Methsuximide Brand Name– Celontin
What is Methsuximide
Methsuximide is an oral succinimide-derivative anticonvulsant chemically related to ethosuximide. It is used to control absence (petit mal) seizures that are refractory to other agents.
Similar to other succinimide anticonvulsants, methsuximide is ineffective in treating tonic-clonic seizures.
Unlike ethosuximide, methsuximide does not usually precipitate tonic-clonic seizures and concurrent administration with other anticonvulsants in the treatment of mixed seizure types (i.e. absence and tonic-clonic) is generally acceptable.
Although not an approved indication, the use of methsuximide as adjunct treatment for refractory complex partial seizures has been studied in a limited number of patients; further study is needed before the drug can be routinely recommended for this purpose.
Methsuximide was approved by the FDA in 1957, and remains on the US market today (personal communication. Pfizer, February 2004).
Indications
- absence seizures
For the treatment of generalized absence seizures
Side Effects
- abdominal pain
- anorexia
- ataxia
- blepharedema
- blurred vision
- confusion
- constipation
- depression
- diarrhea
- dizziness
- drowsiness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dyspepsia
- elevated hepatic enzymes
- emotional lability
- eosinophilia
- hallucinations
- headache
- hematuria
- hepatitis
- hiccups
- hyperemia
- impaired cognition
- insomnia
- irritability
- jaundice
- leukopenia
- lupus-like symptoms
- nausea
- osteomalacia
- pancytopenia
- photophobia
- proteinuria
- pruritus
- psychosis
- rash
- seizures
- Stevens-Johnson syndrome
- suicidal ideation
- urticaria
- vomiting
- weight loss
Monitoring Parameters
- CBC
- LFTs
- serum n-desmethylsuximide concentrations
- urinalysis
Contraindications
- abrupt discontinuation
- bone marrow suppression
- breast-feeding
- depression
- driving or operating machinery
- fever
- geriatric
- hematological disease
- hepatic disease
- hepatitis
- infants
- infection
- jaundice
- porphyria
- pregnancy
- psychosis
- renal disease
- renal impairment
- schizophrenia
- succinimide hypersensitivity
- suicidal ideation
- systemic lupus erythematosus (SLE)
Methsuximide is contraindicated in patients with a known hypersensitivity to methsuximide or a history of succinimide hypersensitivity.
Interactions
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Alprazolam
- Amobarbital
- Amoxapine
- Amphetamine
- Amphetamine; Dextroamphetamine
- Amphetamine; Dextroamphetamine Salts
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Barbiturates
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Butabarbital
- Carbamazepine
- Colesevelam
- Dextroamphetamine
- Ethanol
- Felbamate
- Hydantoins
- Hydroxychloroquine
- Isocarboxazid
- Lamotrigine
- Lisdexamfetamine
- Maprotiline
- Mefloquine
- Mephobarbital
- Methohexital
- Molindone
- Monoamine oxidase inhibitors
- Pentobarbital
- Phenelzine
- Phenobarbital
- Phenothiazines
- Primidone
- Secobarbital
- Thiopental
- Tranylcypromine
- Tricyclic antidepressants
- Valproic Acid, Divalproex Sodium