depakene or Depakote (valproic acid)
• Serzone (nefazodone)
• Hormonal contraceptives (birth control pills, patches, rings, and injections)
• Actos (pioglitazone), Actoplus MET (pioglitazone and metformin), or Duetact (pioglitazone and glimepiride)
• Mycobutin (rifabutin)
• Rifadin or Rimactane (rifampin)
• St. John's wort
• Calan, Covera, Isoptin, or Verelan (verapamil)
• TAO (troleandomycin — not available in the United States)

ZONEGRAN and Other Interactions

ZONEGRAN may cause drowsiness, dizziness, or vision problems. Don't drive or perform any activity that requires alertness until you know how this medicine affects you.

ZONEGRAN and Alcohol

Alcohol may worsen certain side effects of ZONEGRAN. Talk to your doctor before drinking alcohol while taking this medicine.

ZONEGRAN and Grapefruit

Grapefruit and grapefruit juice may interact with the way ZONEGRAN is absorbed in the body.

Talk to your doctor about this potential interaction.

ZONEGRAN comes as a capsule. It's typically taken once or twice a day, with or without food.

Try to take ZONEGRAN around the same time each day.

Follow the instructions on your prescription label carefully. Don't use more or less ZONEGRAN than is recommended.

Don't chew, split, or crush the capsules. Swallow them whole.

Your doctor will probably start you on a low dose of ZONEGRAN and gradually increase it.

ZONEGRAN Overdose

Symptoms of a ZONEGRAN overdose may include:

• Slowed breathing or a slow heartbeat
• Dizziness
• Fainting
• Coma

If you suspect an overdose, contact a poison control center or emergency room immediately.

Missed Dose of ZONEGRAN

If you miss a dose of ZONEGRAN, take it as soon as you remember.

But if it's almost time for your next dose, skip the missed dose and continue with your regular medication schedule.

Don't take extra medicine to make up for a missed dose.