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ETHOSUXIMIDE 250 mg/5mL Solution, 473 mL — NDC 00121-0670-16 package photo

ETHOSUXIMIDE 250 mg/5mL Solution, 473 mL

by PAI Holdings, LLC dba PAI Pharma · 473 mL in 1 BOTTLE (0121-0670-16)
NDC 00121-0670-16
🏷️ FDA NDC (as labeled) 0121-0670-16 billing pads the labeler segment with a zero
Rx only Generic On market Non-controlled
🗂️ Data synced Jul 24, 2026 · sources: openFDA · FDA label (DailyMed) · FDA Orange & Purple Book · First Databank · CMS NADAC, ASP, Medicare & Medicaid · RxNorm
📋 All sources & update times →
Past resolved recalls for this product (1)
Class II · Jul 29, 2021 · Terminated — Lack of CGMP: This recall is being carried out due to potential for carry over of Senna Syrup. (PAI Holdings, LLC. dba Pharmaceutical Associates Inc) · FDA recall D-0723-2021

🆔 Identity & classification

FDA NDC (as labeled) 0121-0670-16
Product NDC 0121-0670
11-digit billing NDC 00121067016
NCPDP billing unit ML — per mL (volume)
RxCUI 251322
UNII 5SEH9X1D1D
UPC 0301210670169
Application # ANDA040253
SPL Set ID 8a5cc930-0b36-48a8-9ad0-de633b208742
Established class (EPC) Anti-epileptic Agent
Physiologic effect Decreased Central Nervous System Disorganized Electrical Activity
DEA schedule Non-controlled
Marketing category ANDA
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 2000-11-22
Route ORAL
Dosage form SOLUTION
Substance ETHOSUXIMIDE
GPI-14 72400010002005
GPI class Ethosuximide
GCN Seq No 004555
GCN 17430
HICL code 001891
Ingredient (HICL) Ethosuximide
HIC1 code H
Therapeutic class — broad (HIC1) Nervous System (Except Autonomic)
HIC2 code H4
Therapeutic class — intermediate (HIC2) Anticonvulsants
HIC3 code H4B
Therapeutic class — specific (HIC3) Anticonvulsants
AHFS code 28:12.20.00
AHFS class Succinimides
FDB label name ETHOSUXIMIDE 250 MG/5 ML SOLN
FDB brand name Ethosuximide
Legend status F — Federal legend — prescription drug or device
TE code (Orange Book) AA · RLD · RS
Why two NDCs? The FDA registers this code as 0121-0670-16 — a 4-4-2 layout, and that's what's printed on the package and shown on DailyMed. For insurance claims, every NDC is standardized to a uniform 11-digit 5-4-2 format by adding a zero to the labeler segment → 00121-0670-16. Same drug, same package — only the format differs.
Where does this data come from?
Identifiers from the FDA openFDA NDC Directory and Structured Product Labeling; RxCUI from RxNorm (NLM); GPI from Medi-Span; GCN / HIC / AHFS / legend from First Databank.

🏷️ RxNorm drug class

This medicine belongs to the Anti-epileptic Agent class.

Pharmacologic class Anti-epileptic Agent
Drug family (ATC) Succinimide derivatives
Where does this data come from?
Therapeutic classes from RxNorm RxClass (U.S. National Library of Medicine) — Established Pharmacologic Class (FDA), ATC drug family (WHO) and mechanism of action, matched by this product’s RxCUI.

🏭 Manufacturer & labeler

LabelerPAI Holdings, LLC dba PAI Pharma
Application holderPHARMACEUTICAL ASSOCIATES INC
FDA applicationANDA040253 (ANDA)
Labeler code00121
First marketedNov 2000
Product typeHuman Prescription Drug
Portfolio142 products on file
The labeler markets the product; the application holder owns the FDA approval. They’re often the same company but can differ (e.g. a repackager or an authorized generic). A mailing address / phone appears here when the manufacturer includes it in the product’s FDA label (not all do).
Where does this data come from?
Labeler, application holder and registered establishment from the FDA openFDA NDC Directory and Drugs@FDA; address/contact from the product’s FDA label.

🩺 Clinical

Label name ETHOSUXIMIDE 250 MG/5 ML SOLN Ingredient Ethosuximide
📖 What it is MedlinePlus · NLM

Ethosuximide is used to control absence seizures (petit mal) (a type of seizure in which there is a very short loss of awareness during which the person may stare straight ahead or blink his eyes and does not respond to others). Ethosuximide is in a class of medications called anticonvulsants. It works by reducing abnormal electrical activity in the brain.

