Formulary
Ethosuximide: Indications, Dosing, Side Effects and Interactions
Ethosuximide clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Ethosuximide: Indications, Dosing, Side Effects and Interactions
Ethosuximide clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Absence seizures,Atypical absence seizures (adjunct),Myoclonic seizures**
- **Child** (By Mouth): 6-17 years Initially 250 mg twice daily, then increased in steps of 250 mg every 5-7 days; usual dose 500-750 mg twice daily, increased if necessary up to 1 g twice daily.
- **Adult** (By Mouth): Initially 500 mg daily in 2 divided doses, then increased in steps of 250 mg every 5-7 days; usual dose 1-1.5 g daily in 2 divided doses, increased if necessary up to 2 g daily.
**Absence seizures, Atypical absence seizures (adjunct), Myoclonic seizures for ethosuximide**
- **Child 1 month-5 years** (By mouth): Initially 5 mg/kg twice daily (max. per dose 125 mg), dose to be increased every 5-7 days; maintenance 10-20 mg/kg twice daily (max. per dose 500 mg), total daily dose may rarely be given in 3 divided doses.
- **Child 6-17 years** (By mouth): Initially 250 mg twice daily, then increased in steps of 250 mg every 5-7 days; usual dose 500-750 mg twice daily, increased if necessary up to 1 g twice daily.
Cautions
Avoid in Acute porphyrias
Side effects
Common or very common Appetite decreased; dizziness; drowsiness; gastrointestinal discomfort; gastrointestinal disorder; headache; movement disorders; nausea; skin reactions; vomiting Uncommon Aggression; agranulocytosis; bone marrow disorders; concentration impaired; depression; diarrhoea; eosinophilia; fatigue; haemorrhage; hiccups; leucopenia; lupus erythematosus; mood altered; myopia; oral disorders; psychotic disorder; severe cutaneous adverse reactions (SCARs); sleep disorders; suicidal behaviours; weight decreased Frequency not known Generalised tonic-clonic seizure; libido increased; thrombocytopenia Side-effects, further information Blood counts required if features of fever, sore throat, mouth ulcers, bruising or bleeding.
Interactions
**Other interactions (1):**
- Since ethosuximide may interact with concurrently administered antiepileptic drugs, periodic serum level determinations of these drugs may be necessary (e.g.
Pregnancy
Important safety information For ethosuximide MHRA/CHM advice: Antiepileptics: risk of suicidal thoughts and behaviour (August 2008) See Epilepsy . MHRA/CHM advice: Antiepileptic drugs: updated advice on switching between different manufacturers' products (November 2017) See Epilepsy . MHRA/CHM advice: Antiepileptic drugs in pregnancy: updated advice following comprehensive safety review (January 2021) See Epilepsy .
Breast feeding
Present in milk. Hyperexcitability and sedation reported.
Hepatic impairment
Use with caution.
Renal impairment
Use with caution-monitor drug concentration. M
Medicinal forms
Capsule,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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