Description
Zonisamide is a sulfonamide anticonvulsant approved for use as an adjunctive therapy in adults with partial-onset seizures. Zonisamide may be a carbonic anhydrase inhibitor although this is not one of the primary mechanisms of action. Zonisamide may act by blocking repetitive firing of voltage-gated sodium channels leading to a reduction of T-type calcium channel currents, or by binding allosterically to GABA receptors. This latter action may inhibit the uptake of the inhibitory neurotransmitter GABA while enhancing the uptake of the excitatory neurotransmitter glutamate.
Top Gene Interactions
Related Pathways
General Information
- Metabolism: Primarily hepatic through cytochrome P450 isoenzyme 3A4 (CYP3A4). Undergoes acetylation and reduction, forming N-acetyl zonisamide, and the open-ring metabolite 2–sulfamoylacetyl phenol, respectively. Route of Elimination: Zonisamide is excreted primarily in urine as parent drug and as the glucuronide of a metabolite. Half Life: 63 hours
- Uses/Sources: For use as adjunctive treatment of partial seizures in adults with epilepsy.
- Health Effects: May cause a potentially dangerous rash that may develop into Stevens Johnson syndrome, an extremely rare but potentially fatal skin disease.
- Symptoms: Symptoms of overdose include diminished breathing, loss of consciousness, low blood pressure, and slow heartbeat.
- Treatment: No specific antidotes for Zonisamide 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. (L1712)
- Route of Exposure: Oral. Variable, yet relatively rapid rate of absorption with a time to peak concentration of 2.8-3.9 hours. Food has no effect on the bioavailability of zonisamide.
Mechanism of Action
Zonisamide Interacts with Diseases
Disease | Inference Score | References/Inference Genes |
Epilepsy | 11.37 |
|
Pneumoconiosis | 10.08 |
|
Autism | 9.42 |
|
Trigeminal Neuralgia | 8.75 |
|
Hyperkinesis | 8.59 |
|
Endometriosis | 8.5 |
|
Pheochromocytoma | 8.42 |
|
Manganese Poisoning | 8.21 |
|
Epilepsy, Temporal Lobe | 8.13 |
|
Disease Models, Animal | 7.87 |
|
Parkinson's disease | 7.8 |
|
Brain Diseases | 7.74 |
|
Amyotrophic lateral sclerosis 1 | 7.52 |
|
Esophageal squamous cell carcinoma | 7.17 |
|
Colonic neoplasm | 6.88 |
|
Seizures | 6.82 |
|
Osteopetrosis with renal tubular acidosis | 6.25 |
|
Cocaine dependence | 6.2 |
|
Substance Withdrawal Syndrome | 6.15 |
|
Amphetamine-Related Disorders | 6.05 |