Category
Anticonvulsant for the control of absence (petit mal) epilepsy.
Contra-Indications
Ethosuximide should not be used in patients with a history of hypersensitivity to succinimides.
Precautions
Blood dyscrasias, including some with fatal outcome, have been reported to be associated with the use of ethosuximide; therefore, periodic blood counts should be performed. Ethosuximide is capable of producing morphological and functional changes in the animal liver. In humans, abnormal liver and renal function studies have been reported. Administer ethosuximide with extreme caution to patients with known liver or renal disease. Periodic urinalysis and liver function studies are advised for all patients receiving the drug. Cases of systemic lupus erythematosus have been reported with the use of ethosuximide. The physician should be alert to this possibility.
Ethosuximide may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks, such as driving a motor vehicle or other such activity requiring alertness; therefore, caution the patient accordingly.
Ethosuximide, when used alone in mixed types of epilepsy, may increase the frequency of generalized tonic-clonic attacks in some patients.
Proceed slowly when increasing or decreasing dosage, as well as when adding or eliminating other medication. Abrupt withdrawal of anticonvulsant medication may precipitate petit mal status.
Adverse Side Effects
Gastrointestinal
Gastrointestinal symptoms occur frequently and include anorexia, vague gastric upset, nausea and vomiting, cramps, epigastric and abdominal pain, weight loss, and diarrhea.
Hemopoietic
Leukopenia, agranulocytosis, pancytopenia, aplastic anemia, eosinophilia.
Nervous system
Neurologic and sensory reactions reported during therapy with ethosuximide have included
- drowsiness
- headache
- dizziness
- euphoria
- hiccups
- irritability
- hyperactivity
- lethargy
- fatigue
- ataxia
Psychiatric or psychological aberrations associated with ethosuximide administration have included
- disturbances of sleep
- night terrors
- inability to concentrate
- aggressiveness
These effects may be noted particularly in patients who have previously exhibited psychological abnormalities. There have been rare reports of paranoid psychosis, increased libido, and increased state of depression with overt suicidal intentions.
Integumentary
Dermatologic manifestations which have occurred with the administration of ethosuximide have included urticaria, Stevens-Johnson syndrome, systemic lupus erythematosus, and pruritic erythematous rashes.
Genitourinary
Microscopic hematuria.
Miscellaneous
Myopia, vaginal bleeding, swelling of the tongue, gum hypertrophy, hirsutism.
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