Absence seizures
May be taken with or without food.
Oral Absence seizures Adult: Initially, 500 mg daily, may increase in steps of 250 mg at intervals of 4-7 days. Usual dose: 1-1.5 g daily. Optimum plasma concentration: 40-100 mg/L (300-700 micromol/L). Max: Up to 2 g in some patients. Strict supervision is recommended if dose >1.5 g daily. Hepatic Impairment Monitor closely
Child: <6 yr: Initially, 250 mg daily, may increase gradually to usual dose of 20 mg/kg daily. >6 yr: Initially, 500 mg daily, may increase in steps of 250 mg at intervals of 4-7 days. Usual dose: 1-1.5 g daily. Max: <6 yr: Up to 1 g/day and ?6 yr: 2 g/day .
Renal Impairment Monitor closely
Hypersensitivity. Pregnancy and lactation.
Ethosuximide is used mainly in the management of absence (petite mal) seizures. It is usually ineffective in the management of partial seizures with complex symptomatology or tonic-clonic seizures.
Hepatic or renal impairment, porphyria. Complete blood cell count, liver function tests, and urinalysis should be performed periodically. May increase the risk of grand mal seizures when used alone in mixed types of epilepsy. Avoid sudden withdrawal. May impair ability to drive or operate machinery. Lactation: enters breast milk; use with caution (AAP Committee states "compatible with nursing")
Common Dizziness,Headache,Somnolence,Anorexia,Diarrhea,GI upset,Nausea,Vomiting Less Common Ataxia, confusion, drowsiness, sleep disturbance,Gum hypertrophy, hiccoughs, swelling of tongue,Blood dyscrasias including aplastic anemia,Allergic reaction,Urticaria,Pruritic erythematous rashes,Blurred vision, myopia Rare Psychosis,Seizure,Suicidal thoughts and behavior,Stevens-Johnson syndrome,Systemic lupus erythematosus,Hirsutism
Pregnancy Category: C Lactation: enters breast milk; use with caution (AAP Committee states "compatible with nursing")
Isoniazid may increase the serum concentration of ethosuximide, leading to toxicity. Antipsychotics, antidepressants, MAOIs, and mefloquine may antagonise anticonvulsant effects of ethosuximide. Plasma conc of ethosuximide may be reduced by carbamazepine, phenobarbital, phenytoin, and primidone; and affected by valproate. Chloroquine or hydroxychloroquine may increase risk of convulsions. Isoniazid.