Read the full MedlinePlus article ↗
📗 Our plain-language guide HelloPharmacist
  • An absence seizure is a brief episode — usually just a few seconds — where you or your child suddenly stares blankly and loses awareness, then snaps back as if nothing happened. Th...
  • What exactly is an absence seizure, and will ethosuximide stop them?
  • Ethosuximide comes as a capsule or a liquid solution, and you take it by mouth. Your doctor will start you on a lower dose and gradually increase it until your seizures are well co...
  • How do I take it, and does it matter if I take it with food?
📖 Read our full Ethosuximide guide →
1
Nutrient depletion considerations

Ethosuximide may be associated with lower levels of 1 nutrient — worth a chat with your pharmacist, not a cause for alarm.

An association is not a deficiency. Educational only — don't start or stop anything without professional guidance.
Where does this data come from?
Plain-language summary from MedlinePlus (U.S. National Library of Medicine); supplement & herbal interactions and nutrient depletion data from the Natural Medicines database; our full guide is HelloPharmacist editorial content.

💊 What it looks like

Color orange
FlavorCherry
One label can cover several strengths, so colors may be combined — always confirm a loose pill against the dispensed prescription label or a pharmacist.
Where does this data come from?
Physical description (imprint, shape, color, scoring, coating) from this product’s FDA Structured Product Labeling (SPL), mirrored from DailyMed / openFDA.

🧪 Inactive Ingredients / Excipients

Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.

💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.

  • UNII XF417D3PSL
    Anhydrous citric acid is a sour, crystalline powder derived from citric acid with water removed. In medicines, it acts as a buffer to control pH, adds tartness to improve taste, and helps tablets disintegrate.
  • UNII WZB9127XOA
    A synthetic red dye used to color medications and make them easier to identify. It serves as a colorant in tablets, capsules, and liquid formulations.
  • UNII H77VEI93A8
    A synthetic yellow dye used to color medications. It helps identify the drug and make it visually distinctive, with no effect on how the medicine works.
  • UNII PDC6A3C0OX
    Glycerin is a clear, thick liquid derived from plant oils or fats. It acts as a humectant to retain moisture, a sweetener, and a solvent in medications.
  • UNII SB8ZUX40TY
    Saccharin sodium is an artificial sweetener made from saccharin salt. It's added to medicines to improve taste, especially in liquid formulations for children or bitter drugs.
  • UNII OJ245FE5EU
    Sodium benzoate is a salt derived from benzoic acid, a preservative. It's added to medicines to prevent growth of bacteria, fungi, and other microorganisms that could spoil the product.
  • UNII 55X04QC32I
    A strong alkaline chemical used to adjust and maintain the pH balance of liquid medicines. It helps keep the medicine stable and ensures it stays effective during storage.
  • UNII C151H8M554
    A natural sugar derived from sugar cane or sugar beets. It's used as a sweetener, filler, and binder to improve taste, add bulk, and help hold tablet or capsule ingredients together.
  • UNII B22547B95K
    A salt derived from citric acid that helps maintain the proper acid-base balance in the medicine. It's used as a buffer to keep the product stable and at the right pH level.
  • UNII 059QF0KO0R
    Water is a liquid solvent that dissolves and mixes ingredients together in liquid medicines, syrups, and injections. It helps distribute the active drug evenly throughout the product.

10 inactive ingredients listed in the exact product block matched to this NDC.

Where does this data come from?
Data sourced from official FDA Structured Product Labeling (SPL) via DailyMedingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.

Inactive ingredient FAQ

Are inactive ingredients the same for every manufacturer?
No. Inactive ingredients can differ by manufacturer, dosage form, strength, and package / product version.
Why might an inactive ingredient be missing?
Some SPLs do not provide a complete structured inactive-ingredient list, and older or unusual labels may only include the information in narrative text.
Can inactive ingredients matter?
Yes. They can matter for allergies, intolerances, dyes, gluten / lactose concerns, preservatives, and formulation differences — but confirm with a pharmacist or the manufacturer when it’s clinically important.

💲 Pricing

A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.

