Zonisamide has 31 known drug interactions based on U.S. FDA drug labeling data. 19 are classified as major interactions requiring close medical supervision. Notable interactions include combinations with Acetazolamide, Alogliptin And Metformin Hydrochloride, Dapagliflozin And Metformin Hydrochloride. Patients taking Zonisamide should inform their healthcare provider of all current medications — including over-the-counter drugs and supplements — to avoid potentially harmful combinations. Data sourced from OpenFDA and the NIH National Library of Medicine.
- Total
- 31
- Major
- 19
- Moderate
- 8
- Minor
- 3
Major (19)
- Zonisamide + Acetazolamide— Concomitant carbonic anhydrase inhibitor use may increase severity of metabolic acidosis and risk of kidney stone format…
- Zonisamide + Alogliptin And Metformin Hydrochloride— Carbonic anhydrase inhibitor that may increase risk of lactic acidosis by decreasing serum bicarbonate and inducing meta…
- Zonisamide + Dapagliflozin And Metformin Hydrochloride— Carbonic anhydrase inhibitor that may increase risk for lactic acidosis when used concomitantly.
- Zonisamide + Dichlorphenamide— Concomitant carbonic anhydrase inhibitor use may increase severity of metabolic acidosis and risk of kidney stone format…
- Zonisamide + Empagliflozin And Metformin Hydrochloride— Zonisamide causes decreased serum bicarbonate and metabolic acidosis; concomitant use may increase risk of lactic acidos…
- Zonisamide + Empagliflozin, Linagliptin, Metformin Hydrochloride— Zonisamide causes decreased serum bicarbonate and metabolic acidosis; concomitant use with TRIJARDY XR may increase risk…
- Zonisamide + Empagliflozin, Metformin Hydrochloride— Carbonic anhydrase inhibitor that decreases serum bicarbonate and may increase risk of lactic acidosis when used with SY…
- Zonisamide + Ertugliflozin And Metformin Hydrochloride— Increases risk of lactic acidosis due to decreased serum bicarbonate and metabolic acidosis when used with metformin.
- Zonisamide + Glyburide And Metformin Hydrochloride— Carbonic anhydrase inhibitor that decreases serum bicarbonate and may increase risk for lactic acidosis when used with g…
- Zonisamide + Linagliptin And Metformin Hydrochloride— Carbonic anhydrase inhibitor that decreases serum bicarbonate and induces metabolic acidosis, increasing risk of lactic …
- Zonisamide + Metformin— Carbonic anhydrase inhibitor that decreases serum bicarbonate and induces metabolic acidosis, increasing risk for lactic…
- Zonisamide + Metformin Er 500 Mg— Carbonic anhydrase inhibitor that decreases serum bicarbonate and may increase risk of lactic acidosis with metformin.
- Zonisamide + Metformin Hydrochloride— Carbonic anhydrase inhibitor that may increase risk of lactic acidosis by decreasing serum bicarbonate and inducing meta…
- Zonisamide + Metformin Hydrochloride Extended-Release Tablets— Carbonic anhydrase inhibitor that decreases serum bicarbonate and may increase risk for lactic acidosis when used with m…
- Zonisamide + Metformin Hydrochloride Tablet— Carbonic anhydrase inhibitor that decreases serum bicarbonate and may increase risk for lactic acidosis when used with m…
- Zonisamide + Pioglitazole And Metformin Hydrochloride— Carbonic anhydrase inhibitor decreases serum bicarbonate and increases lactic acidosis risk with metformin. Requires mor…
- Zonisamide + Saxagliptin And Metformin Hydrochloride— Carbonic anhydrase inhibitor causing metabolic acidosis. Concomitant use may increase risk of metformin-associated lacti…
- Zonisamide + Sitagliptin And Metformin Hydrochloride— Carbonic anhydrase inhibitor that decreases serum bicarbonate and induces metabolic acidosis, increasing risk for lactic…
- Zonisamide + Topiramate— Concurrent use as carbonic anhydrase inhibitor may increase severity of metabolic acidosis and increase risk of kidney s…
Moderate (8)
- Zonisamide + Alcohol— Concomitant use may increase CNS depression and cognitive/neuropsychiatric adverse events. Use with caution.
- Zonisamide + Canagliflozin And Metformin Hydrochloride— Carbonic anhydrase inhibitor that decreases serum bicarbonate and may increase risk for lactic acidosis when used with I…
- Zonisamide + Carbamazepine— Enzyme-inducing AED that increases zonisamide metabolism and clearance, decreasing its half-life to 27-38 hours.
- Zonisamide + Cyp3a Inducers— Potent CYP3A4 inducers may require close monitoring and dose adjustment of zonisamide and other CYP3A4 substrates.
- Zonisamide + Glyburide-Metformin Hydrochloride— Carbonic anhydrase inhibitor that decreases serum bicarbonate and may increase risk for lactic acidosis with glyburide-m…
- Zonisamide + Mao Inhibitors— Concomitant use may increase severity of metabolic acidosis and increase risk of kidney stone formation. Monitor for met…
- Zonisamide + Phenobarbital— Enzyme-inducing AED that increases zonisamide metabolism and clearance, decreasing its half-life to 27-38 hours.
- Zonisamide + Phenytoin— Enzyme-inducing AED that increases zonisamide metabolism and clearance, decreasing its half-life to 27-38 hours.
Minor (3)
- Zonisamide + Cimetidine— No significant effect on zonisamide single dose pharmacokinetic parameters.
- Zonisamide + Lacosamide— Steady-state plasma concentrations of zonisamide were not affected by concomitant lacosamide at any dose in clinical stu…
- Zonisamide + Valproate— Non-enzyme inducing AED; zonisamide half-life of 46 hours when used concomitantly. No appreciable effect on steady-state…