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zonisamide Side Effects

Also known as: Zonegran

Analysis of 14,210 adverse event reports submitted to the FDA from 2004 to 2025.

Total Reports

14,210

Death-Related

869

6.1% of reports

Hospitalizations

4,400

31.0% of reports

Top Indication

Product Used For Unknown Indication

Most Reported Adverse Reactions

DRUG INEFFECTIVE
1,636
SEIZURE
1,574
OFF LABEL USE
872
FATIGUE
697
SOMNOLENCE
645
CONVULSION
623
DIZZINESS
558
NAUSEA
550
HEADACHE
543
FALL
496
DRUG INTERACTION
466
CONDITION AGGRAVATED
447
VOMITING
438
DIARRHOEA
412
EPILEPSY
378
WEIGHT DECREASED
361
DEPRESSION
358
INSOMNIA
354
RASH
339
PYREXIA
326

Who Reports Side Effects

Gender Distribution

Female 6,961 (61%)
Male 4,449 (39%)
Unknown 46

Age Distribution

0-17 1,860 (23%)
18-44 3,110 (38%)
45-64 2,062 (25%)
65-74 733 (9%)
75+ 416 (5%)

Reporting Trend by Year

2004 2025

Reactions in Death Reports

Top reactions reported in 869 reports where death was an outcome. These are voluntarily reported and do not establish causation.

Reaction Reports
DEATH 195
COMPLETED SUICIDE 59
PNEUMONIA ASPIRATION 55
OFF LABEL USE 53
RESPIRATORY FAILURE 41
PNEUMONIA 39
TOXICITY TO VARIOUS AGENTS 39
SUDDEN UNEXPLAINED DEATH IN EPILEPSY 38
CARDIO-RESPIRATORY ARREST 37
DRUG INEFFECTIVE 36
CARDIAC ARREST 34
SEPTIC SHOCK 33
FOETAL EXPOSURE DURING PREGNANCY 30
SOMNOLENCE 28
STATUS EPILEPTICUS 27
FALL 26
SEIZURE 25
SEPSIS 25
ANXIETY 23
CONVULSION 22

Reactions in Hospitalization Reports

Top reactions in 4,400 reports where hospitalization was an outcome.

Reaction Reports
SEIZURE 449
DRUG INEFFECTIVE 427
OFF LABEL USE 253
FALL 249
CONVULSION 230
SOMNOLENCE 229
VOMITING 224
PNEUMONIA 219
DRUG INTERACTION 212
PYREXIA 201
NAUSEA 191
DIZZINESS 172
FATIGUE 171
EPILEPSY 154
WEIGHT DECREASED 154
CONDITION AGGRAVATED 152
STATUS EPILEPTICUS 146
HEADACHE 127
ASTHENIA 126
DIARRHOEA 120

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What the FAERS Data Reveals About zonisamide Side Effects

The FDA Adverse Event Reporting System (FAERS) contains 14,210 voluntary reports linked to zonisamide and its brand equivalents (Zonegran), spanning 2004 through 2025. Of those, 869 (6.1%) listed death as an outcome and 4,400 (31.0%) involved hospitalization. The most common indication reported alongside adverse events was Product Used For Unknown Indication.

Demographic breakdowns help contextualize who is being exposed to the drug. Of reports with known sex, 61% were female and 39% male; age distribution skews toward 18-44, with 3,110 reports in that bracket. The single most reported reaction is drug ineffective with 1,636 submissions, followed by seizure and off label use.

FAERS is a signal-detection tool, not a scorecard. Reports are voluntary, and a single case may list multiple suspect drugs, so numbers above should not be read as incidence rates or per-patient risk. Widely prescribed drugs naturally accumulate more reports than niche therapies even when individual risk is low. These aggregates are useful for spotting patterns that merit further pharmacovigilance, not for choosing between medications. This page is for educational reference only and is not medical advice — speak with a licensed clinician about any side-effect concerns.