Price systemPer mLPer package
Retail pharmacies payNADAC · weekly $0.094 $44.41 / 473 ml
Medicaid paysCMS SDUD · 12 mo $0.1168 $55.25 / 473 ml
Medicare drug plans payPart D · Q2 2026 $0.1446 $68.40 / 473 ml
NADAC price history (per mL) — tap or hover for the price & month
Dec 2021 Aug 2022 Jan 2026 Aug 2026 $0.218 $0.063
▼ Down 57% over the last 20 months.
Where does this data come from?
NADAC (National Average Drug Acquisition Cost) is the CMS weekly pharmacy-acquisition-cost survey — what pharmacies pay. ASP (Average Sales Price) is the CMS Medicare Part B drug-payment file, published quarterly. Medicaid pays is computed by us from CMS State Drug Utilization Data (total reimbursed ÷ units, trailing 12 months) — gross of rebates and inclusive of dispensing fees, so it reflects what Medicaid paid, not an acquisition cost. Medicare drug plans pay is the median negotiated point-of-sale unit cost across plans listing this NDC in the CMS quarterly Prescription Drug Plan pricing files, before rebates. The VA pays is the federal contract price (FSS, and the statutory Big 4 ceiling where listed) from the VA National Acquisition Center pharmaceutical price file. All are free public government data; each measures a different payer, so the figures are not directly comparable.

🔁 Therapeutic equivalents

ProductLabelerPackNADAC/unitTEStatusPrice vs. this
Ethosuximide 250 mg/5mL 59762-2350-06 Mylan 1 bottle $0.081 AA FDA listed save 14%
Ethosuximide 250 mg/5mLthis 00121-0670-16 PAI 473 ml $0.094 AA Availability likely
Zarontin 250 mg/5mL 00071-2418-19 Parke-Davis 1 bottle AA FDA listed
Ethosuximide 250 mg/5mL 62135-0064-47 Chartwell 473 ml AA FDA listed
Ethosuximide 250 mg/5mL 68999-0064-24 Chartwell 10 cups AA FDA listed
About this product: this is a generic version of the medicine. FDA equivalence ratings are shown when available, and other versions are listed above, least expensive first.
Where does this data come from?
Equivalents are other NDCs of the same ingredient, form and route from the openFDA NDC Directory, ranked least-expensive-first by NADAC. Therapeutic-equivalence (AB) ratings come from the FDA Orange Book; biologics use the FDA Purple Book for biosimilar & interchangeable status.

Availability & generic status

🏛️
2000
On the market since
Nov 2000
📍
2026
Currently FDA-listed
26 years listed
🔓
·
Generic on the market
this product is a generic
This is a generic drug

This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.

Where does this data come from?
Patents and exclusivity from the FDA Orange Book (small-molecule drugs), refreshed from public FDA data. Generic launch timing is an estimate, not a guarantee.

