Description Generic formulation Indications Dose titration Plasma levels monitoring Cautions Interactions Special populations Behavioural and cognitive effects in patients with epilepsy Psychiatric use
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ETHOSUXIMIDE

Description Generic formulation Indications Dose titration Plasma levels monitoring Cautions Interactions Special populations Behavioural and cognitive effects in patients with epilepsy Psychiatric use
Product Name
ETHOSUXIMIDE
CAS No.
77-67-8
Chemical Name
ETHOSUXIMIDE
Synonyms
Zarontin;h940;H 940;H-490;Pemal;pm671;Suxin;ci366;Etomal;PM 671
CBNumber
CB1420630
Molecular Formula
C7H11NO2
Formula Weight
141.17
MOL File
77-67-8.mol
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ETHOSUXIMIDE Property

Melting point:
51 °C
Boiling point:
150 °C / 12mmHg
Density 
1.1522 (rough estimate)
refractive index 
1.5026 (estimate)
storage temp. 
2-8°C
solubility 
ethanol: 100 mg/mL
form 
Solid
pka
pKa 9.5 (Uncertain)
color 
White to Off-White
Water Solubility 
190g/L(25 ºC)
Merck 
14,3748
BCS Class
1,3
CAS DataBase Reference
77-67-8
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Safety

Hazard Codes 
Xn,T,F
Risk Statements 
22-39/23/24/25-23/24/25-11
Safety Statements 
36-45-36/37-16-7
WGK Germany 
3
RTECS 
WN2800000
HS Code 
2925190100
Hazardous Substances Data
77-67-8(Hazardous Substances Data)
Toxicity
LD50 in mice (g/kg): 1.65 i.p.; 1.75 orally (Najer)
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Hazard and Precautionary Statements (GHS)

Symbol(GHS)
Signal word
Warning
Hazard statements

H302Harmful if swallowed

Precautionary statements

P264Wash hands thoroughly after handling.

P264Wash skin thouroughly after handling.

P270Do not eat, drink or smoke when using this product.

P301+P312IF SWALLOWED: call a POISON CENTER or doctor/physician IF you feel unwell.

P501Dispose of contents/container to..…

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N-Bromosuccinimide Price

Sigma-Aldrich
Product number
1264002
Product name
Ethosuximide
Purity
United States Pharmacopeia (USP) Reference Standard
Packaging
500mg
Price
$174.4
Updated
2024/03/01
Sigma-Aldrich
Product number
BP146
Product name
Ethosuximide
Purity
British Pharmacopoeia (BP) Reference Standard
Packaging
200MG
Price
$262
Updated
2023/06/20
Sigma-Aldrich
Product number
68459
Product name
Ethosuximide
Purity
analytical standard
Packaging
100mg
Price
$73.5
Updated
2022/05/15
TCI Chemical
Product number
E0746
Product name
Ethosuximide
Purity
>98.0%(GC)(T)
Packaging
5g
Price
$45
Updated
2024/03/01
TCI Chemical
Product number
E0746
Product name
Ethosuximide
Purity
>98.0%(GC)(T)
Packaging
25g
Price
$129
Updated
2024/03/01
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ETHOSUXIMIDE Chemical Properties,Usage,Production

Description

Ethosuximide is a first- generation antiepileptic drug (AED) known under the proprietary brand name of Zarontin® (Pfizer, New York, NY) in the UK and USA.

Generic formulation

MHRA/ CHM advice to minimize risk when switching patients with epilepsy between different manufacturers’ products (including generic products):

  • It is usually unnecessary to ensure that patients are maintained on a specific manufacturer’s product unless there are specific concerns, such as patient anxiety and risk of confusion/ dosing error.

Indications

Epilepsy: monotherapy and adjunctive therapy of absence seizures; adjunctive therapy of generalized tonic- clonic seizures.

Recommendations summarized from NICE (2012)

  • Seizure types: first line (absence seizures), adjunctive (absence seizures).
  • Epilepsy types: first line (absence syndromes), adjunctive (absence syndromes).

Dose titration

250 mg bd, then increased in steps of 250 mg every 5– 7 days; usual maintenance 1000– 1500 mg daily, divided into two doses (max. 2000 mg daily).

Plasma levels monitoring

Monitoring ethosuximide plasma levels can be useful in selected cases, although the evidence for a therapeutic plasma range is limited (suggested therapeutic plasma concentrations 40–100 mg/ L) and a toxic limit has not been consistently defined.

Cautions

Patients with acute porphyrias.

Interactions

With AEDs

  • Plasma concentration of ethosuximide is reduced by the glucuronidation inducers carbamazepine, phenytoin, phenobarbital, and primidone.
  • Plasma concentration of ethosuximide has been reported to be both increased and decreased by valproate.
  • Ethosuximide can raise serum levels of phenytoin.

