Indicated for the control of absence (petit mal) epilepsy. Ethosuximide should not be used in patients with a history of hypersensitivity to succinimides.
Ethosuximide suppresses the paroxysmal three cycle per second spike and wave activity associated with lapses of consciousness which is common in absence (petit mal) seizures. The frequency of epileptiform attacks is reduced, apparently by depression of the motor cortex and elevation of the threshold of the central nervous system to convulsive stimuli.
Absence seizures | Atypical absence seizures (adjunct) | Myoclonic seizures BY MOUTH Child 1 month-5 years: Initially 5 mg/kg twice daily (max. per dose 125 mg), dose to be increased every 5-7 days; maintenance 10-20 mg/kg twice daily (max. per dose 500 mg), total daily dose may rarely be given in 3 divided doses Child 6-17 years: Initially 250 mg twice daily, then increased in steps of 250 mg every 5-7 days; usual dose 500-750 mg twice daily, increased if necessary up to 1 g twice daily Adult: Initially 500 mg daily in 2 divided doses, then increased in steps of 250 mg every 5-7 days; usual dose 1-1.5 g daily in 2 divided doses, increased if necessary up to 2 g daily
The plasma concentrations of ethosuximide may be reduced by carbamazepine, primidone, phenobarbitone and lamotrigine and increased by isoniazid. No consistent changes in levels of ethosuximide occur when used in combination with phenytoin or sodium valproate. Phenytoin levels however are increased by concomitant ethosuximide.
Avoid in acute porphyrias.
Common or very common Anorexia . abdominal pain . diarrhoea . gastro-intestinal disturbances . nausea . vomiting . weight loss Uncommon Aggression . ataxia . dizziness . drowsiness . euphoria . fatigue . headache . hiccup . impaired concentration . irritability Rare Depression . dyskinesia . gingival hypertrophy . increased libido . myopia . photophobia . psychosis . rash . sleep disturbances . tongue swelling . vaginal bleeding Frequency not known Agranulocytosis . aplastic anaemia . blood disorders . hyperactivity . increase in seizure frequency . leucopenia . pancytopenia . Stevens-Johnson syndrome . suicidal ideation . systemic lupus erythematosus
PREGNANCY The dose should be monitored carefully during pregnancy and after birth, and adjustments made on a clinical basis. BREAST FEEDING Present in milk. Hyperexcitability and sedation reported.
Acute overdoses may produce nausea, vomiting and CNS depression including coma with respiratory depression. Relationship between ethosuximide toxicity and its plasma levels has not been established.
Keep away from the reach of children. Store in a cool and dry place protected from light.
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