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Prescription medication · Anticonvulsant (Sulfonamide)

zonisamide

Also sold as Zonegran. Zonisamide is used to treat partial seizures in adults who have epilepsy.

Data updated 2026-05-15

14,210
FDA reportsModerately reported
13
InteractionsSeveral interactions
$0.10
Generic price (NADAC)

What the data shows

zonisamide (Zonegran) is a prescription Anticonvulsant (Sulfonamide), reported less often than most tracked drugs (14,210 FDA reports), with 13 documented drug interactions.

Reporting volume reflects how widely a drug is used and studied, not how dangerous it is, a FAERS report documents a temporal association, never proof of cause.

zonisamide (Zonegran) is a prescription Anticonvulsant (Sulfonamide). Zonisamide is used to treat partial seizures in adults who have epilepsy.

Zonisamide is a medicine used with other medicines to treat partial seizures in adults with epilepsy. It belongs to a class of drugs called anticonvulsants.

Drug Pricing (NADAC)

Generic Price

$0.10/unit

Generic Available

Yes (6 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

View Alternatives → Compare with Another Drug → Full Side Effects Report →

What it does

Zonisamide is used to treat partial seizures in adults who have epilepsy.

Common side effects

Feeling sleepy, Loss of appetite, Dizziness

Key warnings

If you are allergic to sulfonamide medicines, you should not take zonisamide.

The sections below are summarized in plain English from zonisamide's FDA-approved prescribing information. They describe what the official label says, and are not personal medical advice.

How It Works

Zonisamide works by slowing down the electrical signals in the brain that cause seizures. It is thought to stabilize nerve cell membranes, which reduces the chance of seizures. It may also affect certain chemicals in the brain.

How to Take It

Take zonisamide capsules by mouth once or twice a day. You can take it with or without food. Swallow the capsules whole; do not crush or chew them. Your doctor will start you on a low dose and slowly increase it every two weeks.

This is a plain-language summary of zonisamide's FDA labeling, not individualized dosing advice. Ask a pharmacist or prescriber before changing how you take this medication.

Pregnancy & Breastfeeding

Tell your doctor if you are pregnant or plan to become pregnant. It is not known if zonisamide will harm your unborn baby. Talk to your doctor about the risks and benefits of taking zonisamide during pregnancy. It is also not known if zonisamide passes into breast milk, so talk to your doctor before breastfeeding.

This is a plain-language summary of zonisamide's FDA labeling, not individualized advice. Ask a pharmacist or prescriber about pregnancy or breastfeeding on this medication.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take your next dose at the regular time.

This is a plain-language summary of zonisamide's FDA labeling, not individualized advice. Ask a pharmacist or prescriber what to do about your specific missed dose.

Storage

Store zonisamide capsules at room temperature (68°F to 77°F) in a dry place, away from light.

Side Effects (from patient reports)

Based on 14,210 FDA adverse event reports.

Most-reported reactions

Adverse reactions in FAERS for zonisamide, by number of reports

reports

What this shows Bars show how often each reaction was reported, not how likely it is to happen, a report records a temporal association, never proof that the drug caused it.

Source FDA Adverse Event Reporting System (FAERS) As of 2025

Reports over time

Adverse-event reports filed for zonisamide each year to the FDA Adverse Event Reporting System (FAERS).

05001,0001,500 20042007201020132016201920222025 930

Year-to-year volume tracks usage, prescribing, and scrutiny, not a change in per-patient risk. Source: FDA FAERS.

Where zonisamide sits

zonisamide has more FDA adverse-event reports than 47% of the drugs FAERS tracks. A high position reflects how widely a drug is used and watched, not how dangerous it is.

fewest reports most reports

Percentile across all drugs PlainMeds tracks by FAERS report volume. The dot is zonisamide; the line is the median (50th percentile).

FDA Adverse Event Report Analysis

Detailed analysis of 14,210 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.