With other drugs
Metabolism of ethosuximide is inhibited by isoniazid, resulting in increased plasma concentration and risk of toxicity.

With alcohol/food
There are no known specific interactions between alcohol and ethosuximide, and there are no specific foods that must be excluded from diet when taking ethosuximide.

Special populations

Hepatic impairment
Use with caution.

Renal impairment
Use with caution.

Pregnancy

  • The dose of ethosuximide should be monitored carefully during pregnancy and after delivery, and adjustments made on a clinical basis.
  • Ethosuximide crosses the placenta and cases of birth defects have been reported. Therefore, the prescribing physician should weigh the benefits versus the risks of ethosuximide in treating or counselling epileptic women of childbearing age.
  • Ethosuximide is excreted in breastmilk and the effects of ethosuximide on the nursing infant are unknown. Therefore, ethosuximide should be used in nursing mothers only if the benefits clearly outweigh the risks and breastfeeding is best avoided.

Behavioural and cognitive effects in patients with epilepsy

Adverse behavioural effects can be of clinical significance, and include the possible induction of anxiety, depression, confusion, irritability, aggression, hallucinations, and intermittent impairment of consciousness These episodes can occur following cessation of seizures and normalization of the electroencephalogram (EEG), and resolve with discontinuation of ethosuximide and seizure recurrence (alternative psychosis in the context of forced normalization). Among first- generation AEDs, ethosuximide is characterized by a relatively favourable cognitive profile, with low incidence of cognitive adverse effects.

Psychiatric use

Ethosuximide as adjunctive treatment of bipolar disorder was found to be ineffective in patients with acute mania. This AED has no approved indications or clinical uses in psychiatry.

Chemical Properties

White to Off-White Solid

Originator

Zarontin,Parke Davis,US,1960

Uses

Ethosuximide is an anticonvulsant drug that is used in minor forms of epilepsy.

Uses

cholinergic

Uses

Anticonvulsant.

Definition

ChEBI: A dicarboximide that is pyrrolidine-2,5-dione in which the hydrogens at position 3 are substituted by one methyl and one ethyl group. An antiepileptic, it is used in the treatment of absence seizures and may be used for myoclonic seizures, but is ineffect ve against tonic-clonic seizures.

Manufacturing Process

α-Ethyl-α-methylsuccinimide is known in the prior art as a chemical entity, having been prepared according to the method described by Sircar, J. Chem. Soc., 128:600 (1927), and characterized in J. Chem. Soc., 128:1254 (1927).
In its manufacture, methyl ethyl ketone is condensed with ethylcyanoacetate to give ethyl-2-cyano-3-methyl-2-pentenoate. That, in turn, adds HCN to give ethyl-2,3-dicyano-3-methyl pentanoate. Saponification and decarboxylation gives 2-methyl-2-ethyl succinonitrile. Heating with aqueous NH3 gives the diamide which loses NH3 and cyclizes to ethosuximide.

brand name

Epileo Petitmal (Eisai), Pemal (Benzon), Petnidan (Desitin Arzneimittel), Suxilep (Parke – Davis, Jenapharm), Suxinutin/Zarontin (Parke – Davis).

Therapeutic Function

Anticonvulsant

Biological Functions

It is now generally accepted that the specific antiepileptic action of ethosuximide (and the older agent trimethadione, no longer employed) against absence epilepsy is its ability to reduce the low-threshold calcium current (LTCC) or T (transient) current. These currents underlie the 3-Hz spike wave discharges that are characteristic of absence epilepsy. A blockade of T-calcium current is likely also to be a mechanism used by valproic acid.
The only clinical use for ethosuximide (Zarontin) is in the treatment of absence epilepsy. If absence attacks are the only seizure disorder present, ethosuximide alone is effective. If other types of epilepsy are present, ethosuximide can be readily combined with other agents.
For the most part, ethosuximide is a safe drug. Most of the side effects are dose related and consist of nausea, gastrointestinal irritation, drowsiness, and anorexia. A variety of blood dyscrasias have been reported, but serious blood disorders are quite rare.

General Description

Ethosuximide is considered the prototypical anticonvulsantneeded for treating patients with absence seizures.Ethosuximide and the N-dealkylated active metabolite ofmethsuximide work by blocking the lowthresholdT-type calcium channels, thereby reducing thehyperexcitability of thalamic neurons that is specifically associatedwith absence seizure.

Biochem/physiol Actions

Ethosuximide is an anticonvulsant drug and an antagonist for T-type calcium channel. It is known to prevent spike wave discharges, characterized in absence seizures.

