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Tegretol vs. Zonegran

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Carbamazepine (Tegretol) and Zonisamide (Zonegran) are both antiepileptic medications used to control seizures, but they have some key differences. Carbamazepine is used for a wider range of conditions, including partial-onset seizures, generalized tonic-clonic seizures, mixed seizure patterns, trigeminal neuralgia, and bipolar I disorder (Equetro brand only). In contrast, Zonisamide is only approved for partial-onset seizures and must be used alongside other medications. Carbamazepine is available in various forms, such as tablets, chewable tablets, and liquid, while Zonisamide comes as capsules and an oral suspension. Carbamazepine can cause weight gain, whereas Zonisamide might lead to weight loss. Additionally, Zonisamide is not safe for people with sulfa allergies, and it can cause serious skin reactions and kidney problems. Both medications can cause sleepiness and dizziness, but Carbamazepine can also cause liver problems. Lastly, Carbamazepine can interfere with hormonal birth control, while Zonisamide is not recommended during pregnancy due to potential harm to the unborn baby.

Carbamazepine

(Tegretol)

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Zonisamide

(Zonegran)

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Summary for Tegretol

Prescription only

Carbamazepine (Tegretol) is an antiseizure medication used to treat different kinds of seizures. It can also help with trigeminal neuralgia, a type of facial nerve pain. Brand name Equetro is the only formulation that's approved to treat bipolar I disorder. Carbamazepine (Tegretol) available as pills and a liquid. Depending on formulation you take and what medical condition you have, carbamazepine (Tegretol) is taken by mouth 1 to 4 times per day. Common side effects include sleepiness, dizziness, and stomach upset.

Indications for Tegretol

Pros and Cons for Tegretol

Pros

  • Works well for different types of seizures and trigeminal neuralgia (facial nerve pain)
  • Helps stabilize mood in people with bipolar disorder (Equetro brand only)
  • Available as a lower-cost generic
  • Comes in many dosage forms (e.g., chewable tablets, oral pills, liquid form) for people who have difficulty swallowing pills

Cons

  • Might need to take the immediate-release form of the medication up to 4 times a day
  • Can cause a lot of side effects
  • Might require routine blood testing while taking the medication to see how it's affecting your body
  • Can make hormonal birth control not work as well

Common Side Effects for Tegretol

  • Dizziness (44%)
  • Sleepiness (32%)
  • Nausea (29%)
  • Vomiting (18%)
  • Difficulty walking or keeping balance (15%)
  • Constipation (10%)
  • Itching (8%)
  • Dry mouth (8%)
  • Weakness (8%)
  • Rash (7%)
  • Blurry vision (6%)
  • Speech problems (6%)

Warnings for Tegretol

  • Severe skin reactions
  • Low blood cell counts
  • Severe allergic reactions
  • Suicidal thoughts or behavior
  • Harm to unborn babies
  • Withdrawal
  • Difficulty with speech, concentration, and movement
  • Liver problems
  • Low sodium levels
  • High eye pressure
  • Heart block (heart rhythm problems)

Summary for Zonegran

Prescription only

Zonisamide (Zonegran) is an antiepileptic. It helps control partial-onset seizures in people 16 years and older with epilepsy. It's usually taken along with other seizure medications. Zonisamide comes as a capsule in both generic forms and the brand name Zonegran. It also comes as a liquid called Zonisade, which is brand name only. You take it by mouth once or twice a day. Common side effects are drowsiness, dizziness, and headache. Some medications can interact with zonisamide (Zonegran) and make side effects worse or raise the risk of seizures.

Indications for Zonegran

Pros and Cons for Zonegran

Pros

  • Can be a good add-on option when other medications aren't working well enough to help control seizures
  • Can take with or without food
  • Also comes as a liquid suspension for people who have problems swallowing pills

Cons

  • Not approved for children younger than 16
  • Can take several weeks to get the full benefits of the medication
  • Not safe to take if you have a sulfa allergy

Common Side Effects for Zonegran

  • Sleepiness (17%)
  • Dizziness (13%)
  • Low appetite (13%)
  • Headache (10%)
  • Nausea (9%)
  • Agitation or irritability (9%)
  • Fatigue (8%)
  • Tiredness (7%)
  • Stomach pain (6%)
  • Confusion (6%)
  • Depression (6%)
  • Trouble sleeping (6%)
  • Problems with concentration or memory (6%)
  • Clumsy movement (6%)
  • Double vision (seeing double; 6%)

Warnings for Zonegran

  • Potentially serious allergic reaction to sulfa medications
  • Serious skin reactions
  • DRESS syndrome (a serious allergic reaction)
  • Less sweating and risk of heat stroke
  • Serious eye problems
  • Suicidal thoughts or behavior
  • Changes in mood or thinking, or problems with cognitive skills
  • Effect on kidney function
  • Too much acid in the blood
  • High ammonia levels
  • Withdrawal seizures after stopping zonisamide (Zonegran) suddenly
  • Harm to an unborn baby

Prices with our coupons for Tegretol vs. Zonegran

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Carbamazepine180 tablets / 200mg
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Zonisamide120 capsules / 100mg
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