Zonegran Warnings and Precautions

There are several Zonegran warnings and precautions to be aware of before starting treatment. For example, it can cause concentration problems, speech problems, drowsiness, and problems with coordination. The medication may also increase the risk of status epilepticus (a dangerous seizure that lasts a long time). Zonegran warnings and precautions also extend to those who are allergic to "sulfa" drugs or to any component of the medication.

Zonegran: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking Zonegran® (zonisamide) if you have:
  • A history of kidney stones
  • Any blood disorder
  • Liver disease, including liver failure, hepatitis, or cirrhosis
  • Kidney disease, including kidney failure (renal failure)
  • Any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Zonegran Warnings and Precautions

Warnings and precautions to be aware of prior to taking Zonegran include the following:
  • Zonegran is a sulfonamide ("sulfa" drug). If you are allergic to sulfonamides, you should not take Zonegran.
  • The medication can cause life-threatening skin rashes, which may cause a loss of large sections of skin (resulting in disfigurement or even death). Let your healthcare provider know immediately if you have an unexplained rash. Your healthcare provider will decide if your rash might become dangerous and may recommend stopping Zonegran.
  • Zonegran can affect the ability of bone marrow to make blood cells. Let your healthcare provider know if you have signs of low blood cells, including easy bruising or bleeding or frequent infections.
  • Zonegran has been reported to cause cases of decreased sweating accompanied by a fever. This can be dangerous and can lead to heat stroke and even death. Children are at an increased risk of this problem. Let your healthcare provider know if you notice decreased sweating, especially in warm weather.
  • As with all seizure medications, Zonegran should not be stopped suddenly (see Zonegran Withdrawal).
  • Zonegran can cause concentration problems, speech problems, drowsiness, and problems with coordination. Be sure to tell your healthcare provider if you develop any of these Zonegran side effects. Also, make sure you know how the drug affects you before driving or operating any machinery.
  • Zonegran can increase your risk of kidney stones. One way to help prevent this is to drink plenty of water to stay hydrated. Zonegran may not be the best medication for you if you are prone to kidney stones.


  • Zonegran can cause metabolic acidosis, a condition in which there is too much acid in the body. Among other things, metabolic acidosis increases the risk of kidney stones. Kidney disease, severe respiratory disorders, diarrhea, a "ketogenic" diet (a high-fat, low-carbohydrate diet often used by people with epilepsy), or certain other medications may increase the risk of metabolic acidosis with Zonegran. Be sure to watch for any symptoms of this problem, such as:
    • Fast breathing
    • Fatigue or tiredness
    • An irregular heart rhythm (arrhythmia)
    • Feelings of a rapidly or forcefully beating heart (palpitations). 


  • Zonegran can slightly decrease your kidney function. For most people, this is not a problem. However, if you already have kidney problems, any decrease in kidney function can be dangerous.
  • The medication may increase the risk of status epilepticus (a dangerous seizure that lasts a very long time, often more than 30 minutes). If you have a seizure that lasts longer than usual (or is different in any way from your usual seizures), seek immediate medical attention.
  • About 1 percent of people taking Zonegran report experiencing extreme weakness. This usually goes away once the medication is stopped.
  • In dogs, Zonegran binds to tissues in the eye, suggesting that it may cause eye problems. It is not known if this is also true for humans. Tell your healthcare provider if you notice any eye or vision problems that are possibly due to Zonegran.
  • The liver helps remove Zonegran from your body. If you have liver disease, your healthcare provider may suggest a lower Zonegran dosage.
  • Zonegran can interact with other medications (see Zonegran Drug Interactions).
  • Zonegran is considered a pregnancy Category C medication. This means that it may not be safe for pregnant women. Talk to your healthcare provider about the risks and benefits of taking the drug during pregnancy (see Zonegran and Pregnancy).
  • Zonegran passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Zonegran and Breastfeeding).


  • Early evidence suggests that seizure medications, including Zonegran, may increase the risk of suicidal thoughts or behaviors (see Seizure Medications and Suicide for more information).
Know the Signs - Concussion Safety

Zonegran Drug Information

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