Methsuximide

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

  1. abdominal pain
  2. anorexia
  3. ataxia
  4. blepharedema
  5. blurred vision
  6. confusion
  7. constipation
  8. depression
  9. diarrhea
  10. dizziness
  11. drowsiness
  12. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
  13. dyspepsia
  14. elevated hepatic enzymes
  15. emotional lability
  16. eosinophilia
  17. hallucinations
  18. headache
  19. hematuria
  20. hepatitis
  21. hiccups
  22. hyperemia
  23. impaired cognition
  24. insomnia
  25. irritability
  26. jaundice
  27. leukopenia
  28. lupus-like symptoms
  29. nausea
  30. osteomalacia
  31. pancytopenia
  32. photophobia
  33. proteinuria
  34. pruritus
  35. psychosis
  36. rash
  37. seizures
  38. Stevens-Johnson syndrome
  39. suicidal ideation
  40. urticaria
  41. vomiting
  42. 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
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