Total Reports

14,210

Reports Mentioning Death

869

6.1% of reports — not proof of cause

Hospitalization Reports

4,400

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 6,961 (61%)
Male 4,449 (39%)

Age Distribution

0–17 1,860
18–44 3,110
45–64 2,062
65–74 733
75+ 416

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
2 SEIZURE 1,574
4 FATIGUE 697
5 SOMNOLENCE 645
6 CONVULSION 623
7 DIZZINESS 558
8 NAUSEA 550
9 HEADACHE 543
10 FALL 496
11 DRUG INTERACTION 466
12 CONDITION AGGRAVATED 447
13 VOMITING 438
14 DIARRHOEA 412
15 EPILEPSY 378
16 WEIGHT DECREASED 361
17 DEPRESSION 358

Reactions in Death Reports

DEATH 195
COMPLETED SUICIDE 59
PNEUMONIA ASPIRATION 55
RESPIRATORY FAILURE 41
PNEUMONIA 39
TOXICITY TO VARIOUS AGENTS 39
SUDDEN UNEXPLAINED DEATH IN EPILEPSY 38
CARDIO-RESPIRATORY ARREST 37
CARDIAC ARREST 34
SEPTIC SHOCK 33

Reactions in Hospitalization Reports

SEIZURE 449
FALL 249
CONVULSION 230
SOMNOLENCE 229
VOMITING 224
PNEUMONIA 219
DRUG INTERACTION 212
PYREXIA 201
NAUSEA 191
DIZZINESS 172

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

If you are allergic to sulfonamide medicines, you should not take zonisamide. Using zonisamide with other medicines that also inhibit carbonic anhydrase (like topiramate) can increase the risk of metabolic acidosis, kidney stones, and high ammonia levels in the blood.

Known Drug Interactions

moderate alogliptin

Examples: Topiramate, zonisamide, acetazolamide or dichlorphenamide Drugs that Reduce Metformin Clearance Clinical Impact: Concomitant use of drugs that interfere with common renal tubular transport systems involved in the renal elimination of metformin (e.g., organic cationic transporter-2 [OCT2]/multidrug and toxin extrusion [MATE] inhibitors) could increase systemic exposure to metformin and may increase the risk for lactic acidosis [see Clinical Pharmacology (12.3) ] .

Mechanism: Zonisamide interferes with how your kidneys remove metformin from your body, which can increase the risk of a serious condition called lactic acidosis.

What to do: Use these drugs together with caution and follow your doctor's advice on monitoring your health.

7 DRUG INTERACTIONS Table 3: Clinically Significant Drug Interactions with SEGLUROMET Carbonic Anhydrase Inhibitors Clinical Impact: The risk of lactic acidosis may increase due to concomitant use of Topiramate or other carbonic anhydrase inhibitors (e.g., zonisamide, acetazolamide or dichlorphenamide) with metformin.

Mechanism: Both drugs can cause a buildup of acid in the blood. Taking them together increases the risk of a serious condition called lactic acidosis.

What to do: Your doctor may need to monitor your blood levels more closely. Watch for symptoms like unusual tiredness or trouble breathing.

moderate topiramate

7.2 Other Carbonic Anhydrase Inhibitors Concomitant use of topiramate, a carbonic anhydrase inhibitor, with any other carbonic anhydrase inhibitor (e.g., zonisamide or acetazolamide) may increase the severity of metabolic acidosis and may also increase the risk of kidney stone formation.

Mechanism: Both drugs block the same enzyme, which can make your blood too acidic. This combination also makes it more likely that you will develop kidney stones.

What to do: Your doctor should monitor your blood chemistry closely. Make sure to drink plenty of fluids to reduce the risk of kidney stones.

In addition, carbamazepine causes, or would be expected to cause, decreased levels of the following drugs, for which monitoring of concentrations or dosage adjustment may be necessary: acetaminophen, albendazole, alprazolam, aprepitant, buprenorphone, bupropion, citalopram, clonazepam, clozapine, corticosteroids (e.g., prednisolone, dexamethasone), cyclosporine, dicumarol, dihydropyridine calcium channel blockers (e.g., felodipine), doxycycline, ethosuximide, everolimus, haloperidol, imatinib, itraconazole, lamotrigine, levothyroxine, methadone, methsuximide, mianserin, midazolam,...