🗺️ Medicaid utilization & spend

📍 This exact package only: Medicaid data is reported per full 11-digit NDC — labeler, product and pack size — so every number here is for 00121-0670-16, not the drug overall. Other pack sizes report separately.
💊 Pharmacy benefit only: These are Medicaid outpatient pharmacy claims, billed by NDC. They exclude the medical benefit — clinic- or hospital-administered drugs billed under HCPCS J-codes — so drugs used mostly that way (e.g. Avastin, Lucentis, Keytruda) can look low or missing here. That’s expected, not an error.
📅 Q1 2025 – Q4 2025 · 4 quarters of data
ⓘ The newest quarter is usually incomplete when first published; states restate recent quarters in later CMS releases, so the latest figures typically revise upward. State coverage-policy changes can also shift quarter-to-quarter totals.
Prescriptions last 4 qtrs
28.9K
Units reimbursed last 4 qtrs
12.8M
Gross reimbursed last 4 qtrs
$1.49M
Avg / prescription
$51.66
Avg / unit
$0.1168
Latest quarter Q4 2025
7.4KRx
Medicaid pays / mL
$0.1168
gross reimbursed
vs
NADAC / mL
$0.0939
acquisition cost
=
Spread
+$0.0229
+24% vs cost
What Medicaid paid per mL (before rebates; includes the pharmacy’s dispensing fee) compared with NADAC — the average price pharmacies pay to buy the drug. A positive spread means Medicaid reimbursed more than the purchase price, before manufacturer rebates.
Fee-for-service vs managed care
38% FFS 62% MCO
Fee-for-service · 11,046 Rx Managed care · 17,820 Rx
State Medicaid map
Alaska: 11,485 units · 1,567 per 100k residents AK Maine: no data reported ME Washington: 151,177 units · 1,935 per 100k residents WA Idaho: 40,095 units · 2,041 per 100k residents ID Montana: 4,959 units · 438 per 100k residents MT North Dakota: 26,151 units · 3,340 per 100k residents ND Minnesota: 204,472 units · 3,564 per 100k residents MN Wisconsin: 242,104 units · 4,097 per 100k residents WI Michigan: 636,677 units · 6,343 per 100k residents MI New York: 703,859 units · 3,596 per 100k residents NY Vermont: 20,899 units · 3,230 per 100k residents VT New Hampshire: 36,739 units · 2,620 per 100k residents NH Oregon: 68,698 units · 1,623 per 100k residents OR Nevada: 76,983 units · 2,410 per 100k residents NV Wyoming: 27,726 units · 4,748 per 100k residents WY South Dakota: 14,180 units · 1,543 per 100k residents SD Iowa: 99,168 units · 3,092 per 100k residents IA Illinois: 407,468 units · 3,247 per 100k residents IL Indiana: 390,778 units · 5,695 per 100k residents IN Ohio: 683,482 units · 5,800 per 100k residents OH Pennsylvania: 613,894 units · 4,736 per 100k residents PA New Jersey: 217,885 units · 2,345 per 100k residents NJ Massachusetts: 290,182 units · 4,145 per 100k residents MA California: 1,612,149 units · 4,137 per 100k residents CA Utah: 50,374 units · 1,474 per 100k residents UT Colorado: 133,897 units · 2,278 per 100k residents CO Nebraska: 40,554 units · 2,050 per 100k residents NE Missouri: 190,846 units · 3,080 per 100k residents MO Kentucky: 226,780 units · 5,011 per 100k residents KY West Virginia: 108,013 units · 6,102 per 100k residents WV Virginia: 173,652 units · 1,992 per 100k residents VA Maryland: 210,626 units · 3,408 per 100k residents MD Connecticut: 115,161 units · 3,184 per 100k residents CT Rhode Island: 72,665 units · 6,636 per 100k residents RI Arizona: 229,951 units · 3,094 per 100k residents AZ New Mexico: 72,552 units · 3,432 per 100k residents NM Kansas: 84,020 units · 2,858 per 100k residents KS Arkansas: 40,910 units · 1,334 per 100k residents AR Tennessee: 331,034 units · 4,645 per 100k residents TN North Carolina: 646,153 units · 5,964 per 100k residents NC South Carolina: 281,255 units · 5,235 per 100k residents SC Delaware: 55,476 units · 5,381 per 100k residents DE Oklahoma: 112,403 units · 2,773 per 100k residents OK Louisiana: 352,937 units · 7,716 per 100k residents LA Mississippi: 97,035 units · 3,301 per 100k residents MS Alabama: 134,348 units · 2,630 per 100k residents AL Georgia: 505,840 units · 4,586 per 100k residents GA D.C.: 41,036 units · 6,044 per 100k residents DC Hawaii: 13,757 units · 959 per 100k residents HI Texas: 1,083,676 units · 3,553 per 100k residents TX Florida: 675,779 units · 2,989 per 100k residents FL
Units reimbursed · per 100k residents
4387,716
gray = no data reported
Colors are per 100,000 residents, so big states don’t automatically dominate. Tap or hover a state for its actual totals.
Tap or hover a state
…for its Medicaid breakdown
🏆 Top states by units · per 100k residents
1 Louisiana 7,716 /100k
2 Rhode Island 6,636 /100k
3 Michigan 6,343 /100k
4 West Virginia 6,102 /100k
5 D.C. 6,044 /100k
6 North Carolina 5,964 /100k
7 Ohio 5,800 /100k
8 Indiana 5,695 /100k
National units — by quarter
💵 About the dollar figures: “reimbursed” is what Medicaid paid pharmacies before confidential manufacturer rebates, so the program’s real net cost is lower than these numbers. Fee-for-service and managed-care claims are combined unless split above. Source: CMS State Drug Utilization Data; per-100k rates use 2023 Census population estimates.

📊 Medicare Part D spend CMS · PART D · 2026 (Q1)

Medicare Part D (outpatient prescription) spending for Ethosuximide — the program that covers self-administered drugs. 6 manufacturers.
⚠️ Drug-level data: CMS publishes Part D spending by drug, not by NDC — these figures combine every manufacturer, strength and package size sold under the name Ethosuximide. That’s a different level of aggregation than the Medicaid card above, which is specific to this exact 11-digit NDC (pack size included), so the two aren’t directly comparable.
Period
Total Part D spend
$408.9K
Claims incl. refills
3.9K
Beneficiaries
1.9K
Spend / beneficiary
$215.88
Spend / claim
$105.30
Trend by period
💵 About the dollar figures: spending is what Part D plans paid before confidential manufacturer rebates, so the program’s real net cost is lower. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part D Spending by Drug (data.cms.gov), updated quarterly.

