ANTICONVULSANTS,SUCCINIMIDE (Systemic)
Some commonly used brand names are:
In the U.S.?
In Canada?
Note: | For quick reference, the following succinimide anticonvulsants arenumbered to match the corresponding brand names. |
Category
- Anticonvulsant?Ethosuximide; Methsuximide
Description
Succinimideanticonvulsants are used to control certain seizures in the treatment of epilepsy.These medicines act on the central nervous system (CNS) to reduce the numberand severity of seizures.
This medicine is available only with your doctor's prescription, in thefollowing dosage forms:
Oral- Ethosuximide
- Capsules (U.S. and Canada)
- Syrup (U.S. and Canada)
- Methsuximide
- Capsules (U.S. and Canada)
Before Using This Medicine
In deciding to use a medicine,the risks of taking the medicine must be weighed against the good it willdo. This is a decision you and your doctor will make. For succinimide anticonvulsants,the following should be considered:
Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to anticonvulsant medicines. Also tell your health careprofessional if you are allergic to any other substances, such as foods, preservatives,or dyes.
Pregnancy?Although succinimide anticonvulsants have not beenshown to cause problems in humans, there have been unproven reports of increasedbirth defects associated with the use of other anticonvulsant medicines.
Breast-feeding?Ethosuximide passes into breast milk. It is notknown whether methsuximide passes into breast milk. However, these medicineshave not been reported to cause problems in nursing babies.
Children?Succinimide anticonvulsants are not expected to causedifferent side effects or problems in children than they do in adults.
Older adults?Many medicines have not been studied specificallyin older people. Therefore, it may not be known whether they work exactlythe same way they do in younger adults. Although there is no specific informationcomparing use of succinimide anticonvulsants in the elderly to use in otherage groups, they are not expected to cause different side effects or problemsin older people than they do in younger adults.
Other medicines?Although certain medicines should not be usedtogether at all, in other cases two different medicines may be used togethereven if an interaction might occur. In these cases, your doctor may want tochange the dose, or other precautions may be necessary. When you are takingsuccinimide anticonvulsants, it is especially important that your health careprofessional know if you are taking any of the following:
- Central nervous system (CNS) depressants (medicines that cause drowsiness)?Usingthese medicines together may increase CNS depressant effects
- Haloperidol (e.g., Haldol)?A change in the pattern and/or thefrequency of seizures may occur; the dose of either medicine may need to bechanged
Other medical problems?The presence of other medicalproblems may affect the use of succinimide anticonvulsants. Make sure youtell your doctor if you have any other medical problems, especially:
- Blood disease or
- Intermittent porphyria or
- Kidney disease (severe) or
- Liver disease?Succinimide anticonvulsants may make the conditionworse
Proper Use of This Medicine
This medicine must be taken every day in regularly spaced doses as orderedby your doctor. Do not take more or less of it than your doctor ordered.
If this medicine upsets your stomach, take it with food or milk unlessotherwise directed by your doctor.
Dosing?The dose of succinimide anticonvulsants willbe different for different patients. Follow your doctor'sorders or the directions on the label. The following information includesonly the average doses of ethosuximide and methsuximide. If your dose is different, do not change it unless your doctor tellsyou to do so.
The number of capsules or teaspoonfuls of syrup that you take depends onthe strength of the medicine. Also, the number of dosesyou take each day, the time allowed between doses, and the length of timeyou take the medicine depend on the medical problem for which you are takinga succinimide anticonvulsant.
For ethosuximide- For oral dosage form (capsules or syrup):
- As an anticonvulsant:
- Adults and children 6 years of age and over?To start, 250 milligrams(mg) twice a day. Your doctor may increase your dose gradually if needed.However, the dose is usually not more than 1500 mg a day.
- Children up to 6 years of age?To start, 250 mg once a day.Your doctor may increase your dose gradually if needed. However, the doseis usually not more than 1000 mg a day.
For methsuximide- For oral dosage form (capsules):
- As an anticonvulsant:
- Adults, teenagers, and children?To start, 300 milligrams (mg)once a day. Your doctor may increase your dose gradually if needed. However,the dose is usually not more than 1200 mg a day.
Missed dose?If you miss a dose of this medicine, take it assoon as possible. However, if it is within 4 hours of your next dose, skipthe missed dose and go back to your regular dosing schedule. Do not doubledoses.
Storage?To store this medicine:
- Keep out of the reach of children.
- Store away from heat and direct light.
- Do not store the capsule form of this medicine in the bathroom, nearthe kitchen sink, or in other damp places. Heat or moisture may cause themedicine to break down.
- Keep the liquid form of this medicine from freezing. Do not refrigerate.
- Do not keep outdated medicine or medicine that is no longer needed.Be sure any discarded medicine is out of the reach of children.
Precautions While Using This Medicine
Your doctor should check your progress at regular visits,especially during the first few months of treatment with this medicine. Duringthis time the amount of medicine you are taking may have to be changed oftento meet your individual needs.
If you have been taking a succinimide anticonvulsantregularly, do not stop taking it without first checking with your doctor.Your doctor may want you to reduce gradually the amount you are taking beforestopping completely. Stopping this medicine suddenly may cause seizures.
Do not start or stop taking any other medicine withoutyour doctor's advice. Other medicines may affect the way this medicineworks.
This medicine will add to the effects of alcohol and other CNS depressants(medicines that slow down the nervous system, possibly causing drowsiness).Some examples of CNS depressants are antihistamines or medicine for hay fever,other allergies, or colds; sedatives, tranquilizers, or sleeping medicine;prescription pain medicine or narcotics; barbiturates; medicine for seizures;muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above whileyou are using this medicine.
This medicine may cause some people to become drowsy or less alert thanthey are normally. Make sure you know how you react tothis medicine before you drive, use machines, or do anything else that couldbe dangerous if you are not alert. After you have taken this medicinefor a while, this effect may lessen.
Before having any kind of surgery, dental treatment,or emergency treatment, tell the medical doctor or dentist in charge thatyou are taking this medicine. Taking succinimide anticonvulsants togetherwith medicines that are used during surgery or dental or emergency treatmentsmay increase the CNS depressant effects.
Your doctor may want you to carry a medical identification card or braceletstating that you are taking this medicine.
For patients taking methsuximide:
- Do not use capsules that are not full or in which the contents havemelted, because they may not work properly.
Side Effects of This Medicine
Along with its needed effects,a medicine may cause some unwanted effects. Although not all of these sideeffects may occur, if they do occur they may need medical attention.
Check with your doctor as soon as possibleif any of the following side effects occur:
Rare
Chills; increased chance of certaintypes of seizures; mood or mental changes; nosebleeds or other unusual bleeding or bruising; shortness of breath; sores, ulcers,or white spots on lips or in mouth; unusual tirednessor weakness; wheezing, tightness in chest, or troubledbreathing
Other side effects may occurthat usually do not need medical attention. These side effects may go awayduring treatment as your body adjusts to the medicine. However, check withyour doctor if any of the following side effects continue or are bothersome:
Other side effects not listed above may also occur in some patients. Ifyou notice any other effects, check with your doctor.
Revised: 02/05/2001
