Drug interactions
Butalbital + Zonisamide
Severity: Moderate
Butalbital and Zonisamide: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Butalbital is a barbiturate that may induce CYP3A4 and reduce zonisamide levels, though intermittent use makes the effect less predictable. The combination also adds sedation.
What this interaction means in plain words
Butalbital and Zonisamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Barbiturate induction of CYP3A4 increases zonisamide clearance, with additive CNS depression.
What to do
Monitor for breakthrough seizures and excess drowsiness, particularly with frequent butalbital use. Adjust the zonisamide dose according to response.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Zonisamide
- Zonisamide + Zuranolone Major
- Acetazolamide + Zonisamide Moderate
- Amisulpride + Zonisamide Moderate
- Amobarbital + Zonisamide Moderate
- Apalutamide + Zonisamide Moderate
- Asenapine transdermal + Zonisamide Moderate
Frequently asked questions
Can I take Butalbital with Zonisamide?
MediHelp rates the interaction as moderate. Butalbital and Zonisamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Butalbital is a barbiturate that may induce CYP3A4 and reduce zonisamide levels, though intermittent use makes the effect less predictable. The combination also adds sedation.
How serious is the interaction between Butalbital and Zonisamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for breakthrough seizures and excess drowsiness, particularly with frequent butalbital use. Adjust the zonisamide dose according to response.
What other medicines interact with Zonisamide?
MediHelp also lists interactions of Zonisamide with, for example, Zuranolone, Acetazolamide, Amisulpride. The full list is on the Zonisamide page.
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