🔬 Reported adverse events (FAERS)

Read carefully: FAERS reports are voluntary and unverified. Counts are not incidence, do not establish causation, are subject to reporting bias, and cannot be used to compare one drug to another. Shown for signal context only. Reports for Ethosuximide — the ingredient across all brands.

Top reported reactions

Seizure367
Somnolence157
Generalised Tonic-clonic Seizure149
Petit Mal Epilepsy118
Drug Interaction116
Treatment Failure116
Fatigue112

Reporter sex

2,490 reports

Serious outcomes

Death63
Reports over time (by year) — tap or hover for the count & year
2019 2021 2023 2026 251 74
Most recent year is provisional (FAERS lags ~3 months).
Where does this data come from?
Adverse-event reports from the FDA Adverse Event Reporting System (FAERS) via openFDA. FAERS reports are voluntary and unverified — counts are not incidence and don’t establish causation.

📦 Packaging — all sizes for this product

Package NDCDescription Marketing startStatus
00121-0670-16 You're viewing this 473 mL in 1 BOTTLE (0121-0670-16) 2000-11-22 Active

📄 Full prescribing information FDA SPL

The complete FDA label for this product — the official prescribing information, verbatim, section by section. Jump with a chip, search within the label, or expand everything.
🎯 Indications and Usage 14 words

INDICATIONS AND USAGE Ethosuximide is indicated for the control of absence (petit mal) epilepsy.

⏱️ Dosage and Administration 175 words

DOSAGE AND ADMINISTRATION Ethosuximide Oral Solution USP is administered by the oral route. The initial dose for patients 3 to 6 years of age is one teaspoonful (250 mg) per day; for patients 6 years of age and older, 2 teaspoonfuls (500 mg) per day. The dose thereafter must be individualized according to the patient's response.

Dosage should be increased by small increments. One useful method is to increase the daily dose by 250 mg every four to seven days until control is achieved with minimal side effects. Dosages exceeding 1.5 g daily, in divided doses, should be administered only under the strictest supervision of the physician.

The optimal dose for most pediatric patients is 20 mg/kg/day. This dose has given average plasma levels within the accepted therapeutic range of 40 to 100 mcg/mL. Subsequent dose schedules can be based on effectiveness and plasma level determinations.

Ethosuximide may be administered in combination with other anticonvulsants when other forms of epilepsy coexist with absence (petit mal). The optimal dose for most pediatric patients is 20 mg/kg/day.

Contraindications 15 words

CONTRAINDICATION Ethosuximide should not be used in patients with a history of hypersensitivity to succinimides.

⚠️ Warnings ~3 min read

WARNINGS Blood Dyscrasias: Blood dyscrasias, including some with fatal outcome, have been reported to be associated with the use of ethosuximide; therefore, periodic blood counts should be performed. Should signs and/or symptoms of infection (e.g., sore throat, fever) develop, blood counts should be considered at that point. Drug-Induced Immune Thrombocytopenia: Drug-induced immune thrombocytopenia (DITP) has been reported with ethosuximide.

In the reported cases, the onset of symptoms occurred 1 to 3 weeks after initiation of ethosuximide; one patient had recurrence of symptoms within 1 day of a subsequent re-challenge with the drug. In those cases in which the platelet count was specified, the nadir was 2,000 and 3,000/mm 3 . When DITP is suspected, discontinue ethosuximide, monitor serial platelet counts, and treat as appropriate.

If possible, assess the presence of drug-dependent antiplatelet antibodies. Avoid future use of ethosuximide in patients with history of ethosuximide-induced DITP. Effects on Liver and Kidneys: Ethosuximide is capable of producing morphological and functional changes in the animal liver.

In humans, abnormal liver and renal function studies have been reported. Ethosuximide should be administered with extreme caution to patients with known liver or renal disease. Periodic urinalysis and liver function studies are advised for all patients receiving the drug.

Systemic Lupus Erythematosus: Cases of systemic lupus erythematosus have been reported with the use of ethosuximide. The physician should be alert to this possibility. Suicidal Behavior and Ideation: Antiepileptic drugs (AEDs), including ethosuximide, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication.

