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Zonisamide is a sulfonamide anticonvulsant approved for use as an adjunctive therapy in adults with partial-onset seizures for adults; infantile spasm, mixed seizure types of Lennox-Gastaut syndrome, myoclonic, and generalized tonic clonic seizure[1].
HistoryZonisamide was discovered by Uno and colleagues in 1972[2] and launched by Dainippon Sumitomo Pharma (
?, Dainippon Sumitomo Seiyaku?) (formerly Dainippon Pharmaceutical (
??, Dainippon Seiyaku?)) in 1989 as Excegran in Japan.[3] It was marketed by ?lan in the United States starting in 2000 as Zonegran, before ?lan transferred their interests in zonisamide to Eisai (
??) in 2004.[4] Eisai also markets Zonegran in Asia (China, Taiwan, and fourteen others)[5] and Europe (starting in Germany and the United Kingdom).[6]
IndicationsEpilepsyZonisamide is approved in the United States,[7] United Kingdom,[8] for adjunctive treatment of partial seizures in adults and in Japan for both adjunctive and monotherapy for partial seizures (simple, complex, secondarily generalized), generalized (tonic, tonic-clonic (grand mal), and atypical absence) and combined seizures.[9]
Side effectsThe most common side effects include drowsiness, loss of appetite, dizziness, headache, nausea, and agitation/irritability. Zonisamide has also been associated with hypohidrosis.[25]
On February 23, 2009 the U.S. Food and Drug Administration (FDA) issued a warning that zonisamide can cause metabolic acidosis in some patients. It is now recommended that serum bicarbonate levels are assessed before starting treatment and periodically during treatment with zonisamide, even in the absence of symptoms.[26]
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