Zonisamide oral suspension as adjunctive therapy for treating partial seizures in adults and in pediatric patients aged 16 years and older with epilepsy

Introduction: Zonisamide (ZNS), is an antiseizure medication (ASM) approved by the US FDA and the European Medicines Agency (EMA) for focal-onset seizures. An oral suspension formulation has recently been introduced to improve administration for specific patient populations, particularly those with swallowing difficulties. Areas Covered: This article explores the new ZNS oral suspension, evaluating its pharmacokinetic benefits, impact on patient care, and adherence. Bioavailability studies confirm that the oral suspension is bioequivalent to ZNS capsules, though no additional clinical trials in epilepsy patients have been conducted. This review presents and discusses the oral suspension’s benefits, such as ease of administration for those with swallowing difficulties and flexible dosing, while also addressing potential drawbacks, including dosing accuracy and stability issues. Expert opinion: The ZNS oral suspension allows additional flexibility for epilepsy management, particularly for patients unable to swallow capsules. Its bioavailability and specific formulation may improve adherence and seizure control.