Patients treated with any AED for any indication should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Pooled analyses of 199 placebo-controlled clinical trials (mono- and adjunctive therapy) of 11 different AEDs showed that patients randomized to one of the AEDs had approximately twice the risk (adjusted Relative Risk 1.8, 95% CI: 1.2, 2.7) of suicidal thinking or behavior compared to patients randomized to placebo. In these trials, which had a median treatment duration of 12 weeks, the estimated incidence rate of suicidal behavior or ideation among 27,863 AED-treated patients was 0.43%, compared to 0.24% among 16,029 placebo-treated patients, representing an increase of approximately one case of suicidal thinking or behavior for every 530 patients treated.

There were four suicides in drug-treated patients in the trials and none in placebo-treated patients, but the number is too small to allow any conclusion about drug effect on suicide. The increased risk of suicidal thoughts or behavior with AEDs was observed as early as one week after starting drug treatment with AEDs and persisted for the duration of treatment assessed. Because most trials included in the analysis did not extend beyond 24 weeks, the risk of suicidal thoughts or behavior beyond 24 weeks could not be assessed.

The risk of suicidal thoughts or behavior was generally consistent among drugs in the data analyzed. The finding of increased risk with AEDs of varying mechanisms of action and across a range of indications suggests that the risk applies to all AEDs used for any indication. The risk did not vary substantially by age (5-100 years) in the clinical trials analyzed.

Table 1 shows absolute and relative risk by indication for all evaluated AEDs. Table 1 Risk by indication for antiepileptic drugs in pooled analysis Indication Placebo Patients with Events Per 1000 Patients Drug Patients with Events Per 1000 Patients Relative Risk: Incidence of Events in Drug Patients/Incidence in Placebo Patients Risk Difference: Additional Drug Patients with Events Per 1000 Patients Epilepsy 1.0 3.4 3.5

2.4Psychiatric 5.7 8.5 1.5

2.9Other 1.0 1.8 1.9

0.9 T…

🤒 Adverse Reactions 203 words

ADVERSE REACTIONS Body As A Whole: Allergic reaction, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). Gastrointestinal System: Gastrointestinal symptoms occur frequently and include anorexia, vague gastric upset, nausea and vomiting, cramps, epigastric and abdominal pain, weight loss, and diarrhea. There have been reports of gum hypertrophy and swelling of the tongue.

Hemopoietic System: Hemopoietic complications associated with the administration of ethosuximide have included leukopenia, agranulocytosis, pancytopenia, with or without bone marrow suppression, eosinophilia and thrombocytopenia (see WARNINGS ). Nervous System: Neurologic and sensory reactions reported during therapy with ethosuximide have included drowsiness, headache, dizziness, euphoria, hiccups, irritability, hyperactivity, lethargy, fatigue, and ataxia. Psychiatric or psychological aberrations associated with ethosuximide administration have included disturbances of sleep, night terrors, inability to concentrate, and aggressiveness.

These effects may be noted particularly in patients who have previously exhibited psychological abnormalities. There have been rare reports of paranoid psychosis, increased libido, and increased state of depression with overt suicidal intentions. Integumentary System: Dermatologic manifestations which have occurred with the administration of ethosuximide have included urticaria, pruritic erythematous rashes, Stevens-Johnson syndrome, and hirsutism.

Special Senses: Myopia. Genitourinary System: Vaginal bleeding, microscopic hematuria. To report SUSPECTED ADVERSE REACTIONS, contact PAI Pharma at 1-800-845-8210 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

🔄 Drug Interactions 41 words

Drug Interactions: Since ethosuximide may interact with concurrently administered antiepileptic drugs, periodic serum level determinations of these drugs may be necessary (e.g., ethosuximide may elevate phenytoin serum levels and valproic acid has been reported to both increase and decrease ethosuximide levels).

🤰 Pregnancy ~2 min read

Usage in Pregnancy: Ethosuximide crosses the placenta. Reports suggest an association between the use of anticonvulsant drugs by women with epilepsy and an elevated incidence of birth defects in children born to these women. Data are more extensive with respect to phenytoin and phenobarbital, but these are also the most commonly prescribed anticonvulsants; less systematic or anecdotal reports suggest a possible similar association with the use of all known anticonvulsant drugs.

Cases of birth defects have been reported with ethosuximide. The reports suggesting an elevated incidence of birth defects in children of drug-treated epileptic women cannot be regarded as adequate to prove a definite cause and effect relationship. There are intrinsic methodological problems in obtaining adequate data on drug teratogenicity in humans; the possibility also exists that other factors, e.g., genetic factors or the epileptic condition itself, may be more important than drug therapy in leading to birth defects.

The great majority of mothers on anticonvulsant medication deliver normal infants. It is important to note that anticonvulsant drugs should not be discontinued in patients in whom the drug is administered to prevent major seizures because of the strong possibility of precipitating status epilepticus with attendant hypoxia and threat to life. In individual cases where the severity and frequency of the seizure disorder are such that the removal of medication does not pose a serious threat to the patient, discontinuation of the drug may be considered prior to and during pregnancy, although it cannot be said with any confidence that even minor seizures do not pose some hazard to the developing embryo or fetus.

The prescribing physician will wish to weigh these considerations in treating or counseling epileptic women of childbearing potential. Ethosuximide is excreted in human breast milk. Because the effects of ethosuximide on the nursing infant are unknown, caution should be exercised when ethosuximide is administered to a nursing mother.

Ethosuximide should be used in nursing mothers only if the benefits clearly outweigh the risks.

Pregnancy: To provide information regarding the effects of in utero exposure to ethosuximide, physicians are advised to recommend that pregnant patients taking ethosuximide enroll in the NAAED Pregnancy Registry. This can be done by calling the toll free number 1-888-233-2334, and must be done by patients themselves. Information on the registry can also be found at the website: http://www.aedpregnancyregistry.org/ See WARNINGS.

🧒 Pediatric Use 23 words

Pediatric Use: Safety and effectiveness in pediatric patients below the age of 3 years have not been established. (See DOSAGE AND ADMINISTRATION section.)

🆘 Overdosage 96 words

OVERDOSAGE Acute overdoses may produce nausea, vomiting, and CNS depression including coma with respiratory depression. A relationship between ethosuximide toxicity and its plasma levels has not been established. The therapeutic range of serum levels is 40 mcg/mL to 100 mcg/mL, although levels as high as 150 mcg/mL have been reported without signs of toxicity.

Treatment: Treatment should include emesis (unless the patient is or could rapidly become obtunded, comatose, or convulsing) or gastric lavage, activated charcoal, cathartics, and general supportive measures. Hemodialysis may be useful to treat ethosuximide overdose. Forced diuresis and exchange transfusions are ineffective.

🧬 Clinical Pharmacology 54 words

CLINICAL PHARMACOLOGY Ethosuximide suppresses the paroxysmal three cycle per second spike and wave activity associated with lapses of consciousness which is common in absence (petit mal) seizures. The frequency of epileptiform attacks is reduced, apparently by depression of the motor cortex and elevation of the threshold of the central nervous system to convulsive stimuli.

📦 How Supplied / Storage and Handling 59 words

HOW SUPPLIED Ethosuximide Oral Solution USP is an orange-red colored oral solution. Each 5 mL contains 250 mg ethosuximide in a cherry-raspberry flavored base supplied in the following: NDC 0121-0670-16: 16 fl oz (473 mL) bottle STORAGE Store at 20° to 25°C (68° to 77°F). [see USP Controlled Room Temperature] Preserve in tight containers. Protect from freezing and light.

📦 Storage and Handling 23 words

STORAGE Store at 20° to 25°C (68° to 77°F). [see USP Controlled Room Temperature] Preserve in tight containers. Protect from freezing and light.

📋 Description 69 words

DESCRIPTION Ethosuximide is an anticonvulsant succinimide, chemically designated as alpha-ethyl-alpha-methyl-succinimide, with the following structural formula: Each teaspoonful (5 mL), for oral administration, contains 250 mg ethosuximide, USP. Also contains citric acid, FD&C Red No. 40, FD&C Yellow No.

6, cherry-raspberry flavoring, glycerin, purified water, saccharin sodium, sodium benzoate, sodium citrate, and sucrose. Sodium hydroxide may be used for pH adjustment. The pH range is 5.0 to 6.5.

Chemical Structure

💬 Information for Patients ~1 min read

Information for Patients: Inform patients of the availability of a Medication Guide, and instruct them to read the Medication Guide prior to taking ethosuximide. Instruct patients to take ethosuximide only as prescribed. Ethosuximide may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks, such as driving a motor vehicle or other such activity requiring alertness; therefore, the patient should be cautioned accordingly.

