조니사마이드

용도

• Epilepsy (anecdotal)
• Refractory to phenobarbital
• Epilepsy
• Epilepsy
• Refractory epilepsy (with phenobarbital)
• Monotherapy
• Add-on with phenobarbital
• Initial monotherapy
• Add-on agent
• Epilepsy
• Epilepsy (monotherapy or adjunctive)

투여 방법

가능한 부작용

• Sedation (usually transient)
• Ataxia
• Inappetence / Anorexia
• Vomiting
• Diarrhea
• Somnolence
• Keratoconjunctivitis sicca (KCS) - theoretical risk due to sulfonamide structure
• Polyarthropathy or blood dyscrasias - theoretical risk due to sulfonamide structure
• Sedation
• Anorexia
• Keratoconjunctivitis sicca (KCS)
• Hepatotoxicity (rare)
• Metabolic acidosis

주의사항 및 금기

• Hypersensitivity to zonisamide
• Hypersensitivity to sulfonamide drugs
• Pregnancy (known teratogen in dogs)
• Hypersensitivity to sulfonamides
• Severe hepatic impairment
• > **Teratogenic Risk**: Zonisamide is a known teratogen in dogs. Doses of 10-30 mg/kg/day have caused ventricular septal defects, cardiomegaly, and valvular/arterial anomalies (threshold plasma level for malformation is 25 mcg/mL). Use in pregnant dogs carries significant risks. * **Sulfonamide Sensitivity**: Because it is a sulfonamide, monitor for idiosyncratic sulfonamide reactions (e.g., KCS, blood dyscrasias), though clinical reports in veterinary patients are currently rare. * Use with caution in nursing animals as it is unknown if it enters maternal milk.

약물 상호작용

• Phenobarbital: Increases the clearance of zonisamide. Repeated phenobarbital dosing decreases the bioavailability, peak concentrations, half-life, and AUC of zonisamide. This effect can persist up to 10 weeks after phenobarbital discontinuation. Higher zonisamide doses are typically required.
• Ketoconazole: May inhibit the hepatic metabolism of zonisamide, potentially increasing serum concentrations.

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