ETHOSUXIMIDE

Antiepileptic and anticonvulsant medicine

Dosage Forms

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Capsules

250 mg

Uses

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  • Epilepsy (petit mal)

Dose and Duration

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Epilepsy (petit mal)
Adult and child > 6 years: 250 mg every 12 hours, increased by 250 mg every 4–7 days up to a usual daily dose of 500–750 mg every 12 hours (max 2 g)
Child 1 month–6 years: 5 mg/kg (max 125 mg) every 12 hours increased gradually over 2–3 weeks up to a maintenance dose of 10–20 mg/kg (max 500 mg) every 12 hours

Contraindications

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  • Acute porphyria

Side Effects

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  • Nausea, vomiting, diarrhoea, abdominal pain
  • Anorexia, weight loss, suicidal ideation
  • Blood dyscrasias
  • Gum hypertrophy
  • Drowsiness
  • Stevens-Johnson syndrome
  • Systemic lupus erythematosus

Interactions

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  • Isoniazid (increased plasma concentration of ethosuximide and increased risk of toxicity)
  • Phenytoin (reduced concentration of ethosuximide)
  • Mefloquine (anticonvulsant effect antagonised)
  • Antipsychotic (anticonvulsant effect antagonised)
  • Orlistat (possibly increased risk of convulsions)

Patient Instructions

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  • In case you notice symptoms such as fever, mouth ulcers, bruising or bleeding, consult your doctor immediately; could be a sign of blood disorders
  • Seek medical advice if suicidal ideas or behaviour develop

Pregnancy

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  • Do not use

Breast-feeding

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  • Can be used

⚠️ Caution

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  • Avoid abrupt withdrawal
  • Use with caution in hepatic and renal impairment. Monitor liver and renal function
  • If ethosuximide is given as monotherapy, encourage breast-feeding unless adverse effects appear in the infant or child; in which case the mother should stop breast-feeding. Patients should not breast-feed if on multiple drug regimens
  • There is a recognised small increase in congenital malformations. Weigh risk against benefit of treatment