Ethosuximide (ethosuximide)
Anticonvulsants Oral Capsule; Oral Solution, Oral
Last reviewed · Source: First Databank (FDB) drug data
Overview
Ethosuximide is a succinimide-derivative anticonvulsant; the drug is structurally related to other succinimide anticonvulsants (e.g., methsuximide, phensuximide (no longer commercially available in the US)).
Ethosuximide is used as monotherapy or adjunctive therapy (i.e., in conjunction with other anticonvulsants) in the prophylactic management of absence (petit mal) seizures and is generally considered the first-line anticonvulsant drug of choice for such seizures. Ethosuximide is usually ineffective in the management of other seizure types such as partial seizures or tonic-clonic (grand mal) seizures, although some clinicians have reported good results with ethosuximide in controlling partial seizures with complex symptomatology and myoclonic seizures. (For additional information on the treatment of absence seizures, see Uses: Seizure Disorders, in the Anticonvulsants General Statement 28:12.) In a randomized controlled study comparing ethosuximide, valproic acid, and lamotrigine for initial monotherapy in children with absence epilepsy, ethosuximide and valproic acid were more effective than lamotrigine in controlling seizures; among these anticonvulsants, adverse effects generally were more frequent with valproic acid. Based on these findings, experts recommend the use of ethosuximide for optimal efficacy and tolerability in children and adolescents with absence seizures.
Ethosuximide may be used in combination with other anticonvulsants (e.g., valproic acid) for the treatment of coexisting seizure types (e.g., generalized tonic-clonic seizures).
Generic name: ethosuximide
Pronunciation: (ETH-oh-SUX-i-mide)
Drug class: Anticonvulsants
Therapeutic class: Central Nervous System Agents
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
Today’s intelligence on Ethosuximide
Indications
The following indications are listed for Ethosuximide:
- Absence Epilepsy
Also known as: Absence Epilepsy Simple, Absence Seizures, Minor Epilepsy, Petit Mal Epilepsy.
Dosing
Ethosuximide is administered orally as a capsule or oral solution.
Patients who are currently receiving or beginning therapy with ethosuximide and/or any other anticonvulsant should be closely monitored for notable changes in behavior that could indicate the emergence or worsening of suicidal thoughts or behavior or depression. (See Cautions: Precautions and Contraindications, in the Anticonvulsants General Statement 28:12.)
Dosage must be carefully and slowly adjusted according to individual requirements and response. Ethosuximide should be withdrawn or dosage reduced slowly to avoid precipitating seizures or absence status.
The usual initial dosage of ethosuximide for patients 3-6 years of age is 250 mg daily in a single dose; for patients 6 years of age or older, 500 mg may be given daily in a single dose or in divided doses. One method of establishing the maintenance dosage is to increase the daily dosage by 250 mg every 4-7 days until seizure control is achieved with minimal adverse effects. The usual maintenance dosage is 20 mg/kg or 1.2 g/m2 daily. Dosage should not usually exceed 1.5 g daily, given in divided doses. When the dosage exceeds 1.5 g daily, the patient must be closely supervised by the clinician. Some studies indicate that when the patient is well stabilized, the total daily dosage may be given as one dose; however, clinical efficacy of this once-daily regimen has not been established.
Patients undergoing hemodialysis may require a supplemental dose of ethosuximide following each dialysis session or may require dosage adjustment. (See Cautions: Precautions and Contraindications and also see Pharmacokinetics: Elimination.)
No dosing information is available for this tab.
| Drug label | Dosing type | Instructions |
|---|---|---|
| Ethosuximide 250 Mg Capsule | Maintenance | Take 1 capsule (250 mg) by oral route 3 times per day. |
| Ethosuximide 250 Mg/5 Ml Soln | Maintenance | Take 5 milliliters (250 mg) by oral route 3 times per day. |
| Drug label | Dosing type | Instructions |
|---|---|---|
| Ethosuximide 250 Mg/5 Ml Soln | Maintenance | Take 5 milliliters (250 mg) by oral route 3 times per day. |
| Ethosuximide 250 Mg Capsule | Maintenance | Take 1 capsule (250 mg) by oral route 3 times per day. |
| Ethosuximide 250 Mg/5 Ml Cup | Maintenance | Take 5 milliliters (250 mg) by oral route 3 times per day. |
Drug interactions
There is no enhanced messaging for this drug.
There are no contraindication interactions for this drug.
There are no severe interactions for this drug.
There are no moderate interactions for this drug.
Contraindications
There is no enhanced messaging for this drug.
There are no contraindication contraindications for this drug.
- Disease of liver
- Neutropenic disorder
- Pregnancy
- Suicidal ideation
- Acute intermittent porphyria
- Depression
- Kidney disease with reduction in glomerular filtration rate (GFr)
- Mood changes
- Systemic lupus erythematosus
Adverse reactions
There is no enhanced messaging for this drug.
Less Frequent
- Aggressive behavior
- Concentration difficulty
- Depression
- Night terror
Rare or Very Rare
- Abnormal hepatic function tests
- Accidental fall
- Agranulocytosis
- Allergic dermatitis
- Aplastic anemia
- Blood dyscrasias
- DRESS syndrome
- Drug-induced psychosis
- Eosinophilia
- Euphoria
- Gingival hyperplasia
- Hematuria
- Hepatitis
- Hypersensitivity drug reaction
- Lethargy
- Leukopenia
- Lymphadenopathy
- Multiple organ failure
- Myocarditis
- Myopia
- Myositis
- Nephritis
- Neutropenic disorder
- Pancytopenia
- Pruritus of skin
- Skin rash
- Stevens-johnson syndrome
- Suicidal ideation
- Systemic lupus erythematosus
- Thrombocytopenic disorder
- Tonic clonic seizure
More Frequent
- Abdominal pain with cramps
- Anorexia
- Ataxia
- Dizziness
- Drowsy
- Headache disorder
- Hiccups
- Nausea
- Vomiting
Less Frequent
- Diarrhea
- Fatigue
- General weakness
- Increased libido
- Irritability
- Weight loss
Rare or Very Rare
- Abnormal vaginal bleeding
- Behavioral disorders
- Fever
- Hirsutism
- Hyperkinesis
- Sleep disorder
- Tongue swelling
- Urticaria
Precautions
No enhanced messaging available.
No enhanced messaging available.
No enhanced messaging available.
Ethosuximide is distributed into human milk. The drug should be used with caution in nursing women and only when the benefits clearly outweigh the risks; women should be advised to notify their clinician if they plan to breast-feed. (See Cautions: Pregnancy and Lactation, in the Anticonvulsants General Statement 28:12.)
No enhanced messaging available.
ICD codes
| Code | Type | Description |
|---|---|---|
| Absence epilepsy | ||
| G40.A | ICD10CM | Absence epileptic syndrome |
| G40.A0 | ICD10CM | Absence epileptic syndrome, not intractable |
| G40.A09 | ICD10CM | Absence epileptic syndrome, not intractable, without status epilepticus |
| G40.A1 | ICD10CM | Absence epileptic syndrome, intractable |
| G40.A19 | ICD10CM | Absence epileptic syndrome, intractable, without status epilepticus |
ICD code information from First Databank (FDB).
Formulary status
Search health-plan coverage for this drug by ZIP code.
Choose the first character of a health plan name.
Last reviewed · Source: First Databank (FDB) drug data
On this page
Actions
Sign in to save favorites
Saving this drug requires a free Physicians Office Resource account.