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Experience with ZONEGRAN daily doses over 800 mg/day is limited. During ZONEGRAN clinical development, three patients ingested unknown amounts of ZONEGRAN as suicide attempts, and all three were hospitalized with CNS symptoms. One patient became comatose and developed bradycardia, hypotension, and respiratory depression; the zonisamide plasma level was 100.1 μg/mL measured 31 hours post-ingestion. Zonisamide plasma levels fell with a half-life of 57 hours, and the patient became alert five days later.
No specific antidotes for ZONEGRAN overdosage are available. Following a suspected recent overdose, emesis should be induced or gastric lavage performed with the usual precautions to protect the airway. General supportive care is indicated, including frequent monitoring of vital signs and close observation.
Zonisamide has a long half-life (see CLINICAL PHARMACOLOGY). Due to the low protein binding of zonisamide (40%), renal dialysis may be effective. The effectiveness of renal dialysis as a treatment of overdose has not been formally studied. A poison control center should be contacted for information on the management of ZONEGRAN overdosage.
ZONEGRAN is contraindicated in patients who have demonstrated hypersensitivity to sulfonamides or zonisamide.This monograph has been modified to include the generic and brand name in many instances.
Last reviewed on RxList: 9/12/2016
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