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The following information outlines crucial safety warnings associated with the use of Zonisamide (Zonegran). It is essential to review these cautions carefully and consult your healthcare provider if you have any questions or concerns.

• Allergy to Sulfonamides: Zonisamide is a sulfa-based drug. Do not take it if you have an allergy to sulfa medications (e.g., Bactrim, sulfasalazine), as it may cause severe allergic reactions. Seek immediate medical attention if you experience skin rash, facial or throat swelling, or difficulty breathing.

• Serious Skin Reactions: Zonisamide can rarely cause severe skin reactions, starting with flu-like symptoms and leading to painful rashes and blisters. Inform your healthcare provider about any unusual skin changes during treatment.

• Severe Allergic Reactions Involving Organs: Some individuals may experience life-threatening allergic reactions affecting organs like the heart, kidneys, and liver. Symptoms include fever, rash, severe muscle pain, facial swelling, and jaundice. Immediate medical attention is necessary if these occur.

• Reduced Sweating and Heat Stroke Risk: This medication may impair your ability to sweat, increasing the risk of heat stroke, especially in younger individuals. Stay hydrated and avoid prolonged sun exposure in hot weather.

• Serious Eye Problems: Zonisamide may increase eye pressure, leading to blurred vision, pain, and redness. If untreated, this can result in vision loss. Notify your healthcare provider if you experience eye issues within the first month of treatment.

• Suicidal Behavior: The risk of suicidal thoughts or actions may increase with Zonisamide use. If mood changes or thoughts of self-harm arise, contact your healthcare provider immediately.

• Cognitive and Mood Changes: This drug may affect concentration, memory, speech, coordination, and mood, causing drowsiness or depression. Exercise caution when driving or performing tasks requiring alertness.

• Kidney Problems: Zonisamide can increase the likelihood of kidney stones and impair kidney function. Report symptoms like blood in urine, changes in urination frequency, swelling, fatigue, or muscle cramps to your provider.

• Increased Blood Acidity (Metabolic Acidosis): Rarely, Zonisamide can elevate blood acid levels, potentially leading to kidney stones, bone weakness, or high ammonia levels affecting the brain. Regular blood tests may be conducted to monitor acid levels. Symptoms like rapid breathing, vomiting, or confusion should prompt immediate medical consultation.

• Withdrawal Seizures: Abrupt discontinuation can worsen seizures. Consult your provider for a gradual dose reduction plan.

• Pregnancy Risks: Animal studies suggest potential harm to the unborn baby, including heart defects or death. Females of childbearing age should use contraception during treatment and for one month after stopping the medication. The drug should be used during pregnancy only if benefits outweigh risks.

If any of these warnings apply to you, or if you have any concerns, please speak with your healthcare provider before using Zonisamide.

Common side effects:

• Dizziness
• Drowsiness
• Trouble sleeping
• Lack of coordination
• Lightheadedness
• Loss of appetite
• Diarrhea
• Double vision
• Headache
• Nausea
• Fatigue
• Tiredness
• Agitation
• Irritability
• Depression
• Problems with concentration or memory
• Stomach pain
• Flu-like symptoms

Less common but important to monitor:

• Indigestion
• Constipation
• Speech problems
• Tingling in limbs
• Weight loss
• Anxiety
• Rash
• Dry mouth
• Changes in taste

Serious side effects:

• Serious skin reactions (blistering and peeling)
• Severe allergic reactions (swelling and breathing difficulties)
• Heat stroke symptoms (decreased sweating and fever)
• Mood changes indicating suicidal behavior
• Kidney issues (sudden pain and blood in urine)
• Metabolic acidosis (fast heartbeat and confusion)

Interactions with high risk of serious adverse effects and should be avoided:

• Methenamine

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Calcifediol
• Methotrexate
• Orlistat

Interactions with low risk that usually do not require a change in therapy:

• Aminolevulinic Acid
• Ginkgo
• Carbonic anhydrase inhibitors (such as acetazolamide)
• Phenobarbital
• Primidone
• Rifamycins (such as rifabutin)
• St. John's wort
• Alcohol
• Marijuana (cannabis)
• Antihistamines (such as cetirizine, diphenhydramine)
• Drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem)
• Muscle relaxants
• Opioid pain relievers (such as codeine)