Ethosuximide

Also known as: Emeside, Zarontin

Drug #289

Ethosuximide is antiepileptic agent. It was introduced in 1960 as the third of three marketed succinimides. its origin is in the cyclic ureide structure. It has a considerable efficasy against pentylenetetrazol seizures and was introduced as a 'pure petit mal' drug. its popularity continues, based on its safety and efficasy. its role as the first choice anti-absence drug remains undiminished, in part because of the idiosyncratic hepatotoxicity of the alternative drug, valproic acid. Ethosuximide is administered orally.

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Primary Characteristics

Ethosuximide is also known as Emeside, Zarontin.

It is of Synthetic origin and belongs to Pyrrolidinedione.

Molecular Weight: 141.2 · pK_a: 9.3 · Solubility in Water: 1 in 4.5 · Solubility in Alcohol: 1 in < 1 · Non-proprietary name: Ethosuximide.

Pharmacokinetics

Absorption: Ethosuximide has an oral bioavailability is 97% (±2%), pre-systemic (first-pass) metabolism accounts for 0.00255% (±0.00155%).

Distribution: Ethosuximide has a volume of distribution is 0.7 l/kg. plasma protein binding is negligible.

Elimination: it is metabolised via hepatic, plasma half-life is 53-56 hr, renal excretion is 17-38%.

Indications

Ethosuximide is primarily indicated in conditions like Generalised epilepsy with absence seizures.

Ethosuximide is also indicated for secondary conditions like Myoclonic seizures.

Contraindications

Ethosuximide is contraindicated in conditions like Hypersensitivity to any component of product.

Dosage

Ethosuximide's dosage details are as follows:

Dose	Single Dose	Frequency	Route	Instructions
Adult Dosage
17.856 mg/kg	17.856 mg/kg	Every 24h	PO	Maintenance, As Required
1125 mg/d	1125 mg/d	Every 24h	PO	Initially for a week
Paediatric Dosage (20kg)
18.75 mg/kg	18.75 mg/kg	Every 12h	Oral	Start with low doses, and then Gradually Increase
Neonatal Dosage (3kg)
0 – 0	—	—		Not indicated in this age group

Drug Interactions

Unknown8 interactions

1 interaction

Major1 interaction

Moderate2 interactions

Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Side Effects

Ethosuximide in overdosage may give rise to further complications which include Erythema multiforme, Systemic lupus erythematosus , Tonic-clonic seizures .

Ethosuximide produces potentially life-threatening effects which include Bone marrow suppression. Careful monitoring is needed with proper medical management.

The signs and symptoms that are produced after acute overdosage of Ethosuximide are Drowsiness, Headache, Dysequilibrium, Unsteadiness , Lethargy.

Ethosuximide is known to cause more or less tolerable side effects which are usually transient. These include Abdominal discomfort, Anorexia , GI symptoms, Hiccups, Nausea, Vomiting .

Warnings / Precautions

Ethosuximide should be used with extreme caution in patients with hepatic disease because the drug has been associated with the onset of hepatitis and jaundice. Liver function tests (LFT) should be performed periodically. Ethosuximide should be used with caution in patients with intermittent porphyria because it could exacerbate it. Ethosuximide should be used with extreme caution in patients with renal disease. Urinalysis should be performed regularly, especially in patients at risk. It should be used with caution in patients with blood dyscrasias or any hematological disease. It should be used with caution in patients with a known succinimide hypersensitivity. It should be used with caution during pregnancy. Safe use has not been established. Avoid abrupt discontinuation because abrupt discontinuation of ethosuximide can precipitate seizures. Withdraw drug slowly upon the appearance of unusual depression, aggressiveness or other behavioral alteration.

Interference in Pathology

Ethosuximide may interfere in the diagnosis of Urinanalysis , Liver Function Test (LFT) .

Available Brands

None recorded.

Storage Conditions

Ethosuximide should be stored Caps, Syrup.

Drug Classification

1.5 — Anticonvulsants and Antiepileptics