【藥品性質提示】 根據 2019 AGS Beers Criteria，本藥品為【潛在不適當用藥 (PIM)】，不建議用於有骨折風險之老年人(除非用於癲癇、調節情緒)。

治療癲癇 Adjunctive therapy in the treatment of focal onset seizures (simple and complex partial seizure, generalized tonic-clonic seizure)<20220324> in adolescents >16 y/o and adults
#仿單變更2022

Anticonvulsant
Zonisamide stabilizes neuronal membranes and suppresses neuronal hypersynchronization through action at sodium and calcium channels; does not affect GABA activity.

Absorption:
Rapid and complete
Distribution:
1. Vd: 1.45 L/kg; highly concentrated in erythrocytes
2. Protein binding: 40%
Metabolism:
1. Hepatic via CYP3A4; undergoes acetylation to form N-acetyl zonisamide and reduction via cytochrome P450 isoenzyme CYP3A4 to 2-sulfamoylacetylphenol (SMAP); SMAP then undergoes conjugation with glucuronide
2. Bioavailability: >90%
3. Half-life elimination: ~63 hours
4. Time to peak: 2 to 6 hours
Excretion:
Urine (62%, 35% as unchanged drug, 65% as metabolites); feces (3%)

Hypersensitivity to zonisamide, to any of the excipients or to sulphonamides.

C

Due to the potential for serious adverse reactions in the nursing infant, the manufacturer recommends a decision be made taking into account the importance of treatment to the mother.

Anorexia, Dizziness, Drowsiness; Agitation, Irritability, Confusion, Depression, Ataxia, insomnia, lack of concentration, memory impairment, Pruritus

Dosage:
1. Initial 100 mg/day; may be increased to 200 mg/day after 2 weeks. or increased to 300 and 400 mg/day with a minimum of 2 weeks between adjustments.
2. Doses of up to 600 mg/day have been studied; however, there is no evidence of increased response, and doses ≥300 mg/day are associated with increased side effects.
Discontinuation:
1. In chronic therapy, withdraw gradually to minimize the potential of increased seizure frequency and withdrawal symptoms.
2. For seizure disorders, some experts suggest withdrawing antiseizure drugs over a few to several (eg, 2 to 6) months.

1. GFR ≥50 mL/minute: There are no dosage adjustments provided in the manufacturer's labeling. However, slower titration and frequent monitoring are indicated in patients with renal disease; use with caution.
2. GFR <50 mL/minute: Use is not recommended. Marked renal impairment (CrCl <20 mL/minute) was associated with a 35% increase in AUC.

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied). However, slower titration and frequent monitoring are indicated in patients with hepatic impairment; use with caution.