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NERVOUS SYSTEM › ANTIEPILEPTICS › ANTIEPILEPTICS › Succinimide derivatives
ethosuximide, combinations
N03AD51
Forms & Strengths
- Capsules: 250mg
- Oral solution: 250mg/5mL
- Tablets: 250mg
Adult Dosing
- Initial dose: 500mg/day, increase by 250mg every 4-7 days
- Maintenance dose: 1-1.5g/day, in 2-3 divided doses
- Maximum dose: 1.5g/day
Pediatric Dosing
- Initial dose: 10-15mg/kg/day, increase by 5mg/kg every 4-7 days
- Maintenance dose: 20-30mg/kg/day, in 2-3 divided doses
- Maximum dose: 30mg/kg/day or 1.5g/day, whichever is less
Indications
- Absence seizures, simple or complex
- Seizures that are refractory to other treatments
Mechanism of Action
- Blocks T-type calcium channels, reducing low-threshold calcium currents
- Inhibits thalamic neurons, preventing seizure propagation
Contraindications
- Hypersensitivity to ethosuximide or other succinimides
- Pregnancy, especially during the first trimester
Adverse Reactions
- Gastrointestinal: nausea, vomiting, anorexia, abdominal pain
- CNS: drowsiness, dizziness, headache, irritability, ataxia
- Hematologic: agranulocytosis, aplastic anemia, thrombocytopenia
- Dermatologic: rash, Stevens-Johnson syndrome, toxic epidermal necrolysis
Drug Interactions
- Phenytoin: decreases ethosuximide levels
- Valproic acid: increases ethosuximide levels
- Carbamazepine: decreases ethosuximide levels
Curated Content: Needs Vetting Before Put to Clinical Use