The last day of operation for Hertfordshire and West Essex ICB was 31 March 2026. The information on this website has not been updated since 31 March 2026. The legacy policies, prescribing recommendations and pathways can be accessed on this website. Find out more

Indication
Epilepsy
RAG rating
Double Red
Document type
Decision document
Place
Hertfordshire and West Essex ICB
Output type
Pharmacy / Prescribing

Zonisamide oral liquids

HERTFORDSHIRE AND WEST ESSEX AREA PRESCRIBING COMMITTEE (HWE APC)

Zonisamide oral liquid formulations for treating epilepsy

DOUBLE RED

NOT recommended for prescribing by either Community/Secondary/Tertiary or Primary care.

Name generic: Zonisamide oral liquid formulations

What it is:        Anti-seizure medicine

Indication:       Licensed as monotherapy in the treatment of partial seizures, with or without secondary generalisation, in adults with newly diagnosed epilepsy and adjunctive therapy in the treatment of partial seizures, with or without secondary generalisation, in adults, adolescents, and children aged 6 years and above.

Date decision last revised:   March 2025

NICE:              NICE NG217 recommended

HWE APC recommendation:

Zonisamide oral liquid formulations are NOT recommended for restricted use as an option in children, young people and adults in line with NICE guidance NG217.

  • Zonisamide licensed oral suspension is NOT recommended for prescribing by either Community/Secondary/Tertiary or Primary care; DOUBLE RED prescribing status NOT a priority for funding (very high cost): except on rare occasion where cases are managed on individual patient basis only. For existing patients, regular reviews by specialist must be undertaken on whether switching to capsule formulation is appropriate or provide justification for ongoing clinical need to primary care.

  • Zonisamide unlicensed liquid preparations are NOT recommended for prescribing by either Community/Secondary/Tertiary or Primary care for new patients; DOUBLE RED prescribing status NOT a priority for funding (very high cost). For existing patients, regular reviews by specialist must be undertaken on whether switching to capsule formulation or in exceptional circumstances licensed oral suspension 100mg/5ml (Desizon) is appropriate or provide justification for ongoing clinical need to primary care.
Version number
1.0
Developed by
HWE ICB Pharmacy Medicines Optimisation Team
Approved by
HWE ICB Area Prescribing Committee
Date approved / updated
March 2025
Review date
The recommendation is based upon the evidence available at the time of publication. This recommendation will be reviewed upon request in the light of new evidence becoming available.
Superseded version
N/A
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