Mechanism: Carbamazepine speeds up how quickly your body breaks down zonisamide, which can make the zonisamide less effective.

What to do: Your doctor may need to monitor your blood levels or adjust your dose of zonisamide.

Table 4 Clinically Relevant Interactions with SYNJARDY or SYNJARDY XR Carbonic Anhydrase Inhibitors Clinical Impact Topiramate or other carbonic anhydrase inhibitors (e.g., zonisamide, acetazolamide or dichlorphenamide) frequently causes a decrease in serum bicarbonate and induce non-anion gap, hyperchloremic metabolic acidosis.

Mechanism: Zonisamide can cause a buildup of acid in your blood by lowering bicarbonate levels. Taking it with this medicine may increase the risk of this chemical imbalance.

What to do: Your doctor may need to monitor your blood tests more often. Tell your healthcare provider if you feel very tired or have trouble breathing.

Check all your medications →

This is a plain-language summary of interactions documented in FDA labeling, not individualized advice. Ask a pharmacist or prescriber before combining medications.

Common Questions

Can I drink alcohol while taking zonisamide?
It's best to avoid alcohol while taking zonisamide, as it can increase sleepiness and other side effects.
How long does it take for zonisamide to start working?
It may take up to two weeks to reach a steady level of zonisamide in your body after a dose change.
Can I stop taking zonisamide suddenly?
No, do not stop taking zonisamide suddenly. Talk to your doctor first, as stopping suddenly can cause seizures.
Does zonisamide cause weight loss?
Yes, weight loss is a possible side effect of zonisamide.
Can zonisamide affect my thinking?
Yes, zonisamide can cause difficulty with concentration, memory, and mental slowing.
What should I do if I experience side effects?
Tell your doctor about any side effects you experience while taking zonisamide.
Can I take zonisamide with other medications?
Talk to your doctor about all the medications you are taking, including over-the-counter drugs and supplements, before starting zonisamide.
Will zonisamide cure my epilepsy?
Zonisamide helps to control seizures, but it is not a cure for epilepsy.
What size capsules does zonisamide come in?
Zonisamide capsules come in 25 mg, 50 mg, and 100 mg strengths.
Where can I find more information about zonisamide?
You can find more information at www.vionausa.com/medguides or by calling 1-888-304-5011.
What are the common side effects of zonisamide?
The most commonly reported side effects of zonisamide include Feeling sleepy, Loss of appetite, Dizziness, Problems with coordination, Feeling agitated or irritable. Based on 14,210 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does zonisamide interact with other medications?
Yes, zonisamide has 13 known drug interactions. Notable interactions include alogliptin, ertugliflozin, topiramate. Always inform your doctor about all medications you are taking.
What drug class is zonisamide?
zonisamide belongs to the Anticonvulsant (Sulfonamide) drug class. It requires a prescription (Rx). Zonisamide is used to treat partial seizures in adults who have epilepsy.
Is zonisamide safe during pregnancy?
Tell your doctor if you are pregnant or plan to become pregnant. It is not known if zonisamide will harm your unborn baby. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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What the FDA Data Shows for zonisamide

The FDA label for zonisamide (sold under brand names such as Zonegran) classifies it as a prescription-only medication in the Anticonvulsant (Sulfonamide) class. Zonisamide is used to treat partial seizures in adults who have epilepsy. Official labeling lists 6 commonly reported side effects, including Feeling sleepy, Loss of appetite, Dizziness.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 14,210 voluntary reports. The database also lists 13 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS shows a generic unit cost of $0.10.

Report counts do not establish causation, a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice, always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: August 1, 2025

Data currency: FDA FAERS adverse-event reports through 2025, CMS NADAC acquisition-cost pricing effective December 2024, compiled and last refreshed May 2026. See our methodology for per-source dates and refresh cadence. Spot a figure that looks wrong? Report a correction.

All federal data sources used on this page