Patients taking ethosuximide should be advised of the importance of adhering strictly to the prescribed dosage regimen. Patients should be instructed to promptly contact their physician if they develop signs and/or symptoms (e.g., sore throat, fever), suggesting an infection. Patients, their caregivers, and families should be counseled that AEDs, including ethosuximide, may increase the risk of suicidal thoughts and behavior and should be advised of the need to be alert for the emergence or worsening of symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior, or thoughts about self-harm.

Behaviors of concern should be reported immediately to healthcare providers. Prior to initiation of treatment with ethosuximide, the patient should be instructed that a rash may herald a serious medical event and that the patient should report any such occurrence to a physician immediately. Patients should be encouraged to enroll in the North American Antiepileptic Drug (NAAED) Pregnancy Registry if they become pregnant.

This Registry is collecting information about the safety of antiepileptic drugs during pregnancy. To enroll, patients can call the toll free number 1-888-233-2334 (see PRECAUTIONS: Pregnancy section).

💬 Medication Guide ~3 min read

MEDICATION GUIDE Ethosuximide Oral Solution USP (eth" oh sux´ i mide) Read this Medication Guide before you start taking ethosuximide and each time you get a refill. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or treatment.

If you have any questions about ethosuximide, ask your healthcare provider or pharmacist. What is the most important information I should know about ethosuximide? Do not stop taking ethosuximide without first talking to your healthcare provider.

Stopping ethosuximide suddenly can cause serious problems. Ethosuximide can cause serious side effects, including: Rare but serious blood problems that may be life-threatening. Call your healthcare provider right away if you have: fever, swollen glands, or sore throat that come and go or do not go away frequent infections or an infection that does not go away easy bruising red or purple spots on your body bleeding gums or nose bleeds severe fatigue or weakness Drug reactions that may affect different parts of the body such as your liver, kidneys, heart, or blood cells.

You may or may not have a rash with these types of reactions. These reactions can be very serious and can cause death. Call your healthcare provider right away if you have any of these symptoms: joint pain and swelling muscle pain fatigue, weakness low-grade fever pain in the chest that is worse with breathing skin rash swollen lymph glands swelling of your face yellowing of your skin or the white part of your eyes Like other antiepileptic drugs, ethosuximide may cause suicidal thoughts or actions in a very small number of people, about 1 in 500.

Call a healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you: thoughts about suicide or dying attempts to commit suicide new or worse depression new or worse anxiety feeling agitated or restless panic attacks trouble sleeping (insomnia) new or worse irritability acting aggressive, being angry, or violent acting on dangerous impulses an extreme increase in activity and talking (mania) other unusual changes in behavior or mood How can I watch for early symptoms of suicidal thoughts and actions?

Pay attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings. Keep all follow-up visits with your healthcare provider as scheduled. Call your healthcare provider between visits as needed, especially if you are worried about symptoms.

Do not stop ethosuximide without first talking to a healthcare provider. Stopping ethosuximide suddenly can cause serious problems. Stopping a seizure medicine suddenly in a patient who has epilepsy can cause seizures that will not stop (status epilepticus).

Suicidal thoughts or actions can be caused by things other than medicines. If you have suicidal thoughts or actions, your healthcare provider may check for other causes. What is ethosuximide?

Ethosuximide is a prescription medicine used to treat absence (petit mal) seizures. Who should not take ethosuximide? Do not take ethosuximide if you are allergic to succinimides (methsuximide or ethosuximide), or any of the ingredients in ethosuximide oral solution.

See the end of this Medication Guide for a complete list of ingredients in ethosuximide oral solution. What should I tell my healthcare provider before taking ethosuximide? Before you take ethosuximide, tell your healthcare provider if you: have or had liver problems have or have had depression, mood problems or suicidal thoughts or behavior have any other medical conditions are pregnant or plan to become pregnant.

It is not known if ethosuximide can harm your unborn baby. Tell your healthcare provider right away if you become pregnant while taking ethosuximide. You and your healthcare provider should decide if you should take ethosuximide while you are pregnant.

If you become pregnant while taking ethosuximide, talk to your healthcare provider ab…

Source: FDA Structured Product Labeling, mirrored from DailyMed / openFDA. Prefer the government’s original formatting? View this label on DailyMed ↗
For educational and professional reference only — not medical advice. Pricing reflects published NADAC and CMS ASP (free public data) and may differ from your acquisition cost; always verify before billing or dispensing.