Clinical Use

Although ethosuximide is the drug of choice for treatment of simple absence seizures, it is not effective against partial complex or tonic-clonic seizures and may increase the frequency of grand mal attacks. Thus, it must be administered in combination with other AEDs when treating persons with mixed seizure types. Ethosuximide is a substrate for both CYP3A4 and CYP2E1. The major metabolite for ethosuximide is 3-(1-hydroxyethyl) succinimide, which is inactive and excreted unconjugated into the urine Several additional metabolites have been characterized recently. Approximately 20% of an oral dose is excreted unchanged.
Although ethosuximide is thought to be the least toxic of the succinimides, it can cause gastrointestinal disturbances and dose-related CNS effects, such as drowsiness, dizziness, ataxia, sleep disturbances and depression. Idiosyncratic hypersensitivity reactions include severe rashes, leukopenia, agranulocytosis (some fatal), systemic lupus erythematosus, and parkinsonian-like symptoms. In addition to being less toxic than trimethadione, ethosuximide offers a wider range of protection against different kinds of absence seizures.

Synthesis

Ethosuximide, 3-ethyl-3-methypyrrolidine-2,5-dione (9.3.4) is synthesized from methylethylketone and cyanoacetic ester, which are condensed in Knoevanagel reaction conditions. Then hydrogen cyanide is added to the resulting product (9.3.1). After acidic hydrolysis and decarboxylation of synthesized dinitrile (9.3.2), 2-methyl-2-ethylsuccinic acid (9.3.3) is formed. Reacting this product with ammonia gives the diammonium salt, and heterocyclization into the ethosuximide (9.3.4) takes place during subsequent heating [8,9].

Drug interactions

Potentially hazardous interactions with other drugs
Antibacterials: concentration increased by isoniazid
. Antidepressants: lower convulsive threshold; avoid with St John’s wort.
Antiepileptics: concentration possibly reduced by carbamazepine, fosphenytoin, phenytoin and phenobarbital; concentration of fosphenytoin and phenytoin possibly increased; concentration increased by valproate.
Antimalarials: anticonvulsant effect antagonised by mefloquine.
Antipsychotics: lower convulsive threshold.
Orlistat: possible increased risk of convulsions.

Metabolism

Ethosuximide is extensively hydroxylated in the liver to its principal metabolite which is reported to be inactive. Ethosuximide is excreted in the urine mainly in the form of its metabolites, either free or conjugated, but about 12-20% is also excreted unchanged.

ETHOSUXIMIDE Preparation Products And Raw materials

Raw materials

Preparation Products

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ETHOSUXIMIDE Suppliers

Shaanxi Dideu Medichem Co. Ltd
Tel
029-81145920 13259709322
Fax
029-88380327
Email
1027@dideu.com
Country
China
ProdList
10009
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58
J & K SCIENTIFIC LTD.
Tel
010-82848833 400-666-7788
Fax
86-10-82849933
Email
jkinfo@jkchemical.com
Country
China
ProdList
96815
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76
TCI (Shanghai) Development Co., Ltd.
Tel
021-67121386
Fax
021-67121385
Email
Sales-CN@TCIchemicals.com
Country
China
ProdList
24529
Advantage
81
Energy Chemical
Tel
021-021-58432009 400-005-6266
Fax
021-58436166
Email
sales8178@energy-chemical.com
Country
China
ProdList
44689
Advantage
61
Chemsky(shanghai)International Co.,Ltd.
Tel
021-50135380
Email
shchemsky@sina.com
Country
China
ProdList
32321
Advantage
50
Syntechem Co.,Ltd
Tel
Fax
E-Mail Inquiry
Email
info@syntechem.com
Country
China
ProdList
12984
Advantage
57
Sinopharm Chemical Reagent Co,Ltd.
Tel
86-21-63210123
Fax
86-21-63290778 86-21-63218885
Email
sj_scrc@sinopharm.com
Country
China
ProdList
9815
Advantage
79
Spectrum Chemical Manufacturing Corp.
Tel
021-021-021-67601398-809-809-809 15221380277
Fax
021-57711696
Email
marketing_china@spectrumchemical.com
Country
China
ProdList
9658
Advantage
60
Beijing HuaMeiHuLiBiological Chemical
Tel
010-56205725
Fax
010-65763397
Email
waley188@sohu.com
Country
China
ProdList
12335
Advantage
58
TOKYO CHEMICAL INDUSTRY CO., LTD.
Tel
03-36680489
Fax
03-3668-0520
Email
Sales-JP@TCIchemicals.com
Country
Japan
ProdList
28387
Advantage
80
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View Lastest Price from ETHOSUXIMIDE manufacturers

Career Henan Chemical Co
Product
Ethosuximide 77-67-8
Price
US $1.00/KG
Min. Order
1KG
Purity
≥98%
Supply Ability
20 tons
Release date
